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首页> 外文期刊>The Internet Journal of Rescue and Disaster Medicine >Mortality Associated With Injuries Sustained By Aircraft Accident Burn Survivors
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Mortality Associated With Injuries Sustained By Aircraft Accident Burn Survivors

机译：与飞机事故烧伤幸存者受伤相关的死亡率

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INTRODUCTION: Air travel is one of the most popular and efficient means of transportation available today. Although infrequent, disasters involving aircraft are an unfortunate reality. The medical profession is still learning how to best care for air crash survivors. The purpose of this paper is to identify the survivability of aircraft accidents as well as characterize morbidity and mortality of associated injuries sustained by aircraft accident burn survivors admitted to a major burn center over a 40-year period.METHODS: We performed a retrospective chart review of all aircraft accident patients admitted to our institution from January 1955 through July 1997. Data collected included age, gender, total body surface area burned (TBSA), full thickness burn, inhalation injury and associated injuries sustained at time of mishap. As major advances in burn care were achieved after 1975, patients injured prior to January 1975 were placed in group A (N=363); the remainder was placed in group B (N=143). Mortality was reviewed between the two different time periods for full thickness burns using Logistic Regression and Chi-squared method of analysis.RESULTS: During the study period there were 30,718 aircraft accidents tracked by the NTSB. Of these, 19.33% (N=5,939) involved at least one fatality. Of 9175 patients admitted to the U. S. Army Burn center between January 1955 and July 1997, 506 (5.5%) were involved in aircraft crashes. The patient population was 92.3% male (N=467) and 7.7% female (N=23). The average age was 28.7 years. The overall mean TBSA was 32.5% and the full thickness burn was 19.05%. Associated injuries were seen in 77.0% of admissions. Fractures occurred in 39.72% of admissions, while closed head injuries were sustained by 8.1%. Inhalation injury was observed in 25.4% of patients; eye injuries in 7.5%. Hemo/pneumothorax, spleen, and liver injuries were seen in less than 3%. There was a dramatic improvement in mortality (p<.001) in our population with burn size >40% between the two periods. In patients with less than 40% TBSAA, however, associated closed head injuries and fractures were associated with a 350% higher mortality (p<.001). CONCLUSIONS: Less than 20% of aircraft accidents involve a fatality. Most thermally injured survivors of aircraft crashes, 77.0%, are associated with significant blunt injury. Despite a statistically significant decrease in overall mortality of burn patients, closed head injuries and fractures are associated with increased mortality when compared to similarly burned patients without these injuries. A multi-disciplinary, well-coordinated team approach is necessary to optimize the treatment to this sub group of patients. Research Conducted At THE EXTREMITY TRAUMA BRANCH - U. S. ARMY INSTITUTE OF SURGICAL RESEARCH, FORT SAM HOUSTON, TEXAS, 78234 “The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.” Introduction Although infrequent, aircraft disasters are an unfortunate reality. High speed and altitude as well as passenger capacity are distinguishing characteristics of air travel compared to other forms of mass transportation. These features have always posed the highest risk of severe injuries and fatalities from an accident. This difference became all too painfully clear when passengers began air travel in significant volumes in the 1920’s. In April 1967, Congress formed the National Transportation Safety Board (NTSB) to study aircraft accidents 1 The NTSB has maintained the Aviation Accident Database that tracks aircraft accidents from 1962 to present day. From 1962 to 1997, there have been 130,000 accidents involving aircraft with an average of 2250 aircraft accidents per year 1 During the time period of our study, there were 30,718 airplane accidents alone with 5,939 involving at least one fatality. Assuming that each air crash inv
机译：简介：航空旅行是当今最流行，最有效的交通工具之一。尽管不常见，但涉及飞机的灾难却是不幸的现实。医学界仍在学习如何为空难幸存者提供最佳护理。本文的目的是确定飞机事故的可生存性，以及表征在40年内进入主要烧伤中心的飞机事故烧伤幸存者遭受的相关伤害的发病率和死亡率。从1955年1月至1997年7月入我们机构的所有飞机事故患者的总数。收集的数据包括年龄，性别，烧伤总表面积（TBSA），全层烧伤，吸入性伤害以及不幸时遭受的相关伤害。由于在1975年后烧伤护理方面取得了重大进展，因此将1975年1月之前受伤的患者归为A组（N = 363）。其余的放在B组（N = 143）。使用Logistic回归和卡方分析法对两个不同时间段内全厚度燃烧的死亡率进行了评估。结果：在研究期间，NTSB跟踪了30,718例飞机事故。其中，19.33％（N = 5,939）涉及至少一名死亡。在1955年1月至1997年7月之间进入美国陆军烧伤中心的9175名患者中，有506名（5.5％）参与了飞机坠毁。患者人群为男性92.3％（N = 467）和女性7.7％（N = 23）。平均年龄为28.7岁。总体平均TBSA为32.5％，全层烧伤为19.05％。入院时有77.0％的人受伤。入院时发生骨折的比例为39.72％，闭合性头部受伤的比例为8.1％。 25.4％的患者观察到吸入性损伤;眼外伤占7.5％。血/气胸，脾脏和肝损伤的发生率不到3％。在这两个时期之间，烧伤面积> 40％的人群死亡率显着提高（p <.001）。然而，在TBSAA少于40％的患者中，相关的闭合性颅脑损伤和骨折导致死亡率增加350％（p <.001）。结论：少于20％的飞机事故涉及死亡。飞机失事的大多数受热伤幸存者与严重钝伤有关。尽管烧伤患者的总死亡率在统计学上有显着降低，但与没有烧伤的类似烧伤患者相比，闭合性头部受伤和骨折与死亡率增加相关。必须采用多学科，协调良好的团队方法来优化对该亚组患者的治疗。在极端创伤分院进行的研究-美国陆军外科医学研究所，德克萨斯州萨姆休斯敦，78234陆军部或国防部。”引言尽管很少发生飞机灾难，但这是不幸的现实。与其他形式的大众运输相比，高速度和高度以及载客量是空中旅行的显着特征。这些功能始终是事故造成重伤和死亡的最高风险。当乘客在1920年代开始大量飞行时，这种差异变得非常痛苦。 1967年4月，国会成立了国家运输安全委员会（NTSB），以研究飞机事故1。NTSB维护了航空事故数据库，该数据库跟踪了从1962年至今的飞机事故。从1962年到1997年，总共发生了13万起飞机事故，平均每年2250架飞机1。在我们的研究期间，仅发生了30,718架飞机事故，其中5,939起涉及至少一名死亡。假设每次空难发生

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