Backgroud/purpose

Bloodstream infections (BSI) are common in patients with major burns, but its effect on mortality remains controversial. This study was aimed to investigate if BSI is significant risk factor of mortality?

Methods

This is a retrospective chart review study included 266 adult patients admitted to our burn center from 2000 to 2019. Age, sex, inhalation injuries, total burn surface area (TBSA), duration of stay in intensive care unit, BSI and mortality were variables studied. Fisher exact test, Mann–Whitney test and logistic regression was used for statistical analysis.

Results

There were 234 survivors and 32 non-survivors. Male was predominant. The overall incidence of BSI was 18.8%, and the overall crude mortality was 12%. Burns $\ge$30% TBSA and BSI were significant risk factors. A predictive function based on$$30% TBSA and BSI within 14 days after the onset of burns (BSI-14) was derived. The function has a sensitivity of 0.97, specificity of 0.42 and achieved a maximum Youden Index at functional value $\ge$0.05727. The mortality probability of BSI-14 in burns $\ge$30% TBSA was 40.8%.

Conclusions

BSI and burns $\ge$30% TBSA were significant risk factors of mortality. Early detection of BSI-14 is critical in burn care as its probability of mortality can be as high as 40% in patients $\ge$30% TBSA of burns. To reduce the risk of mortality, early in ventilator withdrawal, invasive lines and tubes removal, and early grafting should be emphasized besides infection control and appropriate use of antibiotics.

中文翻译：

---

早期血流感染是否对成人烧伤患者的住院死亡率构成重大风险？

背景/目的

血流感染 (BSI) 在重度烧伤患者中很常见，但其对死亡率的影响仍存在争议。本研究旨在调查 BSI 是否是死亡的重要危险因素？

方法

这是一项回顾性图表回顾研究，包括 2000 年至 2019 年入住我们烧伤中心的 266 名成年患者。年龄、性别、吸入性损伤、总烧伤表面积 (TBSA)、重症监护病房停留时间、BSI 和死亡率是研究的变量. Fisher精确检验、Mann-Whitney检验和逻辑回归用于统计分析。

结果

有 234 名幸存者和 32 名非幸存者。男性占主导地位。BSI 的总体发病率为 18.8%，总体粗死亡率为 12%。伯恩斯$\ge$30% TBSA 和 BSI 是重要的风险因素。基于预测函数$$获得烧伤后 14 天内 30% TBSA 和 BSI (BSI-14)。该函数的灵敏度为 0.97，特异性为 0.42，并在函数值处达到最大约登指数$\ge$0.05727。BSI-14在烧伤中的死亡率$\ge$30% TBSA 为 40.8%。

结论

BSI 和烧伤$\ge$30% TBSA 是死亡的重要危险因素。BSI-14 的早期检测在烧伤护理中至关重要，因为其在患者中的死亡率可能高达 40%$\ge$30% TBSA 的烧伤。为降低死亡风险，除感染控制和适当使用抗生素外，还应重视呼吸机撤除早期、侵入性导管和导管拔除以及早期移植。