The Analysis Of The Results And Risk Factors Forsepsis In Burned Adult

Objective To explore the result and risk factors for sepsis in burned adult with the way of the retrospective analysis. In this retrospective study,we determine the associated with the intensity of mortality and influencing factors of burn sepsis through statistical methods, so as to guide the clinician to judge the risk factors to preferably prevent and cure burn sepsis,hoping that it is propitious to reduce the mortality of burn patients with sepsis.Methods Basing on the confirmed diagnosis of sepsis,we have collected 136 cases of the patients in the burned ward of The General Hospital of Ningxia Medical University from June 2006 to June 2014.We have collected such data:gender,age, the cause of burn, the time of injury,total body surface area(TBSA),third-degree area, inhalation injury, MODS, shock,the first operation time, etiologic results, mortality, hospitalization time,the cause of death,etc. In order to screening out the independent risk factors of death in burn sepsis,we made single factor analysis with the various factors and made multivariate analysis on the factors with statistical significance. According to the different outcome, adult patients with burn sepsis were divided into survival group and death group and compare the influencing factors.Results(1)Of the 136 burn sepsis patients,there were 128 males and 8 females,with a male:female ratio of 16:1;mean age:(36.1±11.39) years.The mean time of injury was(4.82±4.334) hours; hospitalization time was(74.29±61.37) dates and the mean first operation time was(6.51±8.35) dates.There were 105 cases with flame burn and total body surface area: mean(68.55±25.36)% TBSA, Ⅲ° area: mean(38.18±29.51)% TBSA.There were 94 cases complicating with inhalation injury(69.1%);32 cases complicating with MODS(23.5%) and 109 cases complicating with shock(80.1%).Form the etiologic results, 32 cases were negative;46 cases were multiplicity of infection and 58 cases were monoinfect.(2)There were 44 cases died, 38 cases complicating with inhalation injury; 21 cases complicating with MODS; 44 cases complicating with shock and 26 cases died of sepsis, 17 cases died of MODS and 1 cases died of shock.(3)In the results of single factor analysis, the results showed that 7 factors were associated with the death for sepsis in burned adult(P< 0.05), such as the time of burn,TBSA, third- degree burn area, inhalation injury,MODS,shock and the time of first operation.On the controal, gender, age, the cause of burn, etiologic results were eliminated(P > 0.05).(4)According to the multivariate analysis on the factors,we obtained that the time of first operation and MODS were the independent risk factors of death in burn sepsis(r=0.366, P < 0.05;r=0.256, P < 0.05) by Logistic regression analysis.Conclusion(1) The mortality in patients with burn sepsis was 32.4%, with 18 ~ 50 years old male dominated and the flame burns was the main cause of burn.(2). The time of burn,TBSA, third- degree burn area, inhalation injury,MODS,shock and the time of first operation were associated with the death for sepsis in burned adult.Among them, the time of first operation and MODS were the independent risk factors.