器官功能障碍对烧伤≥70%的患者整体生存期的影响TBSA:一个病例对照研究
Heng He1, Haonan Ma2, Yifan Liu3
1Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China; Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, People's Republic of China.
概括
器官功能障碍显著影响严重烧伤患者 (≥70% TBSA) 的存活率. 早期发现和管理器官功能障碍对于改善这些关键病例的结果和生存率至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 创伤外科手术是什么
- 燃烧管理 燃烧管理
背景情况:
- 严重烧伤的死亡率 (≥70% TBSA) 仍然很高,尽管护理方面取得了进展.
- 多器官功能障碍综合征 (MODS),败血症和感染是主要的死亡原因.
- 个体器官功能障碍对严重烧伤患者的生存的具体影响需要进一步研究.
研究的目的:
- 研究严重烧伤 (≥70% TBSA) 患者器官功能障碍和整体存活率 (OS) 之间的关系.
- 确定器官功能障碍作为该患者群体死亡率的独立预测因子.
- 开发严重烧伤患者的OS的预测模型.
主要方法:
- 从2010年到2020年对144名烧伤≥70%的患者进行了分析.
- 根据总生存率 (OS) 划分成活体或死体的分类.
- 应用单变量和多变量考克斯回归分析,以及卡普兰-梅尔生存分析,然后进行名录构造.
主要成果:
- 器官功能障碍显着与更糟糕的生存状况相关 (p < 0.001).
- 多变量分析证实了器官功能障碍作为减少OS (OR = 11.37) 的显著独立预测因素.
- 开发的名图表在预测不同时间点的OS方面表现出很高的准确性 (AUC从0.821到0.943).
结论:
- 器官功能障碍是严重烧伤 (≥70% TBSA) 患者的生存的一个关键决定因素.
- 有效的烧伤护理策略必须专注于预防和管理器官功能障碍.
- 早期检测和器官功能障碍的管理,有助于预测工具,如开发的nomogram,是改善患者生存的必要条件.
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