Epidemiological analysis and comparison of 259 extensive burn patients from 2010 to 2021: Evidence for autonomous medical team.

Abstract

This study aims to investigate the epidemiological and clinical characteristics of patients with extensive burns admitted to a burn center in eastern China from 2010 to 2021 and to evaluate the impact of an autonomous medical team implemented in 2016 on patient management. A retrospective study was conducted on patients admitted to the Burn and Trauma Center at the First Affiliated Hospital of Naval Medical University between January 1, 2010, and December 31, 2021. Data were compared and statistically analyzed using SPSS (version 26.0) for two periods: 2010-2015 and 2016-2021. This study enrolled a total of 259 patients, with 106 cases spanning from 2010 to 2015 and 153 cases from the period of 2016-2021. Among them, there were a total of 198 male patients (76.4%) and 61 female patients (23.6%). The age range of the subjects varied between 1 and 90 years old, with a median age of 44 years (30 ~ 54 years). The distribution of burn total body surface area (%TBSA) ranged from 30% to 99%, with a median TBSA value of 50% (35% ~ 72%). Flame burns constituted the majority cause for extensive burns, accounting for 151 cases (58.8%), followed by scald burns comprising 51 cases (19.8%). Extensive burns predominantly occurred during the summer season. The limbs were identified as the most commonly affected areas, accounting for 146 cases (56.4%). The median length of hospital stay was recorded as 44 days (28-67.75 days), while the overall mortality rate stood at 7.34%. The proportion of middle-aged and elderly individuals increased in recent 6 years compared to earlier period. The incidence of flame and chemical burns decreased, while the severity exhibited an increase. There was a significant rise in the average number of surgical procedures performed during hospitalization. Meanwhile, the mortality rate experienced a decline without any notable variation in total length or cost associated with hospital stay. Our research findings suggest the need for dynamic adjustments in burn prevention measures based on changes in epidemiological characteristics, while also advocating for the establishment of autonomous medical teams with decision-making authority for critical care treatment of extensive burn patients.