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烧伤患者死亡率的预测因素。

Predictive factors of mortality in burn patients.

作者信息

Macedo Jefferson Lessa Soares de, Santos João Barberino

机构信息

Hospital Regional da Asa Norte, Brasília, DF, Brasil.

出版信息

Rev Inst Med Trop Sao Paulo. 2007 Nov-Dec;49(6):365-70. doi: 10.1590/s0036-46652007000600006.

Abstract

Burn mortality statistics may be misleading unless they account properly for the many factors that can influence outcome. Such estimates are useful for patients and others making medical and financial decisions concerning their care. This study aimed to define the clinical, microbiological and laboratorial predictors of mortality with a view to focus on better burn care. Data were collected using independent variables, which were analyzed sequentially and cumulatively, employing univariate statistics and a pooled, cross-sectional, multivariate logistic regression to establish which variables better predict the probability of mortality. Survivors and non-survivors among burn patients were compared to define the predictive factors of mortality. Mortality rate was 5.0%. Higher age, larger burn area, presence of fungi in the wound, shorter length of stay and the presence of multi-resistant bacteria in the wound significantly predicted increased mortality. The authors conclude that those patients who are most apt to die are those with age > 50 years, with limited skin donor sites and those with multi-resistant bacteria and fungi in the wound.

摘要

烧伤死亡率统计数据可能会产生误导,除非它们能恰当地考虑到许多可能影响预后的因素。这样的估计对于患者以及其他做出有关其治疗的医疗和财务决策的人来说是有用的。本研究旨在确定死亡率的临床、微生物学和实验室预测因素,以便专注于更好的烧伤护理。使用自变量收集数据,这些自变量通过单变量统计以及汇总的横断面多变量逻辑回归进行顺序和累积分析,以确定哪些变量能更好地预测死亡概率。比较烧伤患者中的幸存者和非幸存者以确定死亡率的预测因素。死亡率为5.0%。年龄较大、烧伤面积较大、伤口中有真菌、住院时间较短以及伤口中有多重耐药菌显著预测死亡率增加。作者得出结论,最容易死亡的患者是年龄>50岁、皮肤供区有限以及伤口中有多重耐药菌和真菌的患者。

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