|
Outcome analysis of 286 severely burned patients:
retrospective study
WS Ho, SY Ying, A Burd
Department of Surgery, The Chinese University of Hong Kong, Prince
of Wales Hospital, Shatin, Hong Kong
OBJECTIVE. To evaluate the outcomes of severely
burned patients treated at a regional burns unit and to develop
a predictive model for survival and length of hospital stay for
major burn patients in Hong Kong.
DESIGN. Retrospective study.
SETTING. Burns unit of a regional public hospital, Hong Kong.
PATIENTS. Two hundred and eighty-six severely burned patients treated
from March 1993 to February 2000.
MAIN OUTCOME MEASURES. Details of demographics, mechanism of burn,
extent of burn, incidence of inhalation injury, length of hospital
stay, and mortality rate were recorded and entered into a database.
Stepwise logistic regression and linear regression were applied
to develop a predictive model for mortality and morbidity, respectively.
RESULTS. Of 286 major burn patients treated in this 7-year period,
25 patients died from their injuries, yielding a mortality rate
of 8.7%. Stepwise logistic regression was applied to develop a predictive
model for mortality. We found that inhalation injury, age, and total
body surface area involvement were independent significant predictors
of death. Accuracy of this predictive model reached 93%. Similarly,
stepwise linear regression was used to develop a predictive model
for length of hospital stay. Sex, inhalation injury, total body
surface area of burn, and total body surface area2 of burn were
significant predictors of length of hospital stay (R2=0.2). Only
three patients’ duration of hospital stay was more than three
standard deviations from the predicted length of hospital stay.
CONCLUSION. A predictive model for mortality and length of hospital
stay has been developed for major burn patients in Hong Kong. This
model may help clinicians to counsel patients and relatives at an
early stage of care, to provide a basis from which new treatment
plans can be compared, and to facilitate efficient allocation of
valuable resources.
Hong Kong Med J 2002;8:235-9
Key words: Burns; Length of stay; Mortality
|
