Belba M K, Petrela E, Belba A, Mano V, Belba G
Department of Surgery, Burns and Plastic Surgery Service, University Hospital Centre "Mother Teresa", Tirana, Albania.
Department of Public Health, Faculty of Medicine, University Hospital Centre "Mother Teresa", Tirana, Albania.
Ann Burns Fire Disasters. 2016 Sep 30;29(3):163-171.
The purpose of this study was to evaluate independent factors (mainly critical hyperglycaemic values on admission) with an impact on outcome in burn patients (sepsis and mortality) and analyse prevalence of critical hyperglycaemia on admission and during burn disease in adult and elderly patients with severe burns. This was an observational retrospective cohort study involving burn patients (≥ 20 years old) hospitalized in the ICU of the Burn Facility in Albania during 2010-2014. Patients were categorized as having euglycaemia, moderate or critical hyperglycaemia. Regression analysis, hyperglycaemia prediction test and risk measurement were performed for the population. Statistical significance for SIH was only found for glucose values on admission, presence of diabetes and BMI. Using 180 mg/dl as cut off for critical hyperglycaemia, we found that this test had a sensitivity of 66.67% (95% CI: 44.68% to 84.33%), specificity of 88.20% (95% CI: 84.16% to 91.51%), PPV of 29.63% (95% CI: 17.99% to 43.61%) and NPV of 97.26% (95% CI: 94.67% to 98.81%). Statistical significance was found for patients with critical hyperglycaemia on admission regarding relative and absolute risk measures for sepsis and mortality. Glucose values on admission, as one of the derangement features of burn shock, are prognostic factors in critical hyperglycaemia during disease, and have a close relationship with other outcomes (sepsis and mortality).
本研究的目的是评估对烧伤患者预后(脓毒症和死亡率)有影响的独立因素(主要是入院时的严重高血糖值),并分析成年和老年重度烧伤患者入院时及烧伤病程中严重高血糖的患病率。这是一项观察性回顾性队列研究,纳入了2010年至2014年期间在阿尔巴尼亚烧伤科重症监护病房住院的烧伤患者(≥20岁)。患者被分为血糖正常、中度或严重高血糖。对该人群进行了回归分析、高血糖预测测试和风险测量。仅发现入院时的血糖值、糖尿病的存在和体重指数对应激性高血糖具有统计学意义。以180mg/dl作为严重高血糖的临界值,我们发现该测试的灵敏度为66.67%(95%CI:44.68%至84.33%),特异性为88.20%(95%CI:84.16%至91.51%),阳性预测值为29.63%(95%CI:17.99%至43.61%),阴性预测值为97.26%(95%CI:94.67%至98.81%)。对于入院时患有严重高血糖的患者,在脓毒症和死亡率的相对和绝对风险测量方面发现了统计学意义。入院时的血糖值作为烧伤休克的紊乱特征之一,是疾病期间严重高血糖的预后因素,并且与其他结局(脓毒症和死亡率)密切相关。