Changing trends of an endemic trauma
Changing trends of an endemic trauma
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DOI：
10.1016/j.burns.2009.01.008
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发表时间：
2009-08-01
期刊：
影响因子：
2.7
通讯作者：
Rai, Ashish
中科院分区：
文献类型：
--
作者：
Ahuja, Rajeeu B.;Bhattacharya, Samee K.;Rai, Ashish
严重烧伤在低收入和中等收入国家的发病率极高，估计占世界发病率的90%，其中50%在东南亚。通过对我院烧伤病房8年来（1993-2000年第一阶段）11,196例烧伤入院患者的早期分析，我们确定了该损伤的地方性特征[Ahuja RB， Bhattacharya S.]。伯恩斯28:555 2002;61)。在接下来的7年（2001-2007年第11阶段）对5566例烧伤入院患者进行了持续分析，并与第1阶段进行了比较，揭示了流行病学概况的重大变化。年平均入院人数下降了43.14%，从I期的1399.5例患者下降到II期的795.14例患者。年平均入场人数的下降主要发生在16-35岁（下降52.61%）和36-55岁（下降46.51%）年龄组。整体男女比例也从1.26:1变为0.91:1。然而，总体平均TBSA烧伤百分比仅从I期的49.12%略微下降到II期的44.39%。在第11阶段，火焰和烫伤的年入院率也分别下降了46.93%和56.25%。非故意伤害仍然是主要的伤害方式，在第一阶段占87.12%，在第二阶段占89.89%。但是，非故意烧伤的年入院人数从第一期的1219.25人下降到第11期的714.71人，下降幅度为41.38%。厨房仍然是火灾事故的主要发生地点，但厨房事故的年入院率从I期的897.5例下降到II期的368.43例。与此同时，液化石油气（LPG）泄漏事故在一期工程中仅占全部厨房事故的0.72%，在二期工程中上升到10.74%。另一个值得注意的特点是总死亡率从第一阶段的51.8%降低到第二阶段的40.20%。有趣的是，从1993年到2005年，德里的烧伤入院率与年人均收入之间存在非常显著的负相关（显著为0.01水平-2尾），这证明烧伤的发生率和概况直接反映了社会的经济发展。我们认为这是第一个来自发展中国家烧伤单位的长期研究，直接反映了烧伤发病率及其变化概况与经济繁荣的关系。(C) 2009爱思唯尔有限公司和ISBI。版权所有。
The incidence of severe burn is extremely high in the Low and Middle Income Countries with an estimated 90% of the world incidence of which 50% is in South East Asia. Through an earlier analysis of 11,196 burn admission over 8 years (1993-2000-Phase I) to our burn unit we established the endemic nature of the injury [Ahuja RB, Bhattacharya S. An analysis of 11,196 burn admissions and evaluation of conservative management techniques. Burns 2002;28:555-61]. A continued analysis of 5566 burn admissions over the next 7 years (2001-2007-Phase 11) and its comparison with the Phase I reveals a significant change in the epidemiological profile. The average yearly admissions have fallen by 43.14%, from 1399.5 patients in Phase I to 795.14 patients in Phase II. This fall in average yearly admissions is predominant in the age group 16-35 years (52.61% decline) and 36-55 years (46.51% decline). The overall female to male ratio has also changed from 1.26:1 to 0.91:1. However, the overall mean %TBSA burn has reduced only mildly from 49.12% TBSA in Phase I to 44.39% in Phase II. During Phase 11 there was also a significant decline of 46.93% and 56.25% in the yearly admission of flame and scald burn respectively. Non-intentional incidents still remain the main mode of injury accounting for 87.12% in Phase I and 89.89% in Phase II. But, the yearly admissions of non-intentional burns fell from 1219.25 in Phase I to 714.71 in Phase 11, which is a significant drop of 41.38%. Kitchen continues to dominate as the main location for flame incidents, but the yearly admission rate from kitchen accidents dropped from 897.5 patients in Phase I to 368.43 patients in Phase II. At the same time, liquefied petroleum gas (LPG) leaks which accounted for only 0.72% of all kitchen accidents in Phase I rose to 10.74% in Phase II. Another redeeming feature is the reduction in overall mortality from 51.8% in Phase I to 40.20% in Phase II. Interestingly, a very significant negative correlation exists (being significant at 0.01 level-2 tailed) between burn admissions and the yearly per-capita income of Delhi, from 1993 to 2005, to prove that the incidence and profile of burns directly reflects the economic development of the society. We see this as the first long term study from a burn unit of a developing country to directly reflect this association of burn incidence and its changing profile with economic prosperity. (C) 2009 Elsevier Ltd and ISBI. All rights reserved.