烧伤病人住院时间影响因素的流行病学分析

An epidemiological study on the factors influencing length of hospitalization for inpatients of burns

目的 探讨影响烧伤病人住院时间长短的因素 ,为烧伤二级预防的医学干预提供依据。方法 调查 790例烧伤患者 ,应用因子分析与Cox回归分析。结果 影响烧伤病人住院时间的因素有病人的入院方式 (X3 )、烧伤面积 (X4 )、烧伤深度 (X5)及烧伤至获得规范治疗的间隔时间 (X6) ;病人的年龄 (X1)和性别 (X2 )对住院时间的影响不明显。Cox比例风险模型为h (t) /h0 (t) =e( -0 .193 3F1 -0 .6176F2 -0 .1180F3) ,其中公因子Fi 与原变量的换算关系式为F1=- 0 .132X3 - 0 .0 0 9X4 +0 .6 5 5X5+0 .5 83X6,F2 =0 .0 19X3 +0 .875X4 +0 .2 5 7X5- 0 .2 94X6,F3 =1.0 10X3 +0 .0 2 5X4 -0 .176X5+0 .0 30X6,表明烧伤越深、面积越大、烧伤后延误治疗的时间越长 ,病人住院时间也越长 ;在病情相当时 ,急救车送医院者愈合较快。结论 烧伤后治疗的及时性是影响烧伤病人住院时间的主要预后因素之一 。

Objective To provide evidence for intervention on secondary prevention of burns through studying the factors influencing the length of hospitalization on inpatients of burns. Methods Seven hundred and ninety burnt patients with cluster sampling, combined analyzing with Cox regression and factor analysis. Results The influential factors on the length of hospitalization in inpatients with burns included a) how did the patients come to the hospital (X 3), b) total body surface area involved (X 4), c) depth of burns (X 5), and d) the time before hospitalization after burnt (X 6). The Cox proportional hazard model used was h(t)/h 0(t)=e ( -0.193 3 F 1- 0.617 6 F 2- 0.118 0 F 3) ,and the conversion model between factors F i and original variates were F 1 = -0.132 X 3- 0.009 X 4+ 0.655 X 5+ 0.583 X 6, F 2= 0.019 X 3+ 0.875X 4+ 0.257 X 5- 0.294 X 6, F 3= 1.010 X 3+ 0.025X 4- 0.176 X 5+ 0.030 X 6. Data showed that the burnt patients had longer hospitalization time when the burns were deep, larger body surface area involved, and with longer delay before getting to the hospitals, where as the patients got cured faster when taken to the hospital by ambulances. Conclusion One of the major prognostic factors of burns was to treat the patients in time. Secondary prevention of burns must be reinforced.