Egozi D, Hussein K, Filson S, Mashiach T, Ullmann Y, Raz-Pasteur A
Plastic Surgery Department, Rambam Health Care Campus, Haifa,Israel.
Infectious Diseases Unit, Rambam Health Care Campus, Haifa,Israel.
Epidemiol Infect. 2014 Oct;142(10):2172-9. doi: 10.1017/S0950268813002501. Epub 2013 Oct 7.
In this study we collected and analysed data of the severe burn patients at our institution over an 11-year period in order to shed light on the controversial role of bloodstream infection (BSI) as a predictive factor for mortality in this burn population. The factors examined were age, total body surface area, smoke inhalation, presence of BSI, and BSI with resistant bacteria. In total 1081 burn patients were hospitalized from 2001 to 2011, of whom 4% died. We focused here on 158 severe burn patients, 74 of whom developed BSI, and 35 who died. Using univariate analysis, it appeared that the BSI group had a threefold greater chance of mortality compared to the non-BSI group. Patients with a Ryan score 3 had a 100% chance of mortality and those with a score 0 had 0%. Thus, focusing only on Ryan score 1 and score 2 patients, BSI did not contribute to mortality, nor was it shown to contribute to mortality in a multivariate analysis in which the score and BSI were included together. When BSI did occur, it predicted longer hospitalization periods. We conclude that BSI predicts longer length of hospitalization stay but does not contribute to the prediction of mortality beyond that offered by the Ryan score in a severe burn population.
在本研究中，我们收集并分析了我院11年间重度烧伤患者的数据，以阐明血流感染（BSI）作为该烧伤人群死亡率预测因素这一存在争议的作用。所考察的因素包括年龄、总体表面积、吸入烟雾、BSI的存在以及耐药菌引起的BSI。2001年至2011年期间，共有1081名烧伤患者住院，其中4%死亡。我们重点关注了158名重度烧伤患者，其中74人发生了BSI，35人死亡。单因素分析显示，与非BSI组相比，BSI组的死亡几率高出两倍。Ryan评分为3分的患者死亡率为100%，评分为0分的患者死亡率为0%。因此，仅关注Ryan评分为1分和2分的患者，BSI对死亡率没有影响，在将评分和BSI纳入的多因素分析中也未显示其对死亡率有影响。当确实发生BSI时，它预示着住院时间更长。我们得出结论，在重度烧伤人群中，BSI预示着住院时间更长，但除了Ryan评分所提供的预测信息外，它对死亡率的预测没有额外贡献。
