Effects Of Dynamic Changes Of Platelet Count And Other Related Risk Factors On The Prognosis Of Severe Burn Patients

Background:In many diseases,platelet counts are associated with inflammatory activity and prognosis.Platelet counts fluctuations often occur in patients with severe burns.The purpose of this study is to determine whether the dynamic changes in platelet counts after severe burns can be used as a prognostic marker and to evaluate whether platelet counts can predict the prognosis of patients with severe burns.Method:Collect the platelet counts lower than normal from the patients in the ICU of Burn Surgery of the First Affiliated Hospital of Nanchang University from June 2014to June 2019,including all platelet counts,gender,age,length of stay,total burn area.The data were divided into 15 survival groups and 51 death groups based on whether the patients died.Results:?1?In 5 years,66 patients with platelet counts below normal during admission,with a mortality rate of 77.27%.?2?Compared with the survival group and the death group,there were statistical differences in the length of hospitalization and total body surface area and number of operations in the burn area,the difference was statistically significant?P<0.05 or P<0.01?.?3?The changes in platelet count:?1?Most patients developed platelet decline first on the 3rd day after injury;?2?the lowest platelet counts appeared on the 4^th to 5^thh day;?3?and then gradually returned to normal on the 9^th to 16^th day,the difference was statistically significant?P<0.05 or P<0.01?.?4?Cox survival analysis showed that total body surface area and platelet counts were independent risk factors for death in patients with severe burns?risk ratio was0.984,and 95%confidence interval was 0.974 to 0.992,P<0.01?.?5?The area under the ROC curve of the average platelet count for predicting the death of 66 patients with severe burns was 0.834?95%Confidence interval is 0.720?0.948,P<0.01?.The optimal threshold of platelet count is 137×10⁹/L,and its sensitivity and specificity for death prediction are 86.7%and 78.4%.Conclusion:The platelet count decreased fell in severe burn patient at the early stage,and the reduction and duration of platelet decrease in the patients in the death group within 30days lasts longer as well.The dynamic change of platelet counts is closely related to the 30-day mortality of severe burn patients.It can be used as a strong predictor of disease severity and may assess the prognosis of burn patients.