烧伤患者的抗原滴度升高与死亡率

Antigen Titer Elevation and Mortality in Burn Patients.

作者信息

Jachec Sebastian, Perbix Walter, Fuchs Perbix, Lefering Rolf, Weinand Christian

机构信息

Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, Burns, University Hospital Cologne, Merheim, Germany.

Institute for Research in Operative Medicine (IFOM), University Hospital Cologne, Merheim, Germany.

出版信息

World J Plast Surg. 2019 Jan;8(1):18-24. doi: 10.29252/wjps.8.1.18..

DOI:10.29252/wjps.8.1.18.

PMID:30873358

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6409138/

Abstract

BACKGROUND

Mortality in burn patients has several contributing factors as sex, age, degree of burns, or inhalation injuries. Usefulness of antigen (CAG) titer is still being under debate to predict mortality. This study assessed correlation between CAG titer and mortality in burn patients.

METHODS

From 1988 to 2011, 877 burn intensive care patients were evaluated for age, sex, total burn surface area (TBSA), multi organ failure (MOF), burn depth, escharotomy, fasciotomy, antibiotic use, co-morbidities, CAG titer and intubation.

RESULTS

From 870 admitted patients, 190 patients were not enrolled. Increasing age was correlated with a higher mortality. The abbreviated burn severity index (ABSI) score of the deceased was 4 points and the TBSA was 20% higher than the survivors. The correlation for age, intubation, TBSA, inhalation injury, MOF, CAG titer, antibiotic use and escharotomy was significant. An increasing mortality was noted with antibiotic use and a CAG titer of 1:8 and higher. CAG titer of 1:8 and higher had a sensitivity of 51.1% and specificity of 86.3% for mortality. Multivariate analysis confirmed high influence of older age, MOF, comorbidities, antibiotic use and CAG titer of 1:8 and higher on mortality. There was a significant correlation for sex, younger age and CAG titer.

CONCLUSION

CAG titers of 1:8 and higher might warrant beginning of antimycotic treatment in elderly patients with high TBSA to avoid increase in mortality.

摘要

背景

烧伤患者的死亡率受多种因素影响，如性别、年龄、烧伤程度或吸入性损伤。抗原（CAG）滴度在预测死亡率方面的实用性仍存在争议。本研究评估了CAG滴度与烧伤患者死亡率之间的相关性。

方法

1988年至2011年，对877例烧伤重症监护患者进行了年龄、性别、烧伤总面积（TBSA）、多器官功能衰竭（MOF）、烧伤深度、焦痂切开术、筋膜切开术、抗生素使用、合并症、CAG滴度和插管情况评估。

结果

870例入院患者中，190例未纳入研究。年龄增加与死亡率升高相关。死亡患者的简化烧伤严重程度指数（ABSI）评分为4分，TBSA比幸存者高20%。年龄、插管、TBSA、吸入性损伤、MOF、CAG滴度、抗生素使用和焦痂切开术之间的相关性显著。抗生素使用以及CAG滴度为1:8及更高时，死亡率增加。CAG滴度为1:8及更高时，对死亡率的敏感性为51.1%，特异性为86.3%。多因素分析证实，老年、MOF、合并症、抗生素使用以及CAG滴度为1:8及更高对死亡率有高度影响。性别、年轻年龄与CAG滴度之间存在显著相关性。