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The Declining Incidence of Fatal Sepsis following Thermal Injury

 

作者: STEVEN MERRELL,   JEFFREY SAFFLE,   CATHERINE LARSON,   JOHN SULLIVAN,  

 

期刊: The Journal of Trauma: Injury, Infection, and Critical Care  (OVID Available online 1989)
卷期: Volume 29, issue 10  

页码: 1362-1366

 

ISSN:0022-5282

 

年代: 1989

 

出版商: OVID

 

数据来源: OVID

 

摘要:

Successful management of burned patients requires effective prevention and management of infectious complications. This study reviews the incidence of fatal sepsis in our burn center and attempts to analyze factors which may predict septic mortality. From January 1, 1978, through May 31, 1988, 1,913 patients were admitted, with a mean age of 24.8 ± 0.5 years, a mean burn size of 17.7 ± 0.4% total body surface area (%TBSA), and a mean 10.1 ± 0.5% TBSA full-thickness injury. Nine per cent of patients sustained concurrent inhalation injuries. Overall mortality was 7.4%, and 1.6% of patients died from sepsis. Regression analysis showed that overall burn size, presence of inhalation injury, and the extent of full-thickness burn injury were significant independent predictors of death from sepsis, in decreasing order of relative importance. During the period 1983–1988, the incidence of septic mortality was 0.7%, which was significantly lower than the earlier half (1978–1982) of the study period (p< 0.01). These data indicate that fatal infections are becoming increasingly uncommon after thermal injury. The reasons for this decline are probably multiple, and they include the widespread practice of early excision, and improvements in fluid resusitation and the general medical care of burned patients.

 

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