Differences in the outcomes and treatments of extensively burned patients between a Chinese hospital and a Japanese hospital.

To know the therapeutic level at one's own institute is important and contributes to improving the treatment of patients. We compared the outcomes of extensively burned patients between a Chinese hospital and a Japanese hospital in order to identify the differences in the clinical treatment of severe burn patients. Thirty-four burn patients who were admitted to the National Defense Medical College Hospital (NDMC) in Japan and 95 burn patients who were admitted to the Changhai Hospital of the Second Military Medical University (SMMU) in China from January 1999 to December 2003 were studied. All patients were transported to the respective hospitals within 3 days after suffering burns and their total body surface area of burns was greater than 20%. Fourteen of the 34 patients (41.2%) at NDMC hospital and 1 of the 95 patients (1.1%) at SMMU hospital were injured by attempted suicide; namely, the suicide rate was significantly higher in the patients at NDMC hospital (p < 0.001). Moreover, the age (p = 0.005) and inhalation rate (p = 0.013) were significantly higher at NDMC hospital than those at SMMU hospital. Consequently, the survival rate at SMMU was higher than at NDMC in the patients with a burn surface area of greater than 80% or with a burn index of greater than 60. The excellent outcomes of the extensively burned patients at SMMU were in part due to the fact that Chinese doctors tend to perform an immediate tracheostomy and a traditional Chinese operation with alloskin, called microskin grafting or intermingled skin grafting.