{"title":"三军总医院新实施的烧伤治疗方案的影响:20 年经验的结果分析。","authors":"Yu-Tse Weng , Yu-Chi Tsai , Juin-Hong Cherng , Chih-Hsing Wang , Yuan-sheng Tzeng , Kuang Ling Ou , Tim-Mo Chen , Hao-Yu Chiao","doi":"10.1016/j.burns.2024.107293","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To share our 20-year experience in major burn management and the impact of a newly implemented burn protocol since 2015 at Tri-Service General Hospital (TSGH).</div></div><div><h3>Materials and methods</h3><div>We performed a retrospective cohort study of severely burned patients who were admitted to the intensive care unit (ICU) at TSGH from January 2003 to September 2023. Data regarding demographics, complications, and mortality were collected and analyzed. We compared the patient data before (pre-implementation) and after 2015 (post-implementation), when the new major burn management protocol was introduced.</div></div><div><h3>Results</h3><div>No statistically significant differences were observed in the mean total body surface area of the burns between the groups. The post-implementation group had younger age (34.62 vs 45.06, <em>P</em> < 0.001) and lower rate of inhalation injury (60.8 % vs 82.5 %, <em>P</em> = 0.005). No statistically significant difference was observed in the ICU stays between the groups. The post-implementation group had a statistically significant lower all-cause mortality (8.1 % vs 47.6 %, <em>P</em> < 0.0001) and lower rate of renal replacement therapy (RRT) (20.3 % vs 42.9 %, <em>P</em> = 0.004) but earlier initiation of RRT.</div></div><div><h3>Conclusion</h3><div>The new TSGH Burns Protocol revolutionized the care of major burns by introducing tailored, multidisciplinary burn management and improved patient outcomes.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107293"},"PeriodicalIF":3.2000,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of a newly implemented burn protocol at Tri-Service General Hospital: Outcome analysis of 20-year experience\",\"authors\":\"Yu-Tse Weng , Yu-Chi Tsai , Juin-Hong Cherng , Chih-Hsing Wang , Yuan-sheng Tzeng , Kuang Ling Ou , Tim-Mo Chen , Hao-Yu Chiao\",\"doi\":\"10.1016/j.burns.2024.107293\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To share our 20-year experience in major burn management and the impact of a newly implemented burn protocol since 2015 at Tri-Service General Hospital (TSGH).</div></div><div><h3>Materials and methods</h3><div>We performed a retrospective cohort study of severely burned patients who were admitted to the intensive care unit (ICU) at TSGH from January 2003 to September 2023. Data regarding demographics, complications, and mortality were collected and analyzed. We compared the patient data before (pre-implementation) and after 2015 (post-implementation), when the new major burn management protocol was introduced.</div></div><div><h3>Results</h3><div>No statistically significant differences were observed in the mean total body surface area of the burns between the groups. The post-implementation group had younger age (34.62 vs 45.06, <em>P</em> < 0.001) and lower rate of inhalation injury (60.8 % vs 82.5 %, <em>P</em> = 0.005). No statistically significant difference was observed in the ICU stays between the groups. The post-implementation group had a statistically significant lower all-cause mortality (8.1 % vs 47.6 %, <em>P</em> < 0.0001) and lower rate of renal replacement therapy (RRT) (20.3 % vs 42.9 %, <em>P</em> = 0.004) but earlier initiation of RRT.</div></div><div><h3>Conclusion</h3><div>The new TSGH Burns Protocol revolutionized the care of major burns by introducing tailored, multidisciplinary burn management and improved patient outcomes.</div></div>\",\"PeriodicalId\":50717,\"journal\":{\"name\":\"Burns\",\"volume\":\"51 1\",\"pages\":\"Article 107293\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-10-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Burns\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0305417924003334\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Burns","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0305417924003334","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的:分享三军总医院(TSGH)20年来在重度烧伤管理方面的经验以及2015年以来新实施的烧伤治疗方案的影响:我们对2003年1月至2023年9月期间入住三军总医院重症监护室(ICU)的严重烧伤患者进行了一项回顾性队列研究。我们收集并分析了有关人口统计学、并发症和死亡率的数据。我们比较了新的大面积烧伤管理方案实施前(实施前)和2015年(实施后)的患者数据:两组烧伤患者的平均体表总面积无明显统计学差异。实施后组的年龄更小(34.62 岁 vs 45.06 岁,P 结论:实施后组的年龄更小(34.62 岁 vs 45.06 岁,P 结论:实施后组的年龄更小:新的 TSGH 烧伤治疗方案通过引入量身定制的多学科烧伤管理,彻底改变了重度烧伤的治疗方法,并改善了患者的预后。
Impact of a newly implemented burn protocol at Tri-Service General Hospital: Outcome analysis of 20-year experience
Purpose
To share our 20-year experience in major burn management and the impact of a newly implemented burn protocol since 2015 at Tri-Service General Hospital (TSGH).
Materials and methods
We performed a retrospective cohort study of severely burned patients who were admitted to the intensive care unit (ICU) at TSGH from January 2003 to September 2023. Data regarding demographics, complications, and mortality were collected and analyzed. We compared the patient data before (pre-implementation) and after 2015 (post-implementation), when the new major burn management protocol was introduced.
Results
No statistically significant differences were observed in the mean total body surface area of the burns between the groups. The post-implementation group had younger age (34.62 vs 45.06, P < 0.001) and lower rate of inhalation injury (60.8 % vs 82.5 %, P = 0.005). No statistically significant difference was observed in the ICU stays between the groups. The post-implementation group had a statistically significant lower all-cause mortality (8.1 % vs 47.6 %, P < 0.0001) and lower rate of renal replacement therapy (RRT) (20.3 % vs 42.9 %, P = 0.004) but earlier initiation of RRT.
Conclusion
The new TSGH Burns Protocol revolutionized the care of major burns by introducing tailored, multidisciplinary burn management and improved patient outcomes.
期刊介绍:
Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice.
Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.