Smith D L, Cairns B A, Ramadan F, Dalston J S, Fakhry S M, Rutledge R, Meyer A A, Peterson H D
Department of Surgery, University of North Carolina, Chapel Hill 27707-7210.
J Trauma. 1994 Oct;37(4):655-9. doi: 10.1097/00005373-199410000-00021.
The relative impact of inhalation injury, burn size, and age on overall outcome following burn injury was examined in 1447 consecutive burn patients over a five and a half year period. The overall mortality for all patients was 9.5% (138 of 1447). The presence of inhalation injury, increasing burn size, and advancing age were all associated with an increased mortality (p < 0.01). The incidence of inhalation injury was 19.6% (284 of 1447) and correlated with increasing percent total body surface area (%TBSA) burn (r = 0.41, p < 0.01) and advancing age (r = 0.15, p < 0.01). The overall mortality for patients with inhalation injury was 31% (88 of 284) compared with 4.3% (50 of 1163) for those without inhalation injury. Using multivariate analysis inhalation injury was found to be an important variable in determining outcome, but the most important factor in predicting mortality was %TBSA burn (accuracy = 92.8%) or a combination of %TBSA burn and patient age (accuracy = 93.0%). Adding inhalation injury only slightly improved the ability to predict mortality (accuracy = 93.3%). The presence of inhalation injury is significantly associated with mortality after thermal injury but adds little to the prediction of mortality using %TBSA and age alone.
在五年半的时间里，对1447例连续烧伤患者进行了研究，以探讨吸入性损伤、烧伤面积和年龄对烧伤后总体预后的相对影响。所有患者的总死亡率为9.5%（1447例中的138例）。吸入性损伤的存在、烧伤面积增加和年龄增长均与死亡率增加相关（p<0.01）。吸入性损伤的发生率为19.6%（1447例中的284例），与总体表面积（%TBSA）烧伤百分比增加相关（r = 0.41，p<0.01），也与年龄增长相关（r = 0.15，p<0.01）。有吸入性损伤患者的总死亡率为31%（284例中的88例），而无吸入性损伤患者的死亡率为4.3%（1163例中的50例）。通过多变量分析发现，吸入性损伤是决定预后的一个重要变量，但预测死亡率的最重要因素是%TBSA烧伤（准确率=92.8%）或%TBSA烧伤与患者年龄的组合（准确率=93.0%）。仅增加吸入性损伤对预测死亡率的能力略有改善（准确率=93.3%）。吸入性损伤的存在与热损伤后的死亡率显著相关，但仅使用%TBSA和年龄来预测死亡率时，它几乎没有增加预测价值。
