Bordeanu-Diaconescu Eliza-Maria, Grosu-Bularda Andreea, Frunza Adrian, Grama Sabina, Andrei Mihaela-Cristina, Neagu Tiberiu-Paul, Lascar Ioan, Hariga Cristian-Sorin
Department of Plastic Surgery and Reconstructive Microsurgery, "Carol Davila" University of Medicine and Pharmacy Bucharest, 010825 Bucharest, Romania.
Burn Centre, Emergency Clinical Hospital of Bucharest, 014461 Bucharest, Romania.
Diagnostics (Basel). 2024 Mar 9;14(6):582. doi: 10.3390/diagnostics14060582.
Burn injuries are the most severe type of trauma, with complex biological consequences associated with high rates of morbidity and mortality. Prompt recognition and management of burn-related complications are imperative for improving the vital and functional prognosis of the patient. Changes in biological parameters can be essential determinants in the prognosis of the burned patient. Thrombocytopenia in critically ill patients is linked to an elevated risk of mortality. We sought to investigate the significance of thrombocytopenia in severely burned patients while considering the limited available data in the literature.
A two-year retrospective study was conducted on 90 patients with severe burns admitted to our Burn Centre. Demographic data, burn lesion characteristics, and daily total blood counts, including platelet assessment, complications, and mortality, were recorded and analyzed.
Patients with extensive burns in our study had a poor prognosis based on their Abbreviated Burn Severity Index score (ABSI), age, percentage of total body surface area (TBSA) burned, presence of third-degree burns, and inhalation injuries. Regardless of the moment, patients with thrombocytopenia in our study died significantly more frequently. Compared with the survivors, the platelet count was significantly lower at any given time in the non-survivors group. Significant statistical associations between thrombocytopenia and ABSI score, burn surface area, presence of third-degree burns, and inhalation injuries were identified at different timeframes post-burn injury. Sepsis was encountered in one-third of the patients. Thrombocytopenia was more frequent in patients with sepsis who did not survive compared to survivors and did not normalize until the time of death.
Thrombocytopenia represents an early indicator of severe complications and outcome predictor in severely burned patients. It is correlated with recognized negative prognostic factors and also with sepsis occurrence. Future research efforts should focus on refining early detection parameters and interventions to improve the prognosis of burn patients.
烧伤是最严重的创伤类型，具有复杂的生物学后果，发病率和死亡率很高。及时识别和处理烧伤相关并发症对于改善患者的生命和功能预后至关重要。生物学参数的变化可能是烧伤患者预后的重要决定因素。重症患者的血小板减少与死亡风险升高有关。鉴于文献中可用数据有限，我们试图研究血小板减少在重度烧伤患者中的意义。
对我院烧伤中心收治的90例重度烧伤患者进行了为期两年的回顾性研究。记录并分析人口统计学数据、烧伤创面特征以及每日全血细胞计数，包括血小板评估、并发症和死亡率。
根据简化烧伤严重程度指数（ABSI）评分、年龄、烧伤总面积（TBSA）百分比、三度烧伤的存在情况和吸入性损伤，我们研究中大面积烧伤的患者预后较差。无论何时，我们研究中血小板减少的患者死亡频率明显更高。与幸存者相比，非幸存者组在任何给定时间的血小板计数均显著更低。在烧伤后不同时间框架内，血小板减少与ABSI评分、烧伤面积、三度烧伤的存在情况和吸入性损伤之间存在显著的统计学关联。三分之一的患者发生了脓毒症。与幸存者相比，脓毒症患者中未存活者的血小板减少更为常见，且直到死亡时仍未恢复正常。
血小板减少是重度烧伤患者严重并发症的早期指标和预后预测因素。它与公认的不良预后因素相关，也与脓毒症的发生相关。未来的研究应集中在完善早期检测参数和干预措施，以改善烧伤患者的预后。
