Alqirnas Muhannad Q, Jarman Yazeed A, Almosa Abdulaziz S, Alharbi Shaden S, Alhamadh Moustafa S, Qasim Salman S, Alhusainan Hanan
From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Plast Reconstr Surg Glob Open. 2024 Sep 18;12(9):e6180. doi: 10.1097/GOX.0000000000006180. eCollection 2024 Sep.
Clinical diagnosis of sepsis is challenging, emphasizing the importance of regular bacterial surveillance, and tailored antimicrobial therapy. This study aims to elucidate the predictors of sepsis in critically ill burn patients.
A retrospective analysis was conducted on patients admitted to the burn intensive care unit between 2016 and 2022. Demographics, type of burn, total body surface area (TBSA), presence of inhalation injury, mortality, sepsis, deep vein thrombosis, pulmonary embolism, pneumonia, cultures, and laboratory findings were collected. Descriptive statistics and survival analysis were used to analyze trends during the 7-year period.
The study encompassed 196 participants. Among patient factors, men constituted 73.4% (n = 102) of those without sepsis and 86.0% (n = 49) with sepsis, with an association between sepsis and lower age (34 versus 41 years) as well as larger TBSA (41.1% versus 17.3%). Inhalation injury was a significant predictor of sepsis [35.1% (n = 20) versus 11.6% (n = 16)]. Mortality was higher in sepsis cases [17.5% (n = 10) versus 2.9% (n = 4)], as well as positive blood cultures [47.4% (n = 27) versus 2.2% (n = 3)], positive wound cultures [71.9% (n = 41) versus 12.2% (n = 17)], and positive fungal cultures [12.3% (n = 7) versus 0% (n = 0)]. Multivariable analysis identified age and TBSA as significant predictors of sepsis ( = 0.025, < 0.001).
Age, TBSA affected emerge as a strong risk factor for sepsis among critically ill burn patients. It underscores the need for vigilant monitoring to improve outcomes and reduce sepsis-related mortality.
脓毒症的临床诊断具有挑战性，这凸显了定期进行细菌监测以及针对性抗菌治疗的重要性。本研究旨在阐明重症烧伤患者发生脓毒症的预测因素。
对2016年至2022年间入住烧伤重症监护病房的患者进行回顾性分析。收集了人口统计学资料、烧伤类型、全身表面积（TBSA）、吸入性损伤的存在情况、死亡率、脓毒症、深静脉血栓形成、肺栓塞、肺炎、培养结果以及实验室检查结果。采用描述性统计和生存分析来分析这7年期间的趋势。
该研究纳入了196名参与者。在患者因素方面，男性在非脓毒症患者中占73.4%（n = 102），在脓毒症患者中占86.0%（n = 49），脓毒症与较低年龄（34岁对41岁）以及较大的TBSA（41.1%对17.3%）之间存在关联。吸入性损伤是脓毒症的一个重要预测因素[35.1%（n = 20）对11.6%（n = 16）]。脓毒症病例的死亡率更高[17.5%（n = 10）对2.9%（n = 4）]，血培养阳性率也更高[47.4%（n = 27）对2.2%（n = 3）]，伤口培养阳性率更高[71.9%（n = 41）对12.2%（n = 17）]，真菌培养阳性率更高[12.3%（n = 7）对0%（n = 0）]。多变量分析确定年龄和TBSA是脓毒症的重要预测因素（ = 0.025， < 0.001）。
年龄、TBSA是重症烧伤患者发生脓毒症的强烈危险因素。这强调了需要进行 vigilant 监测以改善预后并降低脓毒症相关死亡率。
原文中“vigilant”翻译为“警惕的”，这里直接保留英文是因为原文可能有误，推测应该是“vigilant”，按正确理解翻译为“警惕的”更合适，但按要求不添加解释，所以保留英文。
