Tedesco Diana Julia, Hutter Maria Fernanda, Khalaf Fadi, Ricciuti Zachary, Jeschke Marc G
Department of Biochemistry and Biomedical Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada.
Centre for Burn Research, Hamilton Health Sciences, Hamilton, ON, L8L 2X2, Canada.
Mil Med Res. 2025 Sep 1;12(1):55. doi: 10.1186/s40779-025-00643-x.
Although sepsis is known to be the leading cause of morbidity and mortality in adult burn patients, its epidemiology and impact are poorly understood. This study aims to address these gaps by further characterizing predictors of sepsis and comparing outcomes between septic and non-septic burn patients in different age groups.
We included patients (≥ 18 years) with thermal burn injuries ≥ 5% total body surface area (TBSA) admitted to two burn centers between 1 January 2006 and 30 June 2021, and 1 January 2023 and 6 April 2025. Patients were stratified by age into adults (18-59 years) and older adults (≥ 60 years), and by diagnosis of sepsis during hospitalization (sepsis vs. control). Demographics, injury characteristics, mortality, and in-hospital complications were assessed. Multivariate logistic regression models were used to identify predictors of sepsis and mortality among septic patients.
This study included a total of 1465 patients, including 1094 adults and 371 older adults. Sepsis was diagnosed in 20.1% of adult burn patients, with a median onset at 10 d following injury. Increasing age, greater TBSA, and inhalation injury were identified as significant risk factors for sepsis. Among patients who developed sepsis, earlier onset and female sex were associated with an elevated risk of mortality. In older adults, the incidence of sepsis was 22.9%, with a median onset at 11 d post-burn. The odds of sepsis diagnosis increased with higher TBSA and the presence of inhalation injury. Earlier sepsis onset was associated with increased mortality in older adults.
Sepsis represents a significant clinical challenge in burn patients, with age, TBSA, inhalation injury, and comorbidities significantly influencing its incidence and outcomes. Notably, early sepsis onset and female sex are associated with increased mortality, highlighting the need for advanced monitoring, prompt interventions, and the exploration of innovative sex-specific strategies to optimize outcomes in this high-risk population.
尽管脓毒症是成年烧伤患者发病和死亡的主要原因，但其流行病学和影响仍知之甚少。本研究旨在通过进一步描述脓毒症的预测因素，并比较不同年龄组脓毒症烧伤患者和非脓毒症烧伤患者的结局，来填补这些空白。
我们纳入了2006年1月1日至2021年6月30日以及2023年1月1日至2025年4月6日期间入住两个烧伤中心的热烧伤患者（≥18岁），其烧伤面积≥5%体表面积（TBSA）。患者按年龄分为成年人（18 - 59岁）和老年人（≥60岁），并根据住院期间脓毒症诊断情况（脓毒症组与对照组）进行分层。评估了人口统计学、损伤特征、死亡率和住院并发症。采用多变量逻辑回归模型确定脓毒症患者中脓毒症和死亡的预测因素。
本研究共纳入1465例患者，其中成年人1094例，老年人371例。20.1%的成年烧伤患者被诊断为脓毒症，中位发病时间为受伤后10天。年龄增加、TBSA增大和吸入性损伤被确定为脓毒症的重要危险因素。在发生脓毒症的患者中，发病较早和女性与死亡风险升高相关。在老年人中，脓毒症发病率为22.9%，中位发病时间为烧伤后11天。脓毒症诊断的几率随TBSA升高和存在吸入性损伤而增加。脓毒症发病较早与老年人死亡率增加相关。
脓毒症是烧伤患者面临的重大临床挑战，年龄、TBSA、吸入性损伤和合并症显著影响其发病率和结局。值得注意的是，脓毒症早期发病和女性与死亡率增加相关，这凸显了在这一高危人群中进行高级监测、及时干预以及探索创新性性别特异性策略以优化结局的必要性。
