Influence of age on median lethal burn area of burn patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To discuss the influence of age on the LA50 (the burn area lethal to 50% of patients) of burn patients.</p><p><b>METHODS</b>(1) Twenty-three thousand and seventy-three burn patients hospitalized in our center from December 1958 to December 2004 were enrolled, and they were divided into 25 age groups. LA50 values of total and full-thickness burn areas of patients in each age group were computed with probit regression method with Probit analysis of SPSS 11.0. (2) Those age groups with similar LA50 values were merged into one age group; thus 4 new age groups were formed. LA50 and its 95% confidence interval (CI) of total and full-thickness burn areas of patients in each age group were computed respectively. (3) All the patients were divided into group A (admitted from 1 December 1958 to 31 December 1983) and group B (admitted from 1 January 1984 to 31 December 2004) according to the admission time. LA50 and its 95% CI of total and full-thickness burn areas of patients in each age group of groups A and B were computed respectively.</p><p><b>RESULTS</b>(1) LA50 values of total and full-thickness burn areas of patients among the 25 age groups were low in age groups younger than or equal to 5 years, which increased in age groups older than 5 years, distinctly higher in age groups older than 15 years, and they became lower in age groups older than 60 years. (2) LA50 values of total and full-thickness burn areas of patients in the 4 merged age groups were lowest in age groups older than 60 years (50.90% TBSA) and younger than or equal to 5 years (35.81% TBSA), and highest in age group older than 15 years and younger than or equal to 60 years (89.38% and 59.22% TBSA). There were statistically significant differences in LA50 of total and full-thickness burn areas of patients among 4 merged age groups [with 95% CI values of LA50 of total burn areas of patients in age groups ranging from young to old respectively (56.87 to 64.69)%, (64.46 to 74.36)%, (85.89 to 93.37)%, (44.55 to 60.73)% TBSA; with 95% CI values of LA50 of full-thickness burn areas of patients in age groups from young to old respectively (32.67 to 39.69)%, (40.86 to 50.41)%, (55.27 to 63.85)%, (32.46 to 54.86)% TBSA]. (3) LA50 values of total and full-thickness burn areas of patients in group B (98.94% and 73.23% TBSA) were significantly higher than those in group A (69.61% and 39.79% TBSA). There were differences in LA50 values of patients among different age groups in both group A and group B. The variation trend of LA50 values of patients among the 4 age groups in groups A and B was almost the same. Except for LA50 of total burn areas of patients in age group older than 5 years and younger than or equal to 15 years and LA50 of full-thickness burn areas of patients in age group older than 60 years, there were statistically significant differences in the LA50 of total and full-thickness burn areas of the other patients between group A and group B [with 95% CI of LA50 of total burn areas of patients of younger than or equal to 5 years, older than 15 years and younger than or equal to 60 years, and older than 60 years respectively (48.38 to 56.07)% and (68.68 to 81.35)% TBSA, (75.91 to 84.89)% and (97.09 to 110.45)% TBSA, (30.08 to 45.08)% and (60.67 to 102.69)% TBSA; with 95% CI of LA50 of full-thickness burn areas of patients of younger than or equal to 5 years, older than 5 years and younger than or equal to 15 years, older than 15 years and younger than or equal to 60 years respectively (27.48 to 34.69)% and (42.09 to 54.03)% TBSA, (34.78 to 46.43)% and (49.62 to 69.47)% TBSA, (43.98 to 51.77)% and (66.43 to 77.99)% TBSA].</p><p><b>CONCLUSIONS</b>Age is one of the important factors that influence the LA50 of burn patients. LA50 in different age groups increases with the development of medical technology; however, the influence of age on LA50 is not visibly changed by the advance of treatment.</p>

Categorization of burn severity / 中华烧伤杂志

<p><b>OBJECTIVE</b>To seek a new method for the categorization of burn severity.</p><p><b>METHODS</b>Burn patients hospitalized in our center from December of 1958 to December of 2004 were enrolled in the study, and they were divided into different age groups according to same mortality, then the patients in each group were subdivided into 4 groups according to the burn severity: i.e., mild burns, moderate burns, severe burns, serious severe burns. The total burn area, the number of cases, the mortality, and the area of DI degree burns were statistically analyzed in each subgroup, and the scope in total burn area and area of III degree burns were taken as standards to define the degree of burns. The logistic regression equation was established with probability of death as the variable, and age, total burn area, burn area of different degrees as concomitant variables to form a logistic regression formula. It was used to predict the probability of death of patients hospitalized in 2005, 50 as to check whether the corresponding indices of these patients were consistant with above standard of categorization into degrees, and to judge hum severity of the patients who had concomitant inhalation injury, severe associated injury, or those with serious disease before burns.</p><p><b>RESULTS</b>The patients were divided into three groups: less than 2 years of age (including 2 years of age), 2 to 55 years of age(including 55 years of age), and older than 55 years of age groups. The classification standard of burn area was shown in table 2 of the article. The probability of death and corresponding indices predicted hy the logistic regression equation were highly coincident with our standard. Patients with moderate inhalation injury could be regarded as patients with severe or most severe burns, while severity of those with mild inhalation injury could be determined by burn area alone.</p><p><b>CONCLUSION</b>The logistic regression equation is a good method to predict the severity of burn patients, with reasonable age specificity grouping, and accurate and practical scoring of division for corresponding burn severity.</p>