Prognosis Of Severe Burns Complicated With Hypernatremia And Clinical Analysis Of Risk Factors Related To Death

Objective:To explore the risk factors related to the death of patients with severe burns complicated with hypernatremia,in order to provide a clinical basis for the clinical treatment and control of patients with severe burns and to reduce the mortality of patients with hypernatremia after burns.Methods:To collect the clinical data of patients with severe burns complicated with hypernatremia who met the inclusion criteria of this study from July 2013 to July2018.They were divided into death group and survival group according to survival or not.The correlation between gender,age,burn properties,total burn area,? degree burn area,hospital admission time after burn,first operation time,inhalation injury,tracheotomy,shock,Acute Kidney Injury(AKI),sepsis,Multiple Organ Dysfunction Syndrome(MODS),first high sodium time,highest blood sodium,high sodium duration,etiology results and mortality of severe burn patients complicated with hypernatremia was observed,statistically significant single factor included in multivariate logistic regression analysis,further screening out the independent risk factors of death in patients with severe burns complicated with hypernatremia.Results:1.From July 2013 to July 2018,a total of 430 patients with a total burn area of >30% and ?18 and <65 years of age were enrolled in our hospital.Seventy-four patients who met the inclusion criteria were included in the study and were diagnosed with severe burns with hypernatremia.The overall incidence was 17.2%.2.47 patients died of the 74 patients with severe burns complicated with hypernatremia,27 survived,and the mortality rate was 63.5%.There were 38 males and 9 females in the death group;mean age(44±12)years old;burn characteristics:40 cases of flame burns,7 cases of hydrothermal burns,0 cases of electric shocks;direct cause of death: 40 cases of MODS(85.1%),sepsis There were 5 cases(10.6%)and 2 cases of shock(4.3%).There were 21 males and 6 females in the survival group;mean age(48±12)years old;burn characteristics: 23 cases of flame burn,2cases of hydrothermal burns,and 2 cases of electric shock.3.Univariate analysis showed differences in total burn area,? degree burn area,inhalation injury,tracheotomy,shock,AKI,sepsis,MODS,first high sodium time,highest blood sodium and high sodium duration in both groups.Statistically significant(P<0.05).Multivariate logistic regression analysis showed that ? degree burn area(OR=1.099,95%CI 1.039~1.162,P<0.05),high sodium duration(OR=1.515,95%CI 1.061?2.164,P<0.05)and MODS(OR=38.977,95%CI3.414~444.988,P<0.05)were independent risk factors for death in patients with severe burns complicated with hypernatremia.Conclusions:1.The incidence of hypernatremia after severe burns was 17.2%,and the mortality rate after hypernatremia was as high as 63.5%.The deaths occurred in men between 35 and 54 years old.The cause of death was mainly MODS.The flame was The main cause of injury.2.Total burn area,? degree burn area,inhalation injury,tracheotomy,shock,AKI,sepsis,MODS,first high sodium time,highest blood sodium and high sodium duration were associated with mortality in severe burn patients with hypernatremia.Among them,? degree burn area,high sodium duration and MODS were independent risk factors for death in severe burns complicated with hypernatremia.Further attention to the related risk factors,early establishment of prevention and treatment concept,active control of infection,attention to wound closure,timely correction of hypernatremia,and strengthening the protection and support of organ functions are conducive to improving the prognosis of burn complicated with hypernatremia.