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烧伤患者的感染:七年回顾性观察。

Infections in Burn Patients: A Retrospective View over Seven Years.

机构信息

Department of Plastic Surgery and Hand Surgery, Burn Center, Medical Faculty, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany.

Austrian Cluster of Tissue Regeneration, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology at the Research Centre for Traumatology of the Austrian Workers Compensation Board (AUVA), Donaueschingenstraße 13, 1200 Vienna, Austria.

出版信息

Medicina (Kaunas). 2022 Aug 8;58(8):1066. doi: 10.3390/medicina58081066.

Abstract

Burn patients represent a challenging cohort because the injuries entail a vulnerability to colonisation by microorganisms. The ensuing infections can lead to serious complications and, in many cases, to the death of the burn patient. Surgical intervention and wound dressings, as well as antibiotic treatment, are crucial for optimising the treatment of the patient. In this retrospective analysis, we analysed the treatment course, antibiotic therapy, and general complications of 252 burn patients with second- or third-degree burns over a time span of 7 years. Patients who developed infections tended to have, on average, a higher total body surface area (TBSA), higher abbreviated burn severity index (ABSI) scores, and longer hospital stays. Patients who were admitted to the burn unit after 2006 had significantly shorter stays in the burn unit. TBSA and ABSI scores were lower in the patient cohort admitted after 2006. Patients exhibiting a TBSA greater than 30% had significantly longer hospital stays and antibiotic treatment periods. TBSA and ABSI scores were significantly higher in patients who died. The results of binary logistic regression indicate that a higher ABSI score increases the odds ratio of developing an infection. Bacteria number had no significant effect on the odds of patient death but positively influenced the odds ratio of developing an infection. TBSA was negatively associated with the risk of developing an infection and was an insignificant predictor of mortality. To gauge the optimal treatment for a burn patient, it is crucial for practitioners to correctly select, dose, and time antibiotics for the patient. Monitoring bacterial colonisation is vital to nip rising infection in the bud and ensure the correct antibiotic selection. This will help prevent the development of multi-resistant bacteria.

摘要

烧伤患者是一个具有挑战性的群体,因为他们的伤口容易被微生物定植。由此引发的感染可能导致严重的并发症,在许多情况下,甚至导致烧伤患者死亡。手术干预和伤口敷料以及抗生素治疗对于优化患者的治疗至关重要。 在这项回顾性分析中,我们分析了 252 例二度或三度烧伤患者在 7 年时间内的治疗过程、抗生素治疗和一般并发症。 发生感染的患者平均总体表面积(TBSA)更高,简短烧伤严重程度指数(ABSI)评分更高,住院时间更长。2006 年后入住烧伤病房的患者在烧伤病房的停留时间明显缩短。2006 年后入院的患者 TBSA 和 ABSI 评分较低。TBSA 大于 30%的患者住院时间和抗生素治疗时间明显延长。TBSA 和 ABSI 评分较高的患者死亡风险显著增加。二元逻辑回归的结果表明,较高的 ABSI 评分会增加感染的几率。细菌数量对患者死亡的几率没有显著影响,但会对感染的几率产生积极影响。TBSA 与感染的风险呈负相关,对死亡率无显著预测作用。 为了评估烧伤患者的最佳治疗方案,临床医生必须正确选择、剂量和时间为患者使用抗生素。监测细菌定植对于及时发现感染并确保正确选择抗生素至关重要。这将有助于防止多耐药菌的产生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29bd/9412298/684ee2f1926d/medicina-58-01066-g001.jpg

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