Outcome and changes over time in survival following severe burns from 1985 to 2004
Outcome and changes over time in survival following severe burns from 1985 to 2004
复制标题
DOI：
10.1007/s00134-005-2819-6
复制
发表时间：
2005-12-01
影响因子：
38.9
通讯作者：
Blot, SI
中科院分区：
文献类型：
--
作者：
Brusselaers, N;Hoste, EAJ;Blot, SI
目的：调查严重烧伤患者20年的预后，并评估随时间的生存率。一所拥有1060张床位的大学医院的6张床位烧伤病房的历史队列研究。患者：在20年的时间里，1385名患者入住烧伤病房。测量和结果：结果与死亡的三个主要危险因素有关：年龄60岁或以上，总烧伤面积40%或以上，以及存在吸入性损伤。总死亡率为7.1%。当存在0、1、2或3个危险因素时，死亡率分别为0.5%、9.9%、48.0%和90.5%。在研究期间，平均比例总烧伤面积下降，死亡率。在存在一个或两个危险因素的患者组中，生存获益显著。调整死亡风险因素的多变量回归分析证实，生存率随时间推移而改善（每5年的比值比为0.73）。结论：烧伤后的全球死亡率很低，几乎所有死亡的患者都存在至少一种危险因素。在存在三种危险因素的情况下，烧伤后的预后尤其受到损害。考虑到我们的患者在过去20年中烧伤程度逐渐降低，因此死亡风险降低，严重烧伤后的生存率继续提高。
Objective: To investigate outcome in severely burned patients over a 20-year period and to evaluate survival over time. Historical cohort in a six-bed burn unit of a 1060-bed university hospital. Paitents: 1385 patients admitted to the burn unit over a 20-year period. Measurements and results: Outcome was evaluated in relation to the presence of three major risk factors for death: age 60 years or over, total burned surface area 40% or more, and the presence of inhalation injury. Overall mortality was 7.1%. When zero, one, two, or three risk factors were present, mortality was respectively 0.5%, 9.9%, 48.0%, and 90.5%. Over the study period the average proportional total burned surface area decreased as did mortality. The survival benefit was significant among patient groups with one or two risk factors present. Multivariate regression analysis adjusting for risk factors for death confirmed that survival improved over time (odds ratio 0.73 per 5-year period). Conclusions: Global mortality following burns is low, and nearly all patients who die had at least one risk factor present. In the presence of three risk factors the prognosis following burns is particularly compromised. Taking into account that our patients over the past 20 years have been progressively less extensively burned and hence have a lesser at risk for death, survival following severe burns has continued to improve.