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血小板分布宽度与小儿部分厚度热烧伤短期预后和成本的关系:回顾性对比研究。

Platelet distribution width associated with short-term prognosis and cost in paediatrics with partial-thickness thermal burns: A retrospective comparative study.

机构信息

From Department of Burns and Plastic Surgery, The Forth Medical Center, Chinese PLA General Hospital, Beijing, China.

出版信息

Int Wound J. 2022 Nov;19(7):1853-1859. doi: 10.1111/iwj.13791. Epub 2022 Jun 15.

DOI:10.1111/iwj.13791
PMID:35706362
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9615298/
Abstract

Platelets exert important roles in burn wound healing and involving in inflammatory regulation and tissue repair. Platelet distribution width (PDW) is an indicator representing platelet morphology and activation. In this study, we try to evaluate the value of PDW in predicting short-term prognosis and cost of paediatrics with partial-thickness thermal burns. This retrospective study enrolled 73 children with partial-thickness thermal burns. The Ability of PDW to predict wound healing was evaluated by receiver operating characteristic (ROC) curve. All 73 patients were assigned into high and low PDW group according to optimal cut-off value from ROC curve. Associations between PDW and 2-weeks healing rate, time to wound healing, in-hospital cost and length of stay were evaluated. Furthermore, Univariate and multivariate logistic regression analysis were used to furtherly evaluate the significance of PDW in wound healing. We found that all baseline characteristics between groups were comparable (all P > .05). High PDW group had a significant higher 2-weeks wound healing rate than those with a low PDW (66.7% versus 32.6%, P < .01). Moreover, the mean time to wound healing of high PDW was obviously shorter than that of low PDW group (15.4 ± 10.1 vs 20.7 ± 10.9, P = .04). Univariate (OR: 0.24, 95%CI: 0.09-0.65, P < .01) and multivariate (OR: 0.15, 95CI%:0.05-0.52, P < .01) analysis confirmed PDW as an independent marker for wound healing. Patients in high PDW group had a significant lower medical burden than low PDW group, including in-hospital cost (13.7 ± 10.6 vs 21.9 ± 16.7, ×103RMB, P = .02) and length of stay (12.2 ± 8.8 vs 19.0 ± 10.8 days, P < .01). In conclusion, PDW can sever as a potential indictor to predict the short-term prognosis of paediatrics with partial thickness thermal burns.

摘要

血小板在烧伤创面愈合中发挥着重要作用,参与炎症调节和组织修复。血小板分布宽度(PDW)是反映血小板形态和激活的指标。本研究旨在评估 PDW 预测小儿部分厚度热烧伤短期预后和成本的价值。本回顾性研究纳入 73 例小儿部分厚度热烧伤患者。通过受试者工作特征(ROC)曲线评估 PDW 预测创面愈合的能力。根据 ROC 曲线的最佳截断值,将 73 例患者分为高 PDW 组和低 PDW 组。评估 PDW 与 2 周愈合率、创面愈合时间、住院费用和住院时间的相关性。此外,采用单因素和多因素 logistic 回归分析进一步评估 PDW 在创面愈合中的意义。结果显示,两组间所有基线特征均无统计学差异(均 P >.05)。高 PDW 组 2 周愈合率明显高于低 PDW 组(66.7%比 32.6%,P <.01)。此外,高 PDW 组的平均创面愈合时间明显短于低 PDW 组(15.4 ± 10.1 比 20.7 ± 10.9,P =.04)。单因素(OR:0.24,95%CI:0.09-0.65,P <.01)和多因素(OR:0.15,95%CI%:0.05-0.52,P <.01)分析均证实 PDW 是创面愈合的独立标志物。高 PDW 组患者的医疗负担明显低于低 PDW 组,包括住院费用(13.7 ± 10.6 比 21.9 ± 16.7,×103 RMB,P =.02)和住院时间(12.2 ± 8.8 比 19.0 ± 10.8 天,P <.01)。结论:PDW 可作为预测小儿部分厚度热烧伤短期预后的潜在指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2c1/9615298/3ec85bb445ed/IWJ-19-1853-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2c1/9615298/33ff8b760d4b/IWJ-19-1853-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2c1/9615298/3ec85bb445ed/IWJ-19-1853-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2c1/9615298/33ff8b760d4b/IWJ-19-1853-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2c1/9615298/3ec85bb445ed/IWJ-19-1853-g001.jpg

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本文引用的文献

1
Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns.血小板分布宽度和血小板分布宽度与血小板比值对严重烧伤的预后价值。
Shock. 2022 Apr 1;57(4):494-500. doi: 10.1097/SHK.0000000000001890.
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Incidence and characteristics of non-accidental burns in children: A systematic review.儿童非意外伤害性烧伤的发生率和特征:系统评价。
Burns. 2020 Sep;46(6):1243-1253. doi: 10.1016/j.burns.2020.01.008. Epub 2020 Feb 11.
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Burn injury.烧伤
Nat Rev Dis Primers. 2020 Feb 13;6(1):11. doi: 10.1038/s41572-020-0145-5.
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Effectiveness of platelet rich plasma in burn wound healing: a systematic review and meta-analysis.富血小板血浆在烧伤创面愈合中的疗效:系统评价和荟萃分析。
J Dermatolog Treat. 2022 Feb;33(1):131-137. doi: 10.1080/09546634.2020.1729949. Epub 2020 Feb 21.
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Assessing child quality of life impairments following pediatric burn injuries: Rasch analysis of the children's dermatology life quality index.评估儿童烧伤后生活质量受损情况:儿童皮肤病生活质量指数的 Rasch 分析。
Qual Life Res. 2020 Apr;29(4):1083-1091. doi: 10.1007/s11136-019-02380-w. Epub 2019 Dec 18.
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Healthcare resource utilization, treatment patterns, and cost of care among patients with thermal burns and inpatient autografting in two large privately insured populations in the United States.美国两个大型私人保险人群中热烧伤患者及住院自体移植患者的医疗资源利用、治疗模式及护理成本
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Children Younger Than 18 Years Treated for Nonfatal Burns in US Emergency Departments.在美国急诊科接受非致命烧伤治疗的18岁以下儿童。
Clin Pediatr (Phila). 2020 Jan;59(1):34-44. doi: 10.1177/0009922819884568. Epub 2019 Oct 31.
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Fetal Pediatr Pathol. 2020 Aug;39(4):297-306. doi: 10.1080/15513815.2019.1661051. Epub 2019 Sep 11.
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Medicine (Baltimore). 2019 Jul;98(29):e16510. doi: 10.1097/MD.0000000000016510.
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Contribution of platelets, the coagulation and fibrinolytic systems to cutaneous wound healing.血小板、凝血和纤溶系统对皮肤伤口愈合的贡献。
Thromb Res. 2019 Jul;179:56-63. doi: 10.1016/j.thromres.2019.05.001. Epub 2019 May 2.