Wong M K, Ngim R C
Department of Plastic and Reconstructive Surgery, Singapore General Hospital.
Burns. 1995 Feb;21(1):39-46. doi: 10.1016/0305-4179(95)90780-4.
A prospective study of 352 patients in an Asian National Burn Centre has been used to develop statistical predictive models for mortality and hospitalization time. The patients are largely of Asian origin. Total burn surface area (% TBSA) and presence of respiratory burns are significant independent predictors of mortality in the multiple logistic regression analysis with an accuracy of 98.3 per cent. Age is not a significant predictor of mortality in our patients. Age, % TBSA, full thickness % TBSA and respiratory burns are significant independent predictors of length of stay in hospital with a R2 value of 0.57 in the multiple linear regression analysis. There were 16 deaths, many of whom had developed multiple complications, common causes of which were sepsis, bronchopneumonia, DIVC and multiorgan failure. The final causes of death were septicaemic shock in 10 patients, extensive burns in four patients, ARDS in one patient and bleeding peptic ulcer in one patient. The development of these two mortality and morbidity predictive models is the first step in the evaluation of our results. These models have to be tested against a future set of patients. After confirmation they will aid in patient management, clinical audit, patient and family counselling. They will also serve as baseline standards for evaluation of new therapies, assist us in the allocation of resources and identifying the at-risk population for improvements in therapy.
一项针对亚洲某国家烧伤中心352例患者的前瞻性研究被用于建立死亡率和住院时间的统计预测模型。这些患者大多来自亚洲。在多因素逻辑回归分析中,烧伤总面积(%TBSA)和呼吸道烧伤的存在是死亡率的显著独立预测因素,准确率为98.3%。在我们的患者中,年龄不是死亡率的显著预测因素。在多因素线性回归分析中,年龄、%TBSA、全层%TBSA和呼吸道烧伤是住院时间的显著独立预测因素,R2值为0.57。共有16例死亡,其中许多人出现了多种并发症,常见原因包括败血症、支气管肺炎、弥漫性血管内凝血(DIVC)和多器官功能衰竭。最终死亡原因是10例患者发生败血症性休克,4例患者因大面积烧伤,1例患者因急性呼吸窘迫综合征(ARDS),1例患者因消化性溃疡出血。这两个死亡率和发病率预测模型的建立是评估我们结果的第一步。这些模型必须在未来一组患者中进行检验。确认后,它们将有助于患者管理、临床审计、患者及家属咨询。它们还将作为评估新疗法的基线标准,协助我们进行资源分配,并确定需要改善治疗的高危人群。