血清降钙素原升高预测大面积烧伤的严重程度和预后

IF 2.1 4区 医学 Q2 SURGERY Journal of Investigative Surgery Pub Date : 2022-05-15 DOI:10.1080/08941939.2022.2073489
Zhaoxing Liu, Dawei Li, Xinzhu Liu, Bohan Zhang, Yu Zang, Jinglong Ma, Wen Zhang, Yuezeng Niu, Chuan'an Shen
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PCT level in the shock phase was positively correlated with burn area, depth, degree of inhalation injury, delay in fluid resuscitation, APACHE II, and SOFA scores. The peak values of PCT during shock and infection phases were significantly higher in the non-survivors than in the survivors. The areas under the ROC curve for predicting death were 0.788 and 0.926, respectively, and 5.4 ng/mL (OR = 5.33) and 8.5 ng/mL (OR = 14.49) were the high-risk thresholds for death prediction. Conclusions Serum PCT level in the shock phase is a potential indicator for evaluating the severity of burns, while the PCT level during the infection period can be used as an early warning indicator for severe systemic infection. 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引用次数: 4

摘要

摘要目的分析影响大面积烧伤患者血清降钙素原(PCT)升高的因素,探讨其在评估严重程度和预后方面的潜在价值。方法回顾性分析2014年1月至2019年12月我院烧伤中心收治的139例大面积烧伤患者的临床资料。采用Spearman秩相关系数分析影响PCT水平升高的因素。PCT对死亡的预测能力通过受试者操作特征(ROC)和多元逻辑回归分析进行评估。结果72例患者在休克期血清PCT浓度升高,但均无明显感染迹象。休克期PCT水平与烧伤面积、深度、吸入性损伤程度、液体复苏延迟、APACHE II和SOFA评分呈正相关。在休克和感染阶段,非幸存者的PCT峰值明显高于幸存者。ROC曲线下预测死亡的面积分别为0.788和0.926,以及5.4 ng/mL(或 = 5.33)和8.5 ng/mL(或 = 14.49)是预测死亡的高危阈值。结论休克期血清PCT水平是评估烧伤严重程度的潜在指标,而感染期PCT水平可作为严重全身感染的早期预警指标。休克和感染期间PCT峰值的高水平表明预后不良的风险增加,因此需要有针对性的治疗。
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Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns
Abstract Purpose To analyze the factors affecting the elevation of serum procalcitonin (PCT) in patients with extensive burns, and explore its potential value in evaluating the severity and prognosis. Methods Clinical data of 139 patients with extensive burns admitted to our burn center from January 2014 to December 2019 were retrospectively analyzed. Spearman’s Rank correlation coefficient was used to analyze the factors influencing the elevated PCT levels. The predictive power of PCT for death was evaluated by receiver operating characteristic (ROC) and multiple logistic regression analysis. Results 72 cases exhibited elevated serum PCT concentrations during the shock phase, but none of them had obvious signs of infection. PCT level in the shock phase was positively correlated with burn area, depth, degree of inhalation injury, delay in fluid resuscitation, APACHE II, and SOFA scores. The peak values of PCT during shock and infection phases were significantly higher in the non-survivors than in the survivors. The areas under the ROC curve for predicting death were 0.788 and 0.926, respectively, and 5.4 ng/mL (OR = 5.33) and 8.5 ng/mL (OR = 14.49) were the high-risk thresholds for death prediction. Conclusions Serum PCT level in the shock phase is a potential indicator for evaluating the severity of burns, while the PCT level during the infection period can be used as an early warning indicator for severe systemic infection. High levels of PCT peaks during the shock and infection periods indicate an increased risk of poor prognosis, and targeted treatment is required accordingly.
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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