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Определяне на тежестта на изгарянето и причинената от него телесна повреда: BAUX срещу AIS

E. Kаишева

Abstract

Въпреки постоянното развитие на медицината, термичната травма и нейните последици продължават да са сериозен социален, медицински и съдебномедицински проблем в световен мащаб, наложил създаването и използването на точен метод за определяне на тежестта на термичното увреждане и прогнозиране на изхода от него. Целта на проучването е да oценим точността на R-Baux и AIS системите за прогнозиране на риска от летален изход при термична травма чрез сравняване на изчисления по тях риск с действително реализирания, както и да разгледаме възможността за определяне на тежестта на причинената телесна повреда. Проучени са всички случаи с изгаряне, постъпили в Клиниката по термична травма, пластично-възстановителна и естетична хирургия при „МБAЛ - Варна` за пет годишен период (2011-2015 г.). Получените резултати дават възможност да се оформят групи съобразно тежестта на травмата според стойността на AIS и R-Baux и реализираната опасност за живота. При стойности на AIS 1 леталитетът е под 0,1%. При стойности 2, 3 и 4 леталитетът е между 0,6 и 15%, a при стойности 5 и 6 той е между 60 и 90%. За другата разглеждана система - R-Baux, зависимостта е: при стойности, по-малки от 20 - няма риск за живота, между 21 и 120 - рискът е до 44%, a при стойности над 120 е повече от 90%. Установи се, че двете системи са подходящи за определяне на риска от смъртен изход след термична травма и посочените цифрови стойности могат да се използват като ориентир от съдебните медици при квалифициране на телесната повреда вследствие на изгаряне и за определяне на степента, в която е застрашен животът на пострадалия.

Keywords

thermal injury, scoring systems, trauma assessment, bodily injury

Full Text


References

Andel Н, Kamolz LP. Scoring in burned patients our opinion. Burns 2003, 29: 297–298.

Balseven-Odabasi A, Tumer A, Keten A, Yorganci K. Burn injuries among children aged up to 7 years. The Turkish J of Pediatrics. 2009;51:328-335.

Benito-Ruiz J, Navarro-Monzonis A, Baena-Montilla P, Mirabet-Ippolito V. An analysis of burn mortality. A report from a Spanish regional burn centre. Burns. 1991;27(3): 201-204.

Brusselaers N, Hoste EA, Monstrey S, Colpaert KE, De Waele JJ, Vandewoude KH, et al. Outcome and changes over time in survival following severe burns from 1985 to 2004. Intensive Care Med. 2005; 31:1648-53.

Brusselaers N, Monstrey S, Vogelaers D, Hoste E et al.: Severe burn injury in Europe: a systematic review of the incidence, etiology, morbidity, and mortality. Critical Care. 2010;14(5): 188.

Dahal P, Ghimire S, Maharjan NK, Rai SM. Baux`s and Abbreviated Burn Severity Score for the Prediction of Mortality in Patients with Acute Burn Injury. JCMS Nepal. 2015;11(4): 24-27.

Davoodi P, Fernandez JM, O. SJ. Postburn sequelae in the pediatric patient: clinical presentations and treatment options. J Craniofac Surg. 2008; 19(4):1047-52

Dokter J, Meijs J, Oen IMMH, van Baar ME, van der Vlies CH, Han

Boxma H. External validation of the revised Baux score for the prediction of mortality in patients with acute burn injury. J Trauma Acute Care Surg. 2014;76(3):840-5.

Fujioka M, Tasaki I, Isihara Hiroshi M, Houbara S, Sasaki E. A case of severe smoke inhalation injury without cutaneous burn required massive fluid for resuscitation. Burns. 2007;11: 670-1.

Gennarelli TA. Abbreviated Injury Scale 2005. Update 2008. Association for the Advancement of Automotive Medicine. 2008.

Karimi H, MD; Motevalian SA, MD; Rabbani A, MD; Motabar AR, MD; Vasigh M, MD; Sabzeparvar M, MD; Mobayen M, MD. Prediction of

Mortality in Pediatric Burn Injuries: R-Baux Score to Be Applied in Children (Pediatrics-Baux Score). Iran J Pediatr. 2013;23(2):165-170

Kemp AM, Jones S, Lawson Z, Maguire SA. Patterns of burns and scalds in children. Arch Dis Child. 2014; 99:316-321.

Klein MB, Lezotte DC, Heltshe S, et al. Functional and psychosocial outcomes of older adults after burn injury: results from a multicenter database of severe burn injury. J Burn Care Res. 2011;32(1):66-78

Lionelli GT, Pickus EJ, Beckum OK, DeCoursey RL, Korentager RA. A three decade analysis of factors affecting burn mortality in the elderly. Burns. 2005;31:958-963.

Lundgren RS, Kramer CB, Rivara FP, et al. Influence of comorbidities and age on outcome following burn injury in older adults. J Burn Care Res. 2009;30(2):307-14.

McGill V, Kowal-Vern A, Gamelli RL. Outcome for older burn patients. Arch Surg. 2000;135: 320-5.

Moore EC, Pilcher DV, Bailey MJ, et al. The Burns Evaluation and Mortality Study (BEAMS): predicting deaths in Australian and New Zealand burn patients admitted to intensive care with burns. J Trauma Acute Care Surg. 2013;75(2):298-303

Olaitan PB, Jiburum BC. Analysis of burn mortality in a burns centre. Ann Burns Fire. Disasters 2006;19(2):59-62. PMID:21991024; PMCID: PMC3188036.

Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the Baux score. J Trauma. 2010;68(3):690-7

Roberts G, Lloyd M, Parker M, et al. The Baux score is dead. Long live the Baux score: a 27-year retrospective cohort study of mortality at a regional burns service. J Trauma Acute Care Surg. 2012;72(1):251-6.

Rosario Aldana MC del, Navarrete N. Epidemiology of a decade of pediatric fatal burns in Colombia, South America. Burns. 2015;41:1587- 1592.

Rose JK, Herndon DN. Advances in the treatment of burn patients. Burns. 1997;23(1): 19-26.

Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med. 1998;338(6):362-6.

Saffle JR, Davis B, Williams P. Recent outcomes in the treatment of burn injury in the United States: a report from the American burn association patient registry. J Burn Care Rehabil. 1995;16,3(1):219-32.

Siemers F, Liodaki E, Mauss KL, Stang FH, Wild T von , Mailaender P. Burn Injuries in Elderly - A Retrospective Analysis of a Ten Year Period. Modern Plastic Surgery. 2012;2:13-19.25.

Tahir SM, FCPS; Memon AR, MCPS, MS; Kumar M, FCPS; Ali SA,

FCPS. Prediction of Mortality After Major Burn: Physiological Versus

Biochemical Measures. Wounds. 2009;2(7):1 77-182

Thombs BD, Singh VA, Milner SM. Children under 4 years are at greater risk of mortality following acute burn injury: evidence from a national sample of 12,902 pediatric admissions. Shock. 2006; 26(4):348-52.

Tompkins RG, Burke JF, Schoenfeld DA, et al. Prompt eschar excision: a treatment system contributing to reduced burn mortality: a statistical evaluation of burn care at the Massachusetts General Hospital (1974-1984). Ann Surg. 1986; 204:272-81.

Wibbenmeyer LA, Amelon MJ, Morgan LJ, Robinson BK, Chang PX,

Lewis II R, et al. Predicting survival in an elderly burn patient population. Burns. 2001;27:583-90.

Williams DJ, Walker JD. A nomogram for calculation of the Revised Baux Score. Burns. 2015; 41(1):85-90

Zawacki BE, Azen SP, Imbus SH, Chang YT. Multifactorial probit analysis of mortality in burned patients. Ann Surg. 1979;189(1):1-5.




DOI: http://dx.doi.org/10.14748/sm.v0i3%2F4.5993

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