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[PMID]:27775983
[Au] Autor:Strassle PD; Williams FN; Napravnik S; van Duin D; Weber DJ; Charles A; Cairns BA; Jones SW
[Ad] Endereço:From the *Department of Epidemiology, University of North Carolina at Chapel Hill; †Department of Surgery, University of North Carolina at Chapel Hill, ‡North Carolina Jaycee Burn Center, Chapel Hill; and §Division of Infectious Diseases, University of North Carolina, Chapel Hill.
[Ti] Título:Improved Survival of Patients With Extensive Burns: Trends in Patient Characteristics and Mortality Among Burn Patients in a Tertiary Care Burn Facility, 2004-2013.
[So] Source:J Burn Care Res;38(3):187-193, 2017 May/Jun.
[Is] ISSN:1559-0488
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Classic determinants of burn mortality are age, burn size, and the presence of inhalation injury. Our objective was to describe temporal trends in patient and burn characteristics, inpatient mortality, and the relationship between these characteristics and inpatient mortality over time. All patients aged 18 years or older and admitted with burn injury, including inhalation injury only, between 2004 and 2013 were included. Adjusted Cox proportional hazards regression models were used to estimate the relationship between admit year and inpatient mortality. A total of 5540 patients were admitted between 2004 and 2013. Significant differences in sex, race/ethnicity, burn mechanisms, TBSA, inhalation injury, and inpatient mortality were observed across calendar years. Patients admitted between 2011 and 2013 were more likely to be women, non-Hispanic Caucasian, with smaller burn size, and less likely to have an inhalation injury, in comparison with patients admitted from 2004 to 2010. After controlling for patient demographics, burn mechanisms, and differential lengths of stay, no calendar year trends in inpatient mortality were detected. However, a significant decrease in inpatient mortality was observed among patients with extensive burns (≥75% TBSA) in more recent calendar years. This large, tertiary care referral burn center has maintained low inpatient mortality rates among burn patients over the past 10 years. While observed decreases in mortality during this time are largely due to changes in patient and burn characteristics, survival among patients with extensive burns has improved.
[Mh] Termos MeSH primário: Unidades de Queimados
Queimaduras/mortalidade
Queimaduras/terapia
Centros de Atenção Terciária
[Mh] Termos MeSH secundário: Adulto
Feminino
Mortalidade Hospitalar
Seres Humanos
Tempo de Internação/estatística & dados numéricos
Masculino
Meia-Idade
North Carolina
Sistema de Registros
Fatores de Risco
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1097/BCR.0000000000000456


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[PMID]:27775982
[Au] Autor:Cai AR; Hodgman EI; Kumar PB; Sehat AJ; Eastman AL; Wolf SE
[Ad] Endereço:From the Division of Burns, Trauma, and Critical Care, Department of Surgery, University of Texas-Southwestern Medical Center, Dallas.
[Ti] Título:Evaluating Pre Burn Center Intubation Practices: An Update.
[So] Source:J Burn Care Res;38(1):e23-e29, 2017 Jan/Feb.
[Is] ISSN:1559-0488
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A significant proportion of patients appeared to arrive at our American Burn Association-verified burn center intubated without clear benefit. The current study aims to evaluate regional prehospital intubation practices and their outcomes. All consecutive admissions from November 2012 to June 2014 were reviewed for data points associated with intubation. Demographics and outcomes for patients who were intubated before arrival or within 24 hours of admission were compared using χ, Fisher's exact test, and the Kruskal-Wallis test as appropriate. During this period, 958 patients were admitted. Of these, 120 were intubated before arrival, and 91 survived their injuries. Of these 91 survivors, 45 were extubated within 2 days, suggesting unnecessary intubation rate in 37.5%. Intubation-related complications were roughly three times as common among those intubated before arrival (12.5% vs 4.4%). Patients intubated before arrival to our burn center had a shorter median duration of intubation (1.0 vs 4.0 days), median hospital LOS (5.0 vs 22.0 days), and median intensive care unit length of stay (3.0 vs 10.0 days). Furthermore, we found a significant difference in the pattern of ventilator support duration between those arriving intubated, with a median of 2.0 days, and those intubated at our burn center, with a median of 5.5 days. Patients intubated by pre burn center providers have shorter intubation durations and shorter hospitalizations, suggesting inappropriate use of resources. Impending loss of airway appears unlikely among patients with adequate gas exchange at the time of examination. The current criteria for prehospital intubation should be revised to more accurately identify those who truly benefit from advanced airway maneuvers.
[Mh] Termos MeSH primário: Queimaduras/terapia
Serviços Médicos de Emergência/métodos
Mortalidade Hospitalar
Intubação Intratraqueal/métodos
Admissão do Paciente
[Mh] Termos MeSH secundário: Adulto
Unidades de Queimados
Queimaduras/diagnóstico
Queimaduras/mortalidade
Estudos de Coortes
Feminino
Seguimentos
Seres Humanos
Escala de Gravidade do Ferimento
Intubação Intratraqueal/estatística & dados numéricos
Tempo de Internação
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Respiração Artificial/efeitos adversos
Respiração Artificial/métodos
Ressuscitação/métodos
Ressuscitação/estatística & dados numéricos
Estudos Retrospectivos
Medição de Risco
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1097/BCR.0000000000000457


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[PMID]:28467581
[Au] Autor:Yüce Y; Acar HA; Erkal KH; Tuncay E
[Ad] Endereço:Department of Anaesthesiology and Reanimation, Kartal Dr. Lütfi Kirdar Training and Research Hospital, Istanbul-Turkey. dryyuce@gmail.com.
[Ti] Título:Can we make an early 'do not resuscitate' decision in severe burn patients?
[So] Source:Ulus Travma Acil Cerrahi Derg;23(2):139-143, 2017 Mar.
[Is] ISSN:1306-696X
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. METHODS: Between January 2009 and December 2014, 29 patients (3.44%) with very severe burns were admitted to burn unit. Average total burn surface area (TBSA) was 94.24% (range: 85-100%), and in 10 patients, TBSA was 100%. Additional inhalation burns were present in 26 of the patients (89.65%). All of the patients died, despite every medical intervention. Mean survival was 4.75 days (range: 1-24 days). Total of 17 patients died within 72 hours. Lethal dose 50 (% TBSA at which certain group has 50% chance of survival) rate of our burn center is 62%. Baux indices were used for prognostic evaluation of the patients; mean total Baux score of the patients was 154.13 (range: 117-183). RESULTS: It is well known that numerous problems may be encountered during triage of severely burned patients in Turkey. These patients are referred to burn centers and are frequently transferred via air ambulance between cities, and even countries. They are intubated and mechanical ventilation is initiated at burn center. Many interventions are performed to treat these patients, such as escharotomy, fasciotomy, tangential or fascial excision, central venous catheterization and tracheostomy, or hemodialysis. Yet despite such interventions, these patients die, typically within 48 to 96 hours. Integrity of the body is often lost as result of aggressive intervention with no real benefit, and there are also economic costs to hospital related to use of materials, bed occupancy, and distribution of workforce. For these reasons, as well as patient comfort, early do-not-resuscitate or do-not-intubate protocol for these patients is suggested. Resources could then be directed to other patients with high expectancy of life and patients with burns that are beyond treatment can experience more comfortable end of life. CONCLUSION: At present in Turkey, it is not possible to give DNR order for patient with severe burns that are incompatible with survival due to legal interdiction. This subject should be discussed at high-level meetings with participation of doctors, legal experts, economists, and theologians.
[Mh] Termos MeSH primário: Queimaduras/terapia
Ordens quanto à Conduta (Ética Médica)
[Mh] Termos MeSH secundário: Unidades de Queimados
Queimaduras/epidemiologia
Queimaduras/mortalidade
Queimaduras por Inalação
Hospitalização
Seres Humanos
Estudos Retrospectivos
Índice de Gravidade de Doença
Turquia/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.5505/tjtes.2016.71508


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[PMID]:28865914
[Au] Autor:Yoder LH; McFall DC; Glaser DN
[Ad] Endereço:The University of Texas at Austin School of Nursing, Austin, TX. Electronic address: lyoder@mail.nur.utexas.edu.
[Ti] Título:Quality of life of burn survivors treated in the military burn center.
[So] Source:Nurs Outlook;65(5S):S81-S89, 2017 Sep - Oct.
[Is] ISSN:1528-3968
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Limited research explains the quality of life (QOL) among burn survivors during post-hospitalization rehabilitation. PURPOSE: To determine the QOL of military and civilian burn survivors treated in the military burn center. METHODS: In this longitudinal study, QOL was examined in 131 burn survivors (88 civilians; 43 military). Participants completed the Abbreviated Burn Specific Health Scale (BSHS-A) and the Satisfaction with Life Scale (SWLS) over 5 time points post-discharge. DISCUSSION: Civilian and military participants reported improved QOL over time on most BSHS-A subscales. Military participants had higher global BSHS-A scores at discharge, but at 6 months plateaued while civilians improved and had higher global BSHS-A scores at 18 months. Scores on the SWLS were consistently higher for military participants than for civilians. CONCLUSION: Military versus civilian patients may have different expectations about their ability to rehabilitate. The post-hospitalization period needs to be better understood to develop appropriate QOL interventions.
[Mh] Termos MeSH primário: Unidades de Queimados
Queimaduras/psicologia
Queimaduras/terapia
Militares
Qualidade de Vida
Sobreviventes/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Hospitalização
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Satisfação do Paciente
Estudos Prospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170904
[St] Status:MEDLINE


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[PMID]:28813520
[Au] Autor:Khosravi AD; Motahar M; Abbasi Montazeri E
[Ad] Endereço:Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
[Ti] Título:The frequency of class1 and 2 integrons in Pseudomonas aeruginosa strains isolated from burn patients in a burn center of Ahvaz, Iran.
[So] Source:PLoS One;12(8):e0183061, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pseudomonas aeruginosa is an opportunistic pathogen with the ability to cause severe nosocomial infections and remains a major problem in burn patients. This organism shows a remarkable antimicrobial resistance and is often resistant to multiple antibiotics. Integron genes as mobile genetic elements are playing an important role in the spread of P. aeruginosa antibiotic resistance. This study was aimed to investigate the occurrence of class 1, and 2 integron genes (int1, int2), among P. aeruginosa strains isolated from patients with burn infections. METHODS: In total 93 clinical isolates of P. aeruginosa were screened. The antimicrobial susceptibilities of 9 common antimicrobial agents were tested against the isolates using disk diffusion method. PCR amplification was performed on extracted DNAs for the detection of int1, and int2 genes using the set of specific primers. RESULTS: The majority of P. aeruginosa isolates were from wound infection (69.9%). In disk diffusion method, most isolates showed remarkable resistance to tested antibiotics with highest against gentamicin (94.62%) and ciprofloxacin (93.55%). PCR amplification revealed that 89(95.7%) of P. aeruginosa strains carried int1, but none of them harbored int2 genes. The distribution of int1 gene was highest in blood (100%), followed by wound isolates (95.38%). CONCLUSIONS: We demonstrated a high antimicrobial resistance among P. aeruginosa isolates in our setting. int1 was prevalent and seems to play an important role in multidrug resistance among the isolates. So, performance of antibiotic surveillance programs is necessary for choosing the appropriate therapy and management of infection control practices.
[Mh] Termos MeSH primário: Proteínas de Bactérias/metabolismo
Queimaduras/microbiologia
Integrons/fisiologia
Pseudomonas aeruginosa/isolamento & purificação
Pseudomonas aeruginosa/fisiologia
[Mh] Termos MeSH secundário: Antibacterianos/farmacologia
Proteínas de Bactérias/genética
Unidades de Queimados/estatística & dados numéricos
Ciprofloxacino/farmacologia
Gentamicinas/farmacologia
Seres Humanos
Integrons/genética
Irã (Geográfico)
Testes de Sensibilidade Microbiana
Reação em Cadeia da Polimerase
Pseudomonas aeruginosa/efeitos dos fármacos
Pseudomonas aeruginosa/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Bacterial Proteins); 0 (Gentamicins); 5E8K9I0O4U (Ciprofloxacin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170817
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183061


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[PMID]:28807206
[Au] Autor:Nosanov LB; McLawhorn MM; Hassan L; Travis TE; Tejiram S; Johnson LS; Moffatt LT; Shupp JW
[Ad] Endereço:The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC.
[Ti] Título:Graft loss: Review of a single burn center's experience and proposal of a graft loss grading scale.
[So] Source:J Surg Res;216:185-190, 2017 Aug.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There exists neither a consensus definition of burn "graft loss" nor a scale with which to grade severity. We introduced an institutional scale in 2014 for quality improvement. MATERIALS AND METHODS: We reviewed all burned patients with graft loss on departmental Morbidity and Mortality reports between July 2014 and July 2016. Graft loss grades were assigned during the course of clinical care per institutional scale. Chronic nonhealing wounds and nonburn wounds were excluded. Data abstracted included demographics, medical history, injury details, surgical procedures, graft loss, and lengths of stay (LOS). Photos of affected areas were graded by two blinded surgeons, and a linear weighted κ was calculated to assess interrater agreement. RESULTS: Graft loss was noted in 50 patients, with 43 remaining after exclusions. Mean age was 50.1 y. The majority were male (58.1%) and African American (41.9%). Smoking (30.2%) and diabetes (27.9%) were prevalent. Total body surface area involvement ranged from 0.5% to 51.0% (11.8 ± 12.3%). Grade I graft loss was documented on one patient (2.3%), Grade II in 15 (34.9%), Grade III in 12 (27.9%), and Grade IV in 15 (34.9%). Reoperation was performed in 20 (46.5%). Hospital LOS was longer than predicted in 38 patients (88.4%). Seven had significant morbidity, including two amputations. Moderate agreement was reached between blinded surgeons (κ = 0.44, P = 0.004). CONCLUSIONS: Graft loss is a major source of morbidity in burn patients. In this cohort, reoperation was common and hospital LOS was extended. Use of a grading scale improves dialog among providers and enables improved understanding of risk factors.
[Mh] Termos MeSH primário: Queimaduras/cirurgia
Transplante de Pele
[Mh] Termos MeSH secundário: Adulto
Idoso
Unidades de Queimados
Feminino
Sobrevivência de Enxerto
Indicadores Básicos de Saúde
Seres Humanos
Masculino
Meia-Idade
Melhoria de Qualidade
Estudos Retrospectivos
Fatores de Risco
Método Simples-Cego
Transplante Autólogo
Falha de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170816
[St] Status:MEDLINE


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[PMID]:28712732
[Au] Autor:Mason SA; Nathens AB; Byrne JP; Fowler RA; Karanicolas PJ; Moineddin R; Jeschke MG
[Ad] Endereço:Sunnybrook Research Institute, Toronto, Canada; Department of General Surgery, Division of General Surgery, University of Toronto, Toronto, Canada; Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada. Electronic address: stephanie.mason@mail.utoronto.ca.
[Ti] Título:Burn center care reduces acute health care utilization after discharge: A population-based analysis of 1,895 survivors of major burn injury.
[So] Source:Surgery;162(4):891-900, 2017 Oct.
[Is] ISSN:1532-7361
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Improvements in survival after burns have resulted in more patients being discharged home after severe injury. However, the postdischarge health care needs of burn survivors are not well understood. We aimed to determine the rate and causes of unplanned presentation to acute care facilities in the 5 years after major burn injury. METHODS: Data derived from several population-based administrative databases were used to conduct a retrospective cohort study. All patients aged ≥16 years who survived to discharge after a major burn injury in 2003-2013 were followed for 1-5 years. All emergency department visits and unplanned readmissions were identified and classified by cause. Factors associated with emergency department visits were modeled using negative binomial generalized estimating equations. Factors associated with readmission were modeled using multivariable competing risk regression. RESULTS: We identified 1,895 patients who survived to discharge; 68% of patients had at least one emergency department visit and 30% had at least one readmission. Five-year mortality was 10%. The most common reason for both emergency department visits and readmissions was traumatic injury. After risk adjustment, patients who received their index care in a burn center experienced significantly less need for subsequent unplanned acute care, fewer emergency department visits (relative risk 0.61, 95% confidence interval, 0.52-0.72), and fewer hospital readmissions (hazard ratio 0.77, 95% confidence interval, 0.65-0.92). CONCLUSION: Acute health care utilization is frequent after burn injury and is most commonly related to traumatic injuries. Burn-related events are uncommon beyond 30 days after discharge, suggesting low rates of burn recidivism. Patients treated at burn centers have significantly reduced unplanned health care utilization after their injury.
[Mh] Termos MeSH primário: Unidades de Queimados
Queimaduras/terapia
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Queimaduras/complicações
Queimaduras/mortalidade
Serviço Hospitalar de Emergência
Feminino
Hospitalização/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Ontário
Avaliação de Resultados (Cuidados de Saúde)
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE


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[PMID]:28704546
[Au] Autor:Amissah NA; van Dam L; Ablordey A; Ampomah OW; Prah I; Tetteh CS; van der Werf TS; Friedrich AW; Rossen JW; van Dijl JM; Stienstra Y
[Ad] Endereço:Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
[Ti] Título:Epidemiology of Staphylococcus aureus in a burn unit of a tertiary care center in Ghana.
[So] Source:PLoS One;12(7):e0181072, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In developing countries, hospitalized burn victims are at high risk of nosocomial infections caused by Staphylococcus aureus. Risk factors include poor infection control practices, prolonged hospitalisation and limited capacity for laboratory microbiological analyses. These problems are compounded by widespread use of antibiotics that drives the spread of multi-drug resistant bacteria. METHODS: During the study period (November 2014-June 2015), nasal and invasive S. aureus isolates were collected consecutively from patients and healthcare workers (HCWs) within the burn unit of the Reconstructive Plastic Surgery and Burn Center of Korle Bu Teaching Hospital in Ghana. Antibiotic prescription, antibiotic susceptibility and bacterial typing were used to assess antibiotic pressure, antibiotic resistance, and possible transmission events among patients and HCWs. RESULTS: Eighty S. aureus isolates were obtained from 37 of the 62 included burn patients and 13 of the 29 HCWs. At admission, 50% of patients carried or were infected with S. aureus including methicillin resistant S. aureus (MRSA). Antibiotic use per 100 days of hospitalization was high (91.2 days), indicating high selective pressure for resistant pathogens. MRSA isolates obtained from 11 patients and one HCW belonged to the same spa-type t928 and multi-locus sequence type 250, implying possible transmission events. A mortality rate of 24% was recorded over the time of admission in the burn unit. CONCLUSION: This study revealed a high potential for MRSA outbreaks and emergence of resistant pathogens amongst burn patients due to lack of patient screening and extended empirical use of antibiotics. Our observations underscore the need to implement a system of antibiotic stewardship and infection prevention where microbiological diagnostics results are made available to physicians for timely and appropriate patient treatment.
[Mh] Termos MeSH primário: Portador Sadio/microbiologia
Staphylococcus aureus Resistente à Meticilina/isolamento & purificação
Infecções Estafilocócicas/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Técnicas de Tipagem Bacteriana
Unidades de Queimados/estatística & dados numéricos
Criança
Pré-Escolar
Infecção Hospitalar
Feminino
Gana/epidemiologia
Pessoal de Saúde/estatística & dados numéricos
Mortalidade Hospitalar
Seres Humanos
Masculino
Infecções Estafilocócicas/microbiologia
Centros de Atenção Terciária
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181072


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[PMID]:28651415
[Au] Autor:Ao M; Wu J; Chen J
[Ad] Endereço:Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, Chongqing 400038, China.
[Ti] Título:[Investigation of burn rehabilitation development of China in 2014].
[So] Source:Zhonghua Shao Shang Za Zhi;33(5):260-266, 2017 May 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To further study the development of burn rehabilitation in China, so as to promote the development of burn rehabilitation in China. The questionnaire about the development of burn rehabilitation treatment was started by Specialized Committee of Burn Treatment and Rehabilitation Science of Chinese Association of Rehabilitation Medicine (hereinafter referred to as Specialized Committee) in the end of 2014, and 65 affiliations of Specialized Committee members participated in. There was a total of 26 questions, mainly focusing on problems as below: (1) General information of the burn department of the units, including the number of authorized beds, annual admitted burn patients, annual admitted patients with extremely severe burn, doctors, nurses, rehabilitation therapists, and the condition of rehabilitation area and rehabilitation beds, etc. (2) Development of burn rehabilitation treatment, including the development of rehabilitation treatment, the intervention time of rehabilitation treatment, the rehabilitation treatment carried out in intensive care unit (ICU), the composition of rehabilitation treating personnel, and the professional title and background, educational background, and division of responsibilities of rehabilitation therapists, etc. (3) Major problems affecting the development of burn rehabilitation treatment of the units. The burn treatment units were grouped according to the number of annual admitted patients. The units' situation of authorized beds, admitted patients, allocation of medical personnel and rehabilitation, and the ratio of beds to doctors, beds to nurses, beds to full-time burn rehabilitation treating personnel were recorded. Data were processed with test, one-way analysis of variance, and chi-square test. (1) A total of 65 questionnaires were sent, and 45 questionnaires (69.2%) were retrieved. Among the 45 units that replied the questionnaires, 35 units were burn treatment units. (2) The 35 burn treatment units were divided into less than 500 cases group ( =8), 501-1 000 cases group ( =11), 1 001-1 500 cases group ( =10), and more than 1 500 cases group ( =6) according to the number of annual admitted patients. The number of authorized beds of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group ( =4.563, <0.05). The number of authorized beds of units in more than 1 500 cases group was significantly more than that in the other 3 groups, respectively (with values from 1.859 to 3.743, values below 0.05). The number of annual admitted patients of units in 501-1 000 cases group, 1 001-1 500 cases group, and more than 1 500 cases group was dramatically more than that in less than 500 cases group (with values from 6.027 to 12.684, values below 0.05). The number of annual admitted patients of units in 1 001-1 500 cases group and more than 1 500 cases group was significantly more than that in 501-1 000 cases group (with values respectively 7.408 and 6.980, values below 0.05). The number of annual admitted patients of units in more than 1 500 cases group was significantly more than that in 1 001-1 500 cases group ( =4.239, <0.05). The number of annual admitted patients with extremely severe burn and the condition of rehabilitation area and rehabilitation beds of units in the 4 groups was similar ( =0.820, with (2) values respectively 5.266 and 2.848, values above 0.05). The number of doctors of units in more than 1 500 cases group was significantly more than that in less than 500 cases group ( =2.836, <0.05). The number of nurses of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group ( =2.837, <0.05). The number of nurses and that of rehabilitation therapists of units in more than 1 500 cases group were significantly more than those in the other 3 groups (with values from 1.762 to 4.789, values below 0.05). (3) The 35 burn treatment units were able to provide at least one rehabilitation treatment for patients, among which body positioning, motion of joint exercise, infrared ray irradiation, hydrotherapy, function training, activities of daily life training, scar massage, and drug injection in scar were carried out well, while psychological therapy, music therapy, occupational rehabilitation, and social rehabilitation were mostly not carried out. (4) Only 9 (25.7%) burn treatment units started rehabilitation treatment for patients within 3 days after injury. (5) Twenty-seven (77.1%) burn treatment units could carry out body positioning in ICU. (6) Twenty-three burn treatment units had full-time rehabilitation treating personnel, and the units were divided into less than 500 cases group ( =1), 501-1 000 cases group ( =8), 1 001-1 500 cases group ( =9), and more than 1 500 cases group ( =5) according to the number of annual admitted patients. The ratio of beds to doctors of units in more than 1 500 cases group was significantly higher than that in 501-1 000 cases group ( =2.810, <0.05) and the ratios of beds to doctors of units in 501-1 000 cases group and 1 001-1 500 cases group were similar ( =1.506, >0.05). The ratios of beds to nurses and beds to full-time burn rehabilitation treating personnel in 4 groups were similar (with values respectively 0.783 and 0.434, values above 0.05). (7) Twenty burn treatment units had rehabilitation therapists with rehabilitation treatment related professional background (a total of 73 person, account for 76.0%), 80.8% (59/73) rehabilitation therapists with rehabilitation and therapeutic professions, 60.3% (44/73) with bachelor degree or above, and 87.7% (64/73) with primary and intermediate titles. Besides, 39.7% (29/73) rehabilitation therapists did physical therapy; 12.3% (9/73) rehabilitation therapists did occupational therapy; 38.4% (28/73) rehabilitation therapists did not have specific duties. (8) During the development of burn rehabilitation treatment of 35 burn treatment units, the common problems were reflected in the authorized strength and professional technology level of rehabilitation treatment relating personnel, and the area and equipment for rehabilitation. There were also many problems in cooperation between burn surgeons and rehabilitation therapists and fund. The supports from hospital and department leaders were good. Through the development of several years, the general condition and the development of rehabilitation treatment of burn treatment units in China are improved; the beginning time of burn rehabilitation treatment is advanced; the number of rehabilitation treatment personnel is increased with their speciality improved; the burn rehabilitation work get great support from hospitals and departments.
[Mh] Termos MeSH primário: Unidades de Queimados/organização & administração
Queimaduras/reabilitação
[Mh] Termos MeSH secundário: China
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Posicionamento do Paciente
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2017.05.002


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[PMID]:28645712
[Au] Autor:Pakzad R; Ayubi E; Safiri S
[Ad] Endereço:Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran.
[Ti] Título:Blood transfusions in severe burn patients: Epidemiology and predictive factors: Methodological issues.
[So] Source:Burns;43(6):1363-1364, 2017 09.
[Is] ISSN:1879-1409
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Transfusão de Sangue
Queimaduras/epidemiologia
[Mh] Termos MeSH secundário: Unidades de Queimados
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170625
[St] Status:MEDLINE



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