화상사인의 분석 = ANALYSIS OF THE CAUSES OF DEATH IN THE BURN PATIENTS

다국어 초록 (Multilingual Abstract)

Burn takes a major part of trauma and there has been much improvement in the treatment of the burn during the later half of this century. The mortality of burn was much decreased by the more detailed understanding of its pathophysiology, the introduction of more improved regimen of the fluid resuscitation and antibiotics, many other instrumental inventions, and advanced technique of skin grafting.
Nevertheless, the mortality of severly burned patients is still high.
We reported the results of the clinical observations and the analysis of the causes of 37 deaths among the 408 burn patients who were admitted and treated at the department of plastic ＆ reconstructive surgery in the K.N.U. hospital during the period from October, 1981 to October, 1985.
The results were as followes;
The number of patients below 9 years of age took 48% of the burn patients, and male was affected 1.5 times more than female.
In 90% of the patients below 9 years of age, scalding was the cause of burn, and female was predominent in scalding burn, and male was predominent in electrical burn (p<0.01).
Seasonally, scalding burn occurred more frequently during spring and autumn, and others occurred in relatively even distribution through the seasons.
The case fatality rate of the burn was about 9%, and among the number of death, the patients below 9 years of age and the twenties took 38% and 35%, respectively. Male took more than two fold in number than female.
Flame burn had the highest cause specific case fatality rate (p<0.01). The average burned body surface are among the dead patients was about 56% BSA.
LA 50 (50%-Lethal burned body surface Area) was about 55% BSA. The all patient who sustained burn of more than 70% BSA were died in this series.
Among the causes of death, sepsis was the most common cause (40.5%), and the inhalation burn, the burn shock, the renal shutdown, and the pulmonary edema were also common causes of death.
About half of the death number was occurred within 1 week after burn. Death after 15 days from the injury was mostly due to the sepsis and pseudomonas aeruginosa was the most frequent causative organism.
The dead patients of the inhalation burn were mostly combined with the flame burn more than 40% BSA, and their average survival time was about 11days after the burn.
The patients who died of the burn shock took 14% of the number of all death, and they were extremely low ages or sustained the burn of extremely large area of body surface.