The epidemiology and prognosis of patients with massive burns: A multicenter study of 2483 cases

被引：39

作者：

Cheng, Wenfeng ^{[1
]}

Shen, Chuanan ^{[2
,65
]}

Zhao, Dongxu ^{[2
,65
]}

Zhang, Hongyan ^{[3
]}

Tu, Jiajin ^{[4
]}

Yuan, Zhiqiang ^{[5
,11
]}

Song, Guodong ^{[6
]}

Liu, Miao ^{[7
]}

Li, Dawei ^{[2
]}

Shang, Yuru ^{[2
]}

Qin, Binyu ^{[108
]}

Han, Guangming ^{[8
]}

Cui, Guanghuai ^{[9
]}

Xiang, Xiaoyan ^{[10
]}

Wen, Yuqing ^{[12
]}

Chen, Mingzhi ^{[13
,42
]}

Feng, Yudong ^{[14
]}

Huang, Ruixiao ^{[15
]}

Dong, Yongsheng ^{[16
]}

Huang, Xiaodong ^{[17
]}

Wu, Riqiang ^{[18
]}

Zhou, Qiang ^{[19
]}

Luo, Zhijun ^{[20
]}

Chen, Baiqiu ^{[21
]}

Liao, Wenlun ^{[22
]}

Shou, Jiabao ^{[23
]}

Wu, Wei ^{[24
]}

Zhang, Xiaolin ^{[25
]}

Ge, Hong ^{[26
]}

Ye, Xiangbai ^{[27
]}

Shu, Xiaoli ^{[28
]}

Yang, Shengyi ^{[29
]}

Zhao, Peng ^{[30
]}

Zhang, Qingfu ^{[31
]}

Zu, Hongxu ^{[32
]}

Wang, Guanghua ^{[33
]}

Li, Huaqiang ^{[34
]}

Liu, Xiangye ^{[35
]}

Zhao, Shengyu ^{[36
]}

Jiao, Zhihui ^{[37
]}

Fan, Shengqiang ^{[38
]}

Yin, Weidong ^{[39
]}

Xu, Xisheng ^{[40
]}

Lin, Hailong ^{[41
]}

Bian, Huidong ^{[42
]}

Li, Ying ^{[43
]}

Yu, Ye ^{[44
]}

Yang, Jianmin ^{[45
]}

Tao, Baijiang ^{[46
]}

Guo, Jinlong ^{[47
]}

机构：

[1] Henan Prov Peoples Hosp, Dept Crit Care Med, Zhengzhou, Henan, Peoples R China

[2] Chinese Peoples Liberat Army Gen Hosp, Med Ctr 4, Dept Burns & Plast Surg, Beijing, Peoples R China

[3] Nanchang Univ, Affiliated Hosp 1, Dept Burns, Nanchang, Jiangxi, Peoples R China

[4] Ganzhou Municipal Hosp Jiangxi Prov, Dept Burns, Ganzhou, Peoples R China

[5] Third Mil Med Univ, State Key Lab Trauma Burns & Combined Injury, Inst Burn Res, Chongqing, Peoples R China

[6] Shandong Univ, Affiliated Jinan Cent Hosp, Dept Burns, Jinan, Shandong, Peoples R China

[7] Peoples Liberat Army Gen Hosp, Dept Epidemiol, Inst Geriatr, Beijing, Peoples R China

[8] Huaibei Miners Gen Hosp, Dept Burn & Plast Surg, Huaibei, Peoples R China

[9] Binzhou Med Univ, Affiliated Hosp, Dept Plast & Burn Surg, Yantai, Peoples R China

[10] North Sichuan Med Coll, Affiliated Hosp, Dept Burn, Nanchong, Peoples R China

[11] Third Mil Med Univ, Inst Burn Res, Southwest Hosp, Burns & Combined Injury, Chongqing, Peoples R China

[12] Fujian Med Univ, Union Hosp, Dept Burns, Fuzhou, Fujian, Peoples R China

[13] Pingliang City Peoples Hosp, Dept Burn, Pingliang, Peoples R China

[14] First Peoples Hosp Shunde, Dept Burn, Shunde, Peoples R China

[15] Pengpai Memory Hosp, Dept Burn Injury, Pengpai, Peoples R China

[16] Peoples Hosp Manning, Dept Burn & Plast Surg, Maoning, Peoples R China

[17] Peopls Hosp Chenghai Dist Shantou City, Dept Surg 4, Shantou, Guangdong, Peoples R China

[18] Yunfu Peoples Hosp, Dept Burn & Plast Surg, Yunfu, Peoples R China

[19] Zhaogin First Municipal Hosp, Dept Surg, Shanghai, Peoples R China

[20] Sun Yat Sen Univ, Affiliated Zhongshan Hosp, Dept Plast & Aesthet Surg, Guangzhou, Guangdong, Peoples R China

[21] Houjie Hosp, Dept Burn Surg, Dongguan, Peoples R China

[22] Hezhou Peoples Hosp, Dept Burn, Dongguan, Peoples R China

[23] Guangxi Med Univ, Dept Plast Surg, Hosp 1, Nanning, Peoples R China

[24] GuiZhou Med Univ, Affiliated Hosp 2, Dept Burn Surg, Guiyang, Guizhou, Peoples R China

[25] Bijie First Municipal Peoples Hosp, Dept Burn & Plast Surg, Bijie, Peoples R China

[26] Shuigang Hosp, Dept Burn & Plast Surg, Shuigang, Peoples R China

[27] Navy Gen Hosp, Dept Burn & Plast Surg, Beijing, Peoples R China

[28] HanDan Cent Hosp, Dept Burn & Plast Surg, Handan, Peoples R China

[29] Harrison Int Peace Hosp, Dept Burn & Plast Surg, Hengshui, Peoples R China

[30] Fifth Hosp Xingtai City, Dept Burn & Plast Surg, Xingtai, Peoples R China

[31] Hebei Med Univ, Affiliated Hosp 5, Dept Burns & Plast Surg, Shijiazhuang, Hebei, Peoples R China

[32] Henan Univ Sci & Technol, Affiliated Hosp 1, Dept Burns, Luoyang, Peoples R China

[33] First Peoples Hosp Gongyi, Dept Burns & Plast Surg, Gongyi, Peoples R China

[34] Frist Hosp Kaifeng, Dept Bum & Plast Surg, Zhengzhou, Henan, Peoples R China

[35] NanYang Cent Hosp, Dept Burns, Beijing, Peoples R China

[36] Oil Field Gen Hosp Daqing, Dept Burns, Daqing, Peoples R China

[37] First Hosp SuiHua, Dept Burns, Suihua, Peoples R China

[38] Huanggang Municipal TCM Hosp, Dept Burn, Huanggang, Peoples R China

[39] Jinmen Second Peoples Hosp, Dept Bum & Plast Surg, Jinmen, Peoples R China

[40] Chenzhou 1 Peoples Hosp, Dept Bum & Plast Surg, Chenzhou, Peoples R China

[41] Jilin Chem Grp Corp, Gen Hosp, Burns & Plast Surg, Changchun, Jilin, Peoples R China

[42] Gen Hosp Jinan Mil Reg, Dept Burn & Plast Surg, Jinan, Shandong, Peoples R China

[43] Jining Med Coll, Affiliated Hosp, Dept Burns & Plast Surg, Jining, Peoples R China

[44] Jiangsu Univ, Kunshan Hosp, Dept Burn & Plast Surg, Kunshan Peoples Hosp 1, Zhenjiang, Jiangsu, Peoples R China

[45] Bethune Int Peace Hosp PLA, Dept Burn & Plast Surg, Shijiazhuang, Hebei, Peoples R China

[46] Second Artillery Gen Hosp PLA, Dept Burns, Beijing, Peoples R China

[47] 148 Hosp Chinese Peoples Liberat Army, Dept Burn Surg, Liaoyang, Peoples R China

[48] 153th Hosp PLA, Dept Burns, Zhengzhou, Henan, Peoples R China

[49] 159th Hosp PLA, Burn Ctr, Zhengzhou, Henan, Peoples R China

[50] 169 Hosp PLA, Dept Burns & Plast Surg, Zhengzhou, Henan, Peoples R China

来源：

BURNS | 2019年 / 45卷 / 03期

基金：

中国国家自然科学基金;

关键词：

Burns; Epidemiology; Burn index; Prognosis; PEDIATRIC BURNS; CHINA; SURVIVAL; TRENDS; CARE;

D O I：

10.1016/j.burns.2018.08.008

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: Epidemiological features of massively burned patients in China remains unclear. This study was designed to investigate the epidemiological characteristics and evaluate the burn index (BI) and other risk factors associated with the prognosis of massively burned patients. Methods: Data of patients with >= 30% total body surface area burned admitted in 2014 were retrieved from 106 burn centers in the mainland of China. Information of epidemiological features and the outcome were collected for retrospective analysis. Results: A total of 2483 massively burned patients were included in this study, with a male-to-female ratio of 2.29:1, the mean age of 49.23 + 16.67 years, mean TBSA of 55.53 + 21.39% and the mean BI of 39.75 +/- 21.59. Scald accounted for 81.07% of the injuries in children, while flame accounted for 66.89% and 74.31% of the injuries in adults and seniors. Approximately 17.76% of the patients were admitted to the local burn center after 6 h of injury, and the wound areas of 1154 (46.48%) patients were covered with folk remedies. The mortality was 9.79%, and the area under the receiver operating characteristic (ROC) curve for BI was 0.941 (95% CI, 0.929-0.954). When the value of BI was above a threshold of 29 in the 0-14 years age group, 43.5 in the 15-59 years age group and 35.5 in the 60 years or older age group, the mortality increased significantly. Multivariate logistic regression analyses showed that the odds ratio (OR) of death increased 6% with an increase in the BI of 1.0. Patients older than 60 years, the admission time longer than 6 h after-injury (adjusted OR, 1.797; 95% CI, 1.179-2.740; adjusted p < 0.001), and patients with a combined inhalation injury ( adjusted OR, 6.649; 95% CI, 4.517-9.789; adjusted p < 0.000), were at higher risk of death. Conclusions: There are etiological characteristics of the different age groups that should be considered for prevention. BI can be a reliable index of prognosis in severely burned patients. The results of the study showed that a large BI, elderly age, delayed admission after injury and combined inhalation injury are the main risk factors for extensively burned patients. (C) 2018 Published by Elsevier Ltd.

引用

页码：705 / 716

页数：12

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