Mortality and causes of death nin a burn centre
Mortality and causes of death nin a burn centre
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DOI：
10.1016/j.burns.2008.02.010
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发表时间：
2008-12-01
期刊：
影响因子：
2.7
通讯作者：
Oen, I. M. M. H.
中科院分区：
文献类型：
--
作者：
Bloemsma, G. C.;Dokter, J.;Oen, I. M. M. H.
死亡率是烧伤后重要的结局参数，可作为质量控制的客观终点。严重烧伤后的死亡原因随着时间的推移而发生变化;在国际文献中，多系统器官衰竭被视为最重要的原因，但死亡原因的确切分布仍不清楚。深入了解死亡率潜在因素可以指导研究和预防方案。来自鹿特丹烧伤中心（RBC）和美国国家烧伤资料库（NBR）的结果之间的比较检查了致命结果的最重要的预测参数，即年龄、涉及的总体表面积和吸入性损伤的存在。从1996年到2006年，RBC治疗的所有致死性结局均归因于死亡原因。RBC的死亡率为6.9%，NBR为5.6%，年龄或总体表面积几乎没有差异。死亡率的差异可能是由于红细胞人群中吸入性损伤的发生率较高。然而，入院后RBC的死亡率下降到4.9%。最常见的死亡原因似乎是多系统器官衰竭，占64.9%;其中93%在死亡时有全身炎症反应综合征，45.9%，感染被认为是致命的临床恶化的原因（21.3%的患者被证实为脓毒症，24.6%的患者被高度怀疑）。为了比较不同烧伤中心和不同时间段之间的死亡率，需要统一的分类，特别是对于吸入性损伤的存在和死亡原因。通过更好地处理感染和全身炎症反应综合征来预防多系统器官衰竭，可能是降低烧伤后死亡率的最有效方法。(C)2008 Elsevier Ltd和ISBI。所有的权利都被憎恨。
Mortality rates are important outcome parameters after burn, and can serve as objective end points for quality control. Causes of death after severe burn have changed over time; in the international literature, multisystem organ failure is seen as the most important cause, but the exact distribution of causes of death remains unknown. insight into underlying agents of mortality can be directive in research and prevention programmes. This comparison between results from the Rotterdam Burn Centre (RBC) and the American National Burn Repository (NBR) examines the most important predictive parameters for fatal outcome, i.e. age, total body surface area involved and presence of inhalation injury. Causes of death were attributed for all fatal outcomes treated in the RBC from 1996 to 2006.The mortality rate at the RBC was 6.9% and at the NBR was 5.6%, with almost no differences in age or total body surface area involved. The discrepancy in mortality rate might have been due to the high incidence of inhalation injury among the RBC population. However, the mortality rate at the RBC after admission with intention to treat decreased to 4.9%. The most frequent cause of death appeared to be multisystem organ failure, in 64.9% of cases; 93% of these had systemic inflammatory response syndrome at time of death and, in 45.9%, infection was deemed responsible for the fatal clinical deterioration (in 21.3% sepsis was proved and in 24.6% was highly suspected).To compare mortality rates between different burn centres and periods of time, uniform classifications are needed, particularly for presence of inhalation injury and for causes of death. Prevention of multisystem organ failure, by better management of infection and systemic inflammatory response syndrome, might do most to decrease mortality after burn. (C) 2008 Elsevier Ltd and ISBI. All rights resented.