Factors Associated with Increased Risk of Death of Hospitalized Burn Patients in Taiwan

台灣地區燒燙傷住院病患死亡的影響因子

簡戊鑑(Wu-Chien Chien) ； 白璐(Lu Pai) ； 王先震(Hsian-Jenn Wang) ； 朱基銘(Chi-Ming Chu) ； 董光義(Kwang-Yi Tung)

《中華民國整形外科醫學會雜誌》 12卷3期 (2003/09) Pp. 184-198

https://doi.org/10.7096/JPSA.200309.0184

摘要

以往關於燒燙傷住院病患死亡的研究，多以臨床上的因子與死亡間的關係爲重點，至於入院前的因子對燒燙傷住院病患死亡的影響情況爲何則很少有研究加以探討，本研究目的即在找出燒燙傷住院病患死亡的影響因子，並瞭解入院前的因子對死亡的影響程度。研究方法是以中華民國兒童燙傷基金會燒燙登錄系統所收集的1997年-1999年4741位燒燙傷住院病患資料加以分析，包含病患特性、入院前及臨床上等12個因子與死亡的關係。研究結果顯示，在控制了其他因素後，年齡、燒傷面積、吸入性傷害、入院前沖水、實施手術等5個因素仍呈現統計上顯著意義，前3個因素是危險因子，後2個因素是保護因子。年齡越大、燒傷面積越大、有吸入性傷害，病患死亡的危險性越高；但是，入院前沖水、實施手術，病患死亡的危險性越低。入院前沖水可以降低51.8%的死亡危險性，更重要的是，『入院前沖水』是病患本身就能做得到的因子，而年齡、燒傷面積、吸入性傷害、實施手術等因素，都是無法改變或是需要依賴醫療專業人員才能執行的因子。

並列摘要

Previous studies on burn patients have described the relationship between mortality and clinically observed factors. However few reports have discussed the effect of pre-hospital factors that might also be important in predicting and, moreover, reducing the risk of death due to burn injuries. Our aim here is to identify risk factors of mortality for hospitalized burn patients and to determine the effect of pre-hospital factors on mortality rate. Data from hospitalized burn patients were downloaded from the Burn Injury Information System (BIIS) database over a two-year period from July 1997 to June 1999. Patient characteristics as well as preventive and medical measures were collected and analyzed. Twelve factors were found to be correlated with burn mortality. Using a logistic regression model, 5 of these factors, namely age, burn size, inhalation injury, flushing with cold water as a pre-hospital first aid treatment, and surgical treatments, were statistically significant when incorporated with other factors. Old age, large burn size and inhalation injury had a higher associated risk of death, whereas flushing the wound area with cold water and surgical treatments had a protective effect against burn-related deaths. Treating burn wounds by flushing with cold water prior to reaching hospital can reduce the risk of death by 51.8%. We reconfirmed that age, burn size and inhalation injury are risk factors, but found that surgical treatment is a protective factor against death. These factors are, nevertheless, either unchangeable or dependent on the intervention of medical professionals once the burn injury has occurred. Fortunately, flushing the wound with cold water as a form of pre-hospital first aid treatment was identified as an important protective factor in reducing the risk of death, and is something people can do by themselves before medical treatment is accessed.

並列關鍵字

burns ； risk factor ； mortality ； cold water flush