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A 10-year retrospective study of heat press injury: Characteristics and risk factor for amputation
1Peking University Fourth School of Clinical Medicine, Xinjiekoudongjie Street 31, Xicheng District, Beijing, 100035, PR China; Department of Burns, Beijing Jishuitan Hospital, Xinjiekoudongjie Street 31, Xicheng District, Beijing, 100035, PR China.
Insights
Heat press injuries often affect working-age men and can lead to amputation. Insufficient extremity perfusion is a key predictor of amputation risk in these patients.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Burn Medicine
Background:
- The diagnostic grading system for heat press injury has not evolved for decades, relying solely on surgical observation.
- Understanding the characteristics and risk factors for amputation in heat press injuries is crucial for improving patient outcomes.
Purpose of the Study:
- To describe the demographic and clinical characteristics of patients with heat press injuries.
- To identify potential predictive factors for amputation in patients with heat press injuries.
Main Methods:
- A retrospective cohort study included 129 patients diagnosed with heat press injury between 2010 and 2019.
- Univariable and multivariable logistic regression analyses were used to assess risk factors for amputation.
Main Results:
- The study identified insufficient perfusion of the extremities as a significant independent risk factor for amputation (odds ratio = 156.48).
- Other factors like total body surface area (TBSA), D-dimer level, and white blood cell count were not associated with amputation risk.
- 12 out of 20 patients with insufficient perfusion lost more than one phalanx.
Conclusions:
- Insufficient perfusion of extremities is a critical independent risk factor for amputation in heat press injuries.
- Traditional indicators such as TBSA, D-dimer, and white blood cell count did not predict amputation risk.
- This finding highlights the importance of assessing and managing extremity perfusion in heat press injury cases.
Purpose:
The diagnostic grading system for heat press injury has remained the same for decades and depends solely on surgical observation. This study described the demographic and clinical characteristics of such patients and investigated potential predictive factors for amputation.
Methods:
129 patients diagnosed with heat press injury were admitted at Beijing Jishuitan Hospital from 2010 to 2019. Their demographic and clinical characteristics were described and 64 patients were included in a retrospective cohort to assess the risk factors of amputation with univariable and multivariable logistic regression.
Result:
The annual partial incidence rate of heat press injury was at least 1-4 cases per 10,000,000 people in Beijing. Of our 129 patients, 85 were men and the mean age was 32 years, 126 caused by machines, 70 with full-thickness burns but no open wounds, and the median total body surface area (TBSA) was 1%. After logistic regression, only insufficient perfusion of the extremities (odds ratio = 156.48; 95% confidence interval = 11.24-2177.92) was associated with the risk of amputation, where 12 of 20 patients lost more than 1 phalanx.
Conclusion:
Industrial machines, working age, small TBSA, digit or hand injuries, and full-thickness skin injuries were common in our patients. Insufficient perfusion of extremities was an independent risk factor for amputation, while other indicators, including TBSA, D-dimer level, and white blood cell count, did not.
