Association Dutch Burn Centers, Beverwijk, The Netherlands.
Burns. 2013 Jun;39(4):714-22. doi: 10.1016/j.burns.2013.01.015. Epub 2013 Mar 13.
Thrombocytopenia is common in trauma and critically ill patients and is associated with a poor outcomes. The objective of this retrospective study was to investigate the course of thrombocyte concentration changes in burn patients, the influences of various factors on this course, and a possible predictive value of thrombocyte counts on outcome in 244 patients admitted to our burn centre. Their thrombocyte counts were obtained until 50 days after burn. Data on patient demographics, total percentage burned surface area (%TBSA), sepsis and mortality were collected. Multilevel multivariable analysis was performed to investigate the influence of the variables on the platelet course. Cox regression analysis was performed to analyse the predictive value of the variables for mortality. A distinct pattern of thrombocyte counts was observed, with a nadir at day 3 followed by a peak at day 15 and a temporary thrombocytosis. %TBSA and age (p<0.05) influence this course. The mean thrombocyte course of septic and non-surviving patients depicts a significant lower nadir. Furthermore, higher age, %TBSA and low thrombocyte counts at the peak are predictive for 50 day mortality (p<0.05). Platelets follow a distinct course after burn, influenced by %TBSA and age. These factors and a low thrombocyte peak count predict mortality.
血小板减少症在创伤和危重症患者中很常见，与不良预后相关。本回顾性研究的目的是探讨烧伤患者血小板浓度变化的过程、各种因素对该过程的影响，以及 244 名入住烧伤中心患者的血小板计数对结局的可能预测价值。他们的血小板计数在烧伤后 50 天内获得。收集了患者人口统计学、总烧伤面积百分比（%TBSA）、脓毒症和死亡率的数据。采用多水平多变量分析来研究变量对血小板过程的影响。采用 Cox 回归分析来分析变量对死亡率的预测价值。观察到血小板计数的明显模式，第 3 天达到最低点，第 15 天达到峰值，出现短暂性血小板增多。%TBSA 和年龄（p<0.05）影响这一过程。脓毒症和非存活患者的平均血小板过程显示出明显较低的最低点。此外，高峰时年龄较高、%TBSA 较高和血小板计数较低与 50 天死亡率相关（p<0.05）。烧伤后血小板呈明显的变化过程，受%TBSA 和年龄的影响。这些因素和血小板峰值计数低可预测死亡率。
