| Objective To understand and study the APACHE-II score system in the use of the value of severe burns, APACHE-Ⅱ scoring system that can guide doctors to keep abreast of the severity of burn patients; other hand, can improve quality of life for burn patients.Methods This study was conducted on a total of 177 severe burn patients(Patients with severe burn and extra heavy burn patients) who were clinically diagnosed at Ningxia Medical University General Hospital from 2010 to 2014: Collection of gender, age, 24 hours a physiological index worst value, including:Body temperature, mean arterial pressure, heart rate, breathing, blood gas analysis(PO2, p H value), serum sodium, serum potassium, serum creatinine, hematocrit, white blood cell count etc. Further investigation of patients with history of chronic diseases and patients were scored by GCS. Each item worst value recorded 24 hours of admission, and scored according to APACHE Ⅱ. Each patient can be drawn from the corresponding scores and calculate the predicted risk of death in patients with R-values. Also according to the eighth edition of the surgical book which describes the group ratings ladder(less than 8 points group, 8-15 points group, 15-20 points group, more than 20 points groups). Another patient diagnosis according to the severity of the situation burns group( group can be divided into severe burns, extra heavy burn group). Also according to the survival of the patients were divided into( survival group, death group). Inter- group analysis, we will be able to draw correlations between APACHE Ⅱ scores in each group.Results( 1) 177 cases of severe burn patients, male 155 cases, female 22 cases, male to female ratio was 0.14, with an average age of onset was 37.36 ± 12.576 years old( 17-83 years old). Male average age 37.15 ± 12.475 years old, female average age 38.82 ± 13.482 years. Men who always have severe burns over the age of 20 to 40 years old, female who always have severe burns over the age of 30 to 40 years old.( 2) Serious burns can be divided according to the degree of burns : severe burn patients, accounting for 48.59%; extra heavy burn patients, accounting for 51.41%.( 3) In accordance with APACHE Ⅱ score grouping, which is less than eight points groups, 80 cases, 45.19%. 8-15 points group, 58 cases, accounting for 32.77%. 15-20 points group, 27 cases, accounting for 15.25 %. more than 20 points groups, 12 cases, accounting for 6.77%.( 4) Grouped according to the patient’s survival : survival group, 142 cases, accounting for 80.22%. death group, 35 cases, accounting for 19.78%.( 5) according to the severity of the burn group, there is a difference between the two groups(p <0.05), the group APACHE Ⅱ score was positively correlated with the severity of burn(p <0.05). Where the correlation coefficient( severe group r value : 0.224, extra heavy burn group r value : 0.764, where extra heavy burn group with better correlation).( 6) According APACHE Ⅱ score grouping, there is a difference between the groups of(p <0.05), which is less than 8 points grouping does not exist correlation(p> 0.05). Other groups burn severity among scores of each group were positively correlated(p <0.05). Where the correlation coefficient( r = 8-15 points Grouping : 0.632; 15-20 points grouping r value : 0.692; r values greater than 20 points groups : 0.726).( 7) According to the survival of patients with the disease grouping, there is a difference between the two groups(p <0.05), the group APACHE Ⅱ score was positively correlated with the severity of burn(p <0.05). Where the correlation coefficient( r values survivor group : r = 0.691;dead group : 0.564).( 8) According APACHE Ⅱ score, where the individual risk of death predictive value R value, remove the group of less than 8 points. The remaining group is different, its value and burn severity was negatively related.( 9) 177 cases of patients with APACHE Ⅱ score and area( burn severity) showed a positive correlation, the correlation coefficient r value : 0.680).According severe burns( burns extent) to remove the "less than eight points in the group " in APACHE Ⅱ score packet, the other group has significant differences and statistical significance; According APACHE Ⅱ score, which burns the severity of each group there was a significant difference and statistical significance; According APACHE Ⅱ scoring system, Survival group and death group which have significant differences and statistical significance. 177 patients with an average value of mortality risk prediction coefficient R collection is 4.9527%. More severe burns( risk of death R = 6.3582%) higher than in patients with severe( mortality risk R = 3.6648%). Less than 8 groups( risk of death R = 1.1066%); 8-15 group( mortality risk R = 3.7391%); 15-20 group( mortality risk R = 9.4188%); 20 points or more groups( risk of death R = 19.1221%), R value is increased sequentially by scoring stage.Conclusions 1、 APACHE II score can be applied to patients with severe burns. Minor burns to the patient is not significant. APACHE II score, the higher score, the greater the severity of their burns, severe burn on more obvious. Similarly APACHE II score, the higher score, the greater the value of mortality risk prediction R value.2、 APACHE II score can evaluate the condition of burn cases, assess the condition and prognosis of patients with burns. It can help and guide physicians in clinical use. |
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