量化脱皮皮肤病的临床和经济负担:对超区域烧伤中心的影响
Thomas H Jovic1, Rebecca Watson2, Sarah Hemington Gorse2
1Reconstructive Surgery & Regenerative Medicine Research Centre, Swansea University, Swansea, UK; Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK.
Journal of plastic, reconstructive & aesthetic surgery : JPRAS
|December 8, 2023
概括
脱皮性皮肤疾病,通常被误诊为有毒表皮解症综合征 (TENS),在专门的烧伤病房中存在显著的护理需求和成本. 提高意识和财务规划对于管理这些严重的皮肤病至关重要.
科学领域:
- 皮肤病学 皮肤病学
- 密集护理医学 密集护理医学
- 卫生经济学 卫生经济学
背景情况:
- 脱皮皮肤疾病需要专业的三级护理,通常在烧伤部门.
- 准确的诊断和资源分配对于管理这些严重疾病至关重要.
研究的目的:
- 为了确定脱皮皮肤疾病的范围,请参阅三级烧伤单位.
- 量化这些患者的护理需求和相关成本.
主要方法:
- 对非烧伤引起的皮肤损失的患者记录 (2016-2022) 的回顾性审查.
- 从住院,手术和服装诊所记录中提取数据.
- 使用国家和单位特定成本数据进行成本分析.
主要成果:
- 20名患者的TBSA中位数为30%;30%的总死亡率 (50%的ITU入院).
- 错误诊断率很高:只有32%的疑似有毒表皮解剖综合征 (TENS) 病例得到证实;其他诊断包括线性IgA疾病,黄和牛皮狼.
- 显著的资源利用:平均住院时间为21.2天,全身麻醉下1.5次手术,每位患者更换8.3次带,总单位成本为1,422,106.6英.
结论:
- 脱皮皮肤病是危及生命的,需要大量的护理.
- 对TENS以外的各种脱皮皮肤疾病的认识对于最佳的患者管理至关重要.
- 充分的财务规划是满足这些患者广泛护理需求的关键.
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