| Autor: |
Fiona M Wood, Michael Phillips, Tom Jovic, John T Cassidy, Peter Cameron, Dale W Edgar, Steering Committee of the Burn Registry of Australia and New Zealand (BRANZ) |
| Jazyk: |
angličtina |
| Rok vydání: |
2016 |
| Předmět: |
|
| Zdroj: |
PLoS ONE, Vol 11, Iss 1, p e0147259 (2016) |
| Druh dokumentu: |
article |
| ISSN: |
1932-6203 |
| DOI: |
10.1371/journal.pone.0147259 |
| Popis: |
INTRODUCTION:Reported first aid application, frequency and practices around the world vary greatly. Based primarily on animal and observational studies, first aid after a burn injury is considered to be integral in reducing scar and infection, and the need for surgery. The current recommendation for optimum first aid after burn is water cooling for 20 minutes within three hours. However, compliance with this guideline is reported as poor to moderate at best and evidence exists to suggest that overcooling can be detrimental. This prospective cohort study of a bi-national burn patient registry examined data collected between 2009 and 2012. The aim of the study was to quantify the magnitude of effects of water cooling first aid after burn on indicators of burn severity in a large human cohort. METHOD:The data for the analysis was provided by the Burn Registry of Australia and New Zealand (BRANZ). The application of first aid cooling prior to admission to a dedicated burn service, was analysed for its influence on four outcomes related to injury severity. The patient related outcomes were whether graft surgery occurred, and death while the health system (cost) outcomes included total hospital length of stay and admission to ICU. Robust regression analysis using bootstrapped estimation adjusted using a propensity score was used to control for confounding and to estimate the strength of association with first aid. Dose-response relationships were examined to determine associations with duration of first aid. The influence of covariates on the impact of first aid was assessed. RESULTS:Cooling was provided before Burn Centre admission for 68% of patients, with at least twenty minutes duration for 46%. The results indicated a reduction in burn injury severity associated with first aid. Patients probability for graft surgery fell by 0.070 from 0.537 (13% reduction) (p = 0.014). The probability for ICU admission fell by 0.084 from 0.175 (48% reduction) (p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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