烧伤患者脓毒症和感染性休克的 CBC 参数的大数据洞察:一项回顾性研究。

Big data insights into the diagnostic values of CBC parameters for sepsis and septic shock in burn patients: a retrospective study.

机构信息

Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.

Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.

出版信息

Sci Rep. 2024 Jan 8;14(1):800. doi: 10.1038/s41598-023-50695-z.

Abstract

Sepsis and septic shock are prevalent and life-threatening complications in burn patients. Despite their severity, existing diagnostic methods are limited. This study aims to evaluate the efficacy of Complete Blood Count (CBC) and CBC ratio markers in diagnosing sepsis and septic shock, and in predicting mortality among burn patients. A cohort of 2757 burn patients was examined to ascertain the correlation between various CBC parameters, their ratios, and the incidence of sepsis and related mortality. Key markers analyzed included Red Cell Distribution Width (RDW), Mean Platelet Volume (MPV), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume-to-Platelet Ratio (MPVPR). Our findings indicate that 65.5% of the patients developed sepsis, and 24.3% succumbed to their conditions. The CBC parameters RDW, MPV, NLR, MPVPR, and MPV-to-Lymphocyte Ratio (MPVLR) were significantly associated with sepsis and mortality. These markers showed considerable temporal variation and yielded an Area Under the Curve (AUC) of over 0.65 in an unadjusted Generalized Estimating Equations (GEE) model. This study underscores the potential of RDW, MPV, NLR, MPVPR, and MPVLR as vital prognostic tools for diagnosing sepsis, septic shock, and predicting mortality in burn patients. Although based on a single-center dataset, our results contribute to the enhancement of sepsis management by facilitating earlier, more precise diagnosis and treatment strategies. Further multi-center research is necessary to confirm these findings and broaden their applicability, establishing a solid base for future explorations in this crucial field.

摘要

脓毒症和感染性休克是烧伤患者普遍存在且危及生命的并发症。尽管这些并发症很严重,但现有的诊断方法却存在局限性。本研究旨在评估全血细胞计数(CBC)和 CBC 比值标志物在诊断脓毒症和感染性休克以及预测烧伤患者死亡率方面的效果。研究对 2757 例烧伤患者进行了评估,以确定各种 CBC 参数、它们的比值与脓毒症及其相关死亡率之间的相关性。分析的关键标志物包括红细胞分布宽度(RDW)、平均血小板体积(MPV)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和平均血小板体积与血小板比值(MPVPR)。研究结果表明,65.5%的患者发生了脓毒症,24.3%的患者死亡。CBC 参数 RDW、MPV、NLR、MPVPR 和 MPV 与淋巴细胞比值(MPVLR)与脓毒症和死亡率显著相关。这些标志物表现出相当大的时间变化,在未调整的广义估计方程(GEE)模型中,曲线下面积(AUC)超过 0.65。本研究强调了 RDW、MPV、NLR、MPVPR 和 MPVLR 作为诊断脓毒症、感染性休克和预测烧伤患者死亡率的重要预后工具的潜力。尽管这是基于单中心数据集的研究,但研究结果通过促进更早期、更精确的诊断和治疗策略,为脓毒症管理提供了参考。需要进一步开展多中心研究来验证这些发现并扩大其适用性,为该关键领域的未来探索奠定坚实基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c5e/10774327/062af82f7de9/41598_2023_50695_Fig1_HTML.jpg

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