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1.
Sevgi Yavuz Ali Anarat Sabri Acartürk Ahmet Cemil Dalay Erol Kesiktaş Metin Yavuz Tahsin Oğuz Acartürk 《Burns : journal of the International Society for Burn Injuries》2014
Introduction
Neutrophil gelatinase associated lipocalin (NGAL) is a novel predictor of acute kidney injury (AKI), which increases with inflammation. We aimed to assess whether serum NGAL (SNGAL) and urine NGAL (UNGAL) can predict AKI in burned children.Methods
Patients were referred within the 12 h of burn to our center. Serum samples for SNGAL, C-reactive protein (CRP), procalcitonin (PCT) and urine for UNGAL, microalbumine (Umalb), creatinine (Ucr) were obtained at both admission and the 5th day after burn. Blood urea nitrogen (BUN) and serum creatinine (Scr) were examined daily.Results
Twenty-two subjects were enrolled and six (27.2%) of them developed AKI within the 48 h of injury. Burn size and abbreviated burn severity index (ABSI) were significantly increased in patients with AKI. CRP, PCT, SNGAL and UNGAL levels at admission and day 5 were significantly higher in patients with AKI than in those without AKI and controls. Scr was not significant between AKI and non-AKI groups at hospital days 1 and 5. A SNGAL level of 315 ng/ml and a UNGAL level of 100 ng/ml were determined as predictive cut-off values of AKI at admission (sensitivity and specificity: 71.4%, 83.3% and 93.3%, 93.7%, respectively). SNGAL and UNGAL were positively correlated with CRP, PCT, ABSI and Umalb/Ucr.Conclusion
SNGAL and UNGAL are good early predictors of AKI in children with severe burn. NGAL might reflect the severity of burn insult and also could be used as an indicator of inflammation in burn children. 相似文献2.
《Burns : journal of the International Society for Burn Injuries》2020,46(1):136-142
IntroductionAir-fluidized therapy (AFT) has long been used in the treatment of severe burns. In patients with extensive burns involving the posterior trunk, we aim to keep affected posterior areas dry and to postpone their treatment, initially applying available split-thickness skin grafts in functionally more important regions. We retrospectively assessed the impact of AFT on the survival of patients treated in the burn intensive care unit (ICU) of the Medical University of Vienna, Austria, between 2003 and 2016.MethodsThis retrospective single-center study included patients aged ≥18 years with burned total body surface area (TBSA) ≥20% and IIb–III° thermal injuries on the posterior trunk who received AFT. Survival rates were compared with those predicted by the abbreviated burn severity index (ABSI). Demographic, clinical, and surgical data were analyzed.ResultsSeventy-five of 110 patients with posterior trunk burns received AFT. Their survival rate exceeded that predicted by the ABSI score (mean ABSI, 10.0 ± 2.0; 73.3% (95% CI: 62-83%) survival rate vs. 20-40% predicted; p < 0.0001); no such difference was observed in the non-AFT group (mean, 8.8 ± 1.9; 65.7% (95% CI: 48-81%) survival rate vs. 50-70% predicted). Patients receiving AFT had significantly greater TBSA (median, 50% (35–60) vs. 30% (25–45) and longer ICU stays (median, 63 (36–92) vs. 18 (9–52) days; both p < 0.0001). Fifty-one (68.0%) patients in the AFT group and 26 (74.3%) patients in the non-AFT group underwent posterior trunk surgery (p = 0.66) a median of 16 (10–26) and 5 (2.5–9.5) days, respectively, after admission (p < 0.0001).ConclusionsPatients receiving AFT had significantly better survival than predicted by ABSI score in contrast to patients not receiving AFT although burn injuries in this group were more severe (greater TBSA, higher ABSI). As intensive care was similar in these groups aside from AFT, the better survival could be attributed to this additional therapy. 相似文献
3.
Hemington-Gorse SJ Clover AJ Macdonald C Harriott J Richardson P Philp B Shelley O Dziewulski P 《Burns : journal of the International Society for Burn Injuries》2011,37(6):981-985
Introduction
Despite advances in burn care some injuries remain non survivable. Good end of life care for these patients is arguably as important as life prolonging care. The Liverpool Care Pathway is a useful tool for providing good quality end of life care. It has previously been modified for the acute setting. We modified it further specifically for use in burn care in 2007 and would like to share our experience of using it.Methods
A retrospective case series of deaths occurring between 01/01/08 and 31/12/09 is presented and adherence to the Burn Modified Liverpool Care Pathway (BM-LCP) is assessed.Results
There were 22 deaths over the study period with a mean TBSA of 55%. Mean Acute Burn Severity Index score (ABSI) 12.5. A decision of futility was made in 14 cases, 11 of these were started on the BM-LCP. 7 were started on the pathway at the time of admission. Mean time from decision to start the pathway to death 11 h (range 3-48). There were no variances from the pathway.Conclusion
The BM-LCP appears to be an appropriate tool for assisting in end of life care in burns and when used appears to improve end of life care. We recommend its use and would encourage others to implement its use. 相似文献4.
Burn trauma leads to increased production of reactive oxygen species and compromises the antioxidant systems. The aim of present study was to assess the total antioxidant capacity of plasma (TAC) in burn patients and evaluate its usefulness in clinical practice through analysis of association between TAC and indices of patient prognosis. We investigated TAC in 48 adults and 27 children with severe burn trauma and in 26 healthy controls. TAC was measured on the admission and every week thereafter until discharge or death of patients. The prognosis of the patients was evaluated by the Baux Index and the Abbreviated Burn Severity Index (ABSI). TAC was significantly decreased in both groups with burn trauma as compared with the controls and the decrease was a long lasting event. Significant indirect negative correlation was found between BSAB and TAC values measured in the later phase of injury. In adults an indirect correlation was found between ABSI and the lowest TAC measured on the 7th day or later. Correlations between TAC values and Baux Index were absent both in adults and in children. 相似文献
5.
François Dépret Louis Boutin Jiří Jarkovský Maité Chaussard Sabri Soussi Aurélien Bataille Haikel Oueslati Nabila Moreno Christian de Tymowski Jiří Parenica Klára Benešová Thomas Vauchel Axelle Ferry Mourad Benyamina Alexandru Cupaciu Maxime Coutrot Jean-Pierre Garnier Kevin Serror Matthieu Legrand 《Burns : journal of the International Society for Burn Injuries》2018,44(8):1887-1894
Objective
We aimed at assessing the predictive value of plasmatic Neutrophil Gelatinase Associated Lipocalin (pNGAL) at admission and severity scores to predict major adverse kidney events (MAKE, defined as death and/or need for renal replacement therapy (RRT) and/or non-renal recovery at day 90) in critically ill burn patients.Material and methods
Single-center cohort study in a burn critical care unit in a tertiary center, including all consecutive severely burn patients (total burned body surface >20%) from January 2012 until January 2015 with a pNGAL dosage at admission. Reclassification of patients was assessed by Integrated Discrimination Improvement (IDI).Measurements and results
87 patients were included. Mean age was 47.7 (IQ 25–75: 33.4–65.2) years; total burn body surface area was 40 (IQ 25–75: 30–55) % and ICU mortality 36%. 39 (44.8%) patients presented a MAKE, 32 (88.9%) patients died at day 90. pNGAL was higher in the MAKE group (423 [IQ 25–75: 327–518] pg/mL vs 184 [IQ 25–75: 147–220] pg/mL, p < 0.001). In multivariate analysis, pNGAL and abbreviated burn severity index (ABSI) remained associated with MAKE (OR 1.005 [CI 95% 1.0005–1.009], p = 0.03 and OR 1.682 [CI95%1.038–2.726], p = 0.035 respectively). Adding pNGAL to abbreviated burn severity index, simplified organ failure assessment and the simplified acute physiology score 2 did outperform clinical scores for the prediction of MAKE and AKI and for most severe forms of AKI and allowed a statistically significant reclassification of patients compared to ABSI for MAKE, RRT, AKI at Day 7 and AKI during hospitalization with a number of patients needed to screen to detect one extra episode of MAKE was 44, 13 for severe AKI and 15 for AKI.Conclusions
pNGAL at admission is associated with the risk of MAKE in this population, and outperform severity scores when associated. Interventional studies are now needed to assess if impact of biomarkers-guided strategies would improve outcome. 相似文献6.
Forster NA Zingg M Haile SR Künzi W Giovanoli P Guggenheim M 《Burns : journal of the International Society for Burn Injuries》2011,37(6):958-963
In light of changes in patient demographics together with constant developments in burn care, the predictive accuracy of the Abbreviated Burns Severity Index (ABSI) - first described in 1982 - for estimating the mortality of present day burns patients, may be questionable.We reviewed the records of 2813 burns patients treated between January 1968 and December 2008 in the intensive care unit at our institution, aiming to identify emerging discrepancies between the estimated and calculated outcome, based on each of the ABSI variables and the total burn score.The predictive value of each of the defined ABSI variables was confirmed to be highly significant. Univariable and multivariable analysis revealed an exponential increase in odds ratio (OR) for mortality for patients older than 60 years and more than 30% TBSA burned and showed OR values over 10 times higher than other significant variables like inhalation injury. Nevertheless, the ABSI for the estimation of mortality in our entire patient collective was highly accurate and could not be optimised by adapting the point distribution to the increase in OR.Our data indicates that despite significant changes in patient demographics and medical advances over the past 30 years, the ABSI scoring system is still an accurate and valuable tool in the prediction of burn patient mortality. 相似文献
7.
Ursula Mirastschijski Jan-Thorben Sander Birgit Weyand Hans-Oliver Rennekampff 《Burns : journal of the International Society for Burn Injuries》2013
Purpose
Patients with burns utilise intensive medical care and rehabilitation. Deep dermal burns lead to scar contractures. Virtually no published data exists on costs for treatment of acute burns in comparison to burn sequelae. Our purpose was to collect financial data on burn therapy to estimate the socio-economic burden of thermal injuries.Methods
German-DRG for in-patient treatment of burns was collected from our burn center. DRG-related T95.- coding served as a search tool for burn associated sequelae. To include rehabilitation costs, data from the largest health care insurance and a workmen compensation fund were acquired.Findings
Acute burn treatment comprised 92% of costs for intensive care with approximately 4.600 EUR per percent total burned surface area (TBSA). Expenses for non-intensive care patients were significantly lower than for burn sequelae. Rehabilitation expenses were 4.4-fold higher than costs for acute burns including 59% for manual therapy and 37% for auxiliary material.Conclusions
TBSA multiplied by factor 4600 could serve for cost calculation of severely burned patients. Approximately 0.3 billion EUR in total or 270.000 EUR per patient/year were spent on burn sequelae. Early admission to specialized burn centers is advocated with state-of-the-art treatment to minimize burn sequelae and health care expenses. 相似文献8.
9.
《Burns : journal of the International Society for Burn Injuries》2023,49(6):1344-1355
BackgroundExtensive burns are devastating trauma. This study aimed to explore the predictive value of early lactate dehydrogenase (LDH) level, the abbreviated burn severity index (ABSI) and their combination on acute kidney injury (AKI) and mortality after severe burns.Methods and results194 severe burn patients (TBSA ≥ 30%) were included. After multivariate analyses, early LDH value (first 24 h after admission) was an independent risk factor for early AKI (OR=1.095, CI,1.025–1.169,p = 0.007) and AKI (OR=1.452, CI,1.131–1.864, p = 0.003) in severe burn patients and was still a significant risk factor for mortality (OR=1.059, CI,1.006–1.115,p = 0.03). In ROC analysis, after combining LDH and ABSI, the AUC values were 0.925 for AKI, 0.926 for stage 3 AKI, and 0.904 for mortality. Based on cut-off values, patients were divided into different risk groups. The cumulative incidence of AKI (within 5 days, 30 days) and survival rate (within 60 days) were analyzed by the Kaplan-Meier method. The mortality, AKI incidence, and AKI staging showed a significant upward trend with the increasing risk level (P < 0.001).ConclusionEarly LDH level is an independent risk factor for early AKI and AKI. LDH combined with ABSI can better predict mortality and AKI than single indicators. 相似文献
10.
Ehde DM Patterson DR Wiechman SA Wilson LG 《Burns : journal of the International Society for Burn Injuries》1999,25(7):587-592
The occurrence and predictors of acute post-traumatic stress symptoms were assessed in a large, prospective sample of persons with new burn injuries (N = 172). Participants completed a self-report post-traumatic stress symptom checklist, pain ratings, and a premorbid mental health inventory within 24 h of admission to a burn center (Day 1). Over half of the sample reported sleep disturbance and recurrent, intrusive recollections of the burn injury on Day 1. Other commonly endorsed symptoms were difficulties concentrating, avoidance of thoughts/feelings associated with the burn, flashbacks, and exaggerated startle response. Persons with less favorable premorbid mental health and larger burns reported a greater number of stress symptoms on Day 1. These results suggest that experiencing some post-traumatic stress symptoms immediately following a burn trauma is normal. It is recommended that burn care professionals identify and intervene with patients who are suffering clinically significant distress early in the hospitalization. 相似文献
11.
Kuan-Hsun Lin Chi-Ming Chu Yu-Kai Lin Hao-Yu Chiao Ta-Wei Pu Yuan-Ming Tsai Ying-Yi Chen Hsu-Kai Huang Shih-Chun Lee Tsai-Wang Huang 《Burns : journal of the International Society for Burn Injuries》2018,44(6):1573-1578
Here, we investigated whether the abbreviated burn severity index (ABSI) scoring system predicts acute respiratory distress syndrome (ARDS) in a retrospective analysis of a severe flammable starch-based powder burn population. Demographics, total body surface area (TBSA) burn, the presence of mouth and nose burn, ABSI, inhalation injury, and clinical outcomes for each patient were analysed for association with inpatient ARDS based on the Berlin definition. We treated 53 patients (64% male, 36% female) and observed no fatalities. The median age, TBSA burn, and the ABSI were 22.2 ± 3.6, 42.2 ± 21, and 7.8 ± 2.8, respectively. Inhalation injury was present in 56.6% of the cases, and mouth and nose burn was present in 30.2%. ARDS was prevalent at 30%. The mean abbreviated burn severity index (ABSI) was 10.6 ± 1.5 in the ARDS group and 6.6 ± 2.3 in the non-ARDS (P < 0.001) group. The mean TBSA burn percentage for ARDS and the non-ARDS groups were 61.4 ± 13.9% and 34 ± 18%, respectively (P < 0.001). The area under the curve of the receiver operating characteristic curves for an ABSI ≥ 9 was 0.905. Our results show that the ABSI is effective for predicting ARDS in young individuals with severe starch-based powder burn. 相似文献
12.
Thomas Muehlberger Christian Ottomann Nidal Toman Adrien Daigeler Marcus Lehnhardt 《The surgeon》2010,8(2):101-104
Intensive care and the surgical therapy of burn injuries have made significant advancements. The immediate care on the scene of the accident, however, is not uniform. There is no ‘golden hour’ which will decide the further clinical process. The acute estimate of the percentage of the extent of the burns is of little relevance and does not facilitate the admission to a burn unit. The emergency calculation of the volume of intravenous infusion is not advisable. The choice of transport has no discernible impact on the prognosis of the patient. Avoiding hypothermia and perceiving associated trauma can be of crucial prognostic importance in the pre-hospital care of burn patients. Detailed knowledge about the circumstances of the injury is of exceeding importance. 相似文献
13.
Denis Ehrl Paul I. Heidekrueger Milomir Ninkovic P. Niclas Broer 《Burns : journal of the International Society for Burn Injuries》2018,44(3):524-530
Objective
Burns represent a special form of severe trauma. Due to long hospitalization, rehabilitation, and extensive scar treatment, severe burn injuries rank among the most expensive traumatic injuries regarding associated health care costs. The presented single-burn-center experiences evaluated the effects of primary versus secondary burn intensive care unit (BICU) admissions on outcomes in severely burned patients.Methods
Within 30 months, 186 patients were admitted to the BICU. The cases were divided into two groups depending on their admission type: “primary” vs. “secondary”. All patients were analyzed retrospectively regarding the need for surgery, encountered complications, time of hospitalization and overall survival.Results
The incidence of primary BICU-admissions was 65.1%. Both patient groups were comparable regarding demographics, comorbidities, % TBSA burn, associated inhalation injuries, ABSI scores and intubation rates (p > 0.05). Both groups received similar numbers of operations and had overall comparable mortality rates (p > 0.05). However, duration until first burn excision, length of ventilation, as well as BICU- and overall hospital length of stay were significantly shorter in the “primary”- compared to the “secondary” group (p < 0.05).Conclusion
Several burn societies have published precise criteria of when a patient needs to be referred to a burn center. In the presented series, patients that were primarily treated at a BICU showed significantly better outcomes regarding several parameters. In order to further optimize treatment of burn patients it therefore appears that precise initial assessment and if appropriate respective primary transport to dedicated burn centers needs to be re-emphasized, especially among first- and emergency care providers. 相似文献14.
Panagiotis Theodorou Weiguo Xu Christian Weinand Walter Perbix Marc Maegele Rolf Lefering Truong Quang Vu Phan Max Zinser Gerald Spilker 《Burns : journal of the International Society for Burn Injuries》2013
Objective
To analyze trends in incidence and treatment of thermal injuries over the last two decades.Methods
We retrospectively reviewed our local single center database of patients with thermal injuries admitted to the burn intensive care unit (BICU) of the Cologne-Merheim Medical Center (University Hospital of Witten/Herdecke). The cohort was divided into two groups according to the decade of admission and the epidemiology and clinical course of the patient sample admitted during the period 1991–2000 (n = 911) was compared to that of 2001–2010 (n = 695).Results
The following variables were significantly different in the bivariate analysis: mean age (39.8 years vs. 44.0 years), burn size of total body surface area (23.2% vs. 18.0%) and size of 3rd degree burns (9.6% vs. 14.9%). The incidence of inhalation injury was significantly lower in the last decade (33.3% vs. 13.7%) and was associated with a shorter duration of mechanical ventilation (10.8 days vs. 8.5 days). The ABSI-score as an indicator of burn severity declined in the second period (6.3 vs. 6.0) contributing partially to the decline of BICU length of stay (19.1 days vs. 18.8 days) and to the mortality rate decrease (18.6% vs. 15.0%).Conclusion
The severity of burn injuries during the last two decades declined, probably reflecting the success of prevention campaigns. Concerning mortality, the chance of dying for a given severity of injury has decreased. 相似文献15.
Is high PEEP low volume ventilation in burn patients beneficial? A retrospective study of 61 patients 总被引:1,自引:0,他引:1
Wolter TP Fuchs PC Horvat N Pallua N 《Burns : journal of the International Society for Burn Injuries》2004,30(4):368-373
In burn care lung damage by inhalation injury is a major cause of mortality in burn patients. In the field of intensive care medicine ventilation strategies to reduce lung injury caused by ventilation are under investigation. The promising results of the application of pressure controlled high PEEP low volume (HPLV) ventilation prompted us to use this ventilation strategy in our burn ICU. To establish whether this ventilation regime is beneficial the charts of 61 consecutive patients needing artificial respiration were reviewed. A scoring system for PEEP level and tidal volume was developed and treatment groups with high PEEP and low volume and low PEEP high volume regimes were compared. No statistically significant differences could be found when comparing treatment versus mortality, the number of pulmonary complications or incidence of pneumothoraces. However, the trend showed a benefit in mortality for patients with an ABSI scoring up to 9, but at the same time pulmonary complications increase. The Horovitz oxygenation index showed no advantage for the HPLV Group. In a separate analysis we found a significant correlation between absolute PEEP and mortality. The correlation between PEEP level and mortality is a dynamic factor predicting outcome, This not been described yet and can be an addition to the static ABSI score. Differences between ventilation strategies were not as evident as expected in this retrospective study, so prospective randomized studies are needed. 相似文献
16.
A review of the specialties that care for inpatient burns and smoke inhalation in the English counties of Lancashire and South Cumbria 总被引:2,自引:0,他引:2
Rajpura A 《Burns : journal of the International Society for Burn Injuries》2002,28(2):131-134
Prevention is by far the best strategy to minimise the burden of burns and smoke inhalation injuries on public health. However, it is inevitable that some injuries will occur despite the best attempts to prevent them. We must, therefore, optimise treatment in order to restore individuals to the best possible condition. Previous experience has shown that a wide range of specialties, many of which are untrained in burn care medicine, are involved in the care of inpatient burns/smoke inhalation victims in the UK. In light of this, a local review of which specialties care for such injuries was conducted for the population of Lancashire and South Cumbria in the north-west of England. Using population-based health authority data from 1997 to 1999, all Hospital Episodes relating to a primary diagnosis of burns or smoke inhalation were ascertained. The results showed that 41% of all burns episodes were treated by specialties other than burns/plastics. The short lengths of stay in non-plastics/burns specialties suggest that relatively minor injuries are being admitted to these units. Analysis of smoke inhalation injuries showed admission to various different specialties. Admission to burn services ensures that key specialties are available for the care of complex burn injuries. These multidisciplinary teams include burn nurses, burn surgeons and burn anaesthetists/intensivists. From the data available, it was not possible to assess the appropriateness of admission of burns and smoke inhalation injuries to the various branches of medicine. In order to assess appropriateness, we need information on severity of injury and outcome of treatment in each specialty. Further research in this area is required since it is concerning that many burns/smoke inhalation injuries are being treated by specialties with no formal training in burn care medicine. This may have major implications for service planning alongside changes in referral patterns. 相似文献
17.
Guido Alsfasser Bettina M. Rau Ernst Klar 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2013,398(6):789-797
Background
Acute pancreatitis remains as one of the most difficult and challenging digestive disorder to predict in terms of clinical course and outcome. Every case has an individual course and therefore acute pancreatitis remains challenging and fascinating. Due to this variability, many different scoring systems have evolved during the last decades. Every scoring system has advantages and disadvantages. Not every scoring system is capable of assessing the clinical time course of the disease, some are only suitable for the time of initial presentation.Aim
This paper will give an overview on the development of different widely used scoring systems and their performance in assessing severity and prognosis of acute pancreatitis.Conclusion
Severity assessment means objective quantification of overall severity of illness. Early and reliable stratification of severity is required to decide best treatment of the individual patient, preparation for possible evolving complications or for referral to specialist centers. No single scoring system is able to cover the entire range of problems associated with treatment and assessment of acute pancreatitis. In our clinical experience, we recommend hematocrit upon admission, daily sequential organ failure assessment score and procalcitonin, C-reactive protein on day 3 and CT severity index beyond the first week. These scoring tools together with close clinical follow-up of the patient ultimately lead to an optimized treatment of this challenging disease. 相似文献18.
O J McAnena F A Moore E E Moore K L Mattox J A Marx P Pepe 《The Journal of trauma》1992,33(4):504-6; discussion 506-7
The APACHE II scoring system has been promulgated as a useful tool in the assessment of the severity of injury and prognosis for acutely ill patients. The physiologic basis for stratification is weighted toward older patients with chronic medical conditions. Recently, the APACHE II system has been proposed as a method for determining diagnosis related group (DRG) reimbursement for individual trauma patients. The present study applied the APACHE II scoring system to 280 patients with blunt or penetrating trauma who had documented systolic blood pressure < 90 mm Hg. Fifty-seven (20%) died of their injuries within the first 24 hours. APACHE II scores were recorded both in the emergency room (ED) and at 24 hours following admission. Injury Severity Scores (ISS), Revised Trauma Scores (RTS), and TRISSCAN were calculated. The APACHE II (n = 223) recorded at 24 hours (2.5 +/- 0.2) was significantly less than that recorded in the ED (6.6 +/- 0.3, p < 0.05, Mann-Whitney analysis). Using regression analysis, there was no correlation between APACHE II and ISS if recorded in the ED (r2 = 0.06) or 24 hours following admission (r2 = 0.08). APACHE II also demonstrated a poor correlation with the length of hospital stay (r2 = 0.03 [ED], = 0.19 [24 hours]). Whereas APACHE II may be helpful in defining severity of disease among patients with acute-on-chronic medical conditions, the classification lacks an anatomic component, which is essential to assess the magnitude of acute injury in patients who are typically otherwise healthy. 相似文献
19.
Correlation between QT dispersion and burn severity 总被引:2,自引:0,他引:2
Suzuki M Aoki K Sekine K Aikawa N 《Burns : journal of the International Society for Burn Injuries》2002,28(5):481-485
QT dispersion, defined as the maximal-minus-minimal QT interval on a 12-lead electrocardiogram, has emerged as a non-invasive measurement for quantifying the spatial inhomogeneity of ventricular repolarization under various conditions, including acute stress. Because burn injuries elicit acute stress reactions, it was hypothesized that QT dispersion increases with the severity of the burn injury. To test the hypothesis, 13 burned patients (age range of 22-76 years, nine males, ranging from 4.0 to 75.0% of total body surface area burned) in whom a measurable 12-lead electrocardiogram had been obtained within 4h after arrival at the emergency department were identified retrospectively, and their QTc intervals, i.e. QT intervals corrected for heart rate by the standard Bazett formula, were measured. QTc dispersion (QTcd) was then calculated, and correlations were assessed with burn severity (burn index, BI; prognostic burn index, PBI). Of the 13 patients, nine patients had a prolonged QTcd (>40 ms), and linear correlation analyses showed significant positive correlations between QTcd and both BI and PBI (r=0.61 and 0.62, respectively). In conclusion, QT dispersion was greater in the burned patients, and although the pathophysiology was unclear from the present study, the findings suggested that acute stress contributed to the spatial inhomogeneity of ventricular repolarization. 相似文献
20.