Delayed admission to hospital with proper prehospital treatments prevents severely burned patients from sepsis in China: A retrospective study
Sepsis is one of the major causes of morbidity and mortality in burn patients. However, the optimal timing of admission which can minimize the probability of sepsis is still unclear. This study aims to determine the optimal time period of admission for severely burned patients and find out the possi...
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| Veröffentlicht in: | Burns 2024-11, Vol.50 (8), p.1977-1990 |
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| container_end_page | 1990 |
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| container_issue | 8 |
| container_start_page | 1977 |
| container_title | Burns |
| container_volume | 50 |
| creator | Huang, Runzhi Li, Yuanan Xian, Shuyuan Zhang, Wei Liu, Yifan Xie, Sujie Xu, Dayuan Zhu, Yushu Sun, Hanlin Yan, Jiale Guo, Xinya Li, Yixu Lu, Jianyu Tong, Xirui Yao, Yuntao Qian, Weijin Lu, Bingnan Shi, Jiaying Ding, Xiaoyi Li, Junqiang Xiao, Shichu Ji, Shizhao |
| description | Sepsis is one of the major causes of morbidity and mortality in burn patients. However, the optimal timing of admission which can minimize the probability of sepsis is still unclear. This study aims to determine the optimal time period of admission for severely burned patients and find out the possible reasons for it.
185 victims to the Kunshan factory aluminum dust explosion accident, which happened on August 2nd, 2014, were studied. The optimal cutpoint for continuous variables in survival models was determined by means of the maximally selected rank statistic. Univariate and multivariate analyses were further conducted to verify that admission time was not a risk factor for sepsis. Subgroup analyses were performed to find out possible contributing factors for the result.
The cutoff point for admission time was determined as seven hours, which was supported by the survival curve (p |
| doi_str_mv | 10.1016/j.burns.2024.07.029 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3105492401</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0305417924002286</els_id><sourcerecordid>3105492401</sourcerecordid><originalsourceid>FETCH-LOGICAL-c239t-454b0043cac4572216ac0188dd9f6fe2bb59af552cfe5b4f685a48177ab7cda73</originalsourceid><addsrcrecordid>eNp9UctuHCEQRFGseG3nCyJFHHOZCTAwDJZysNZPyVIu8Rkx0KNlNa8As9H-RL457K7tY7g06q5-VBVCXygpKaH1923ZLmGMJSOMl0SWhKkPaEUbqQrKifqIVqQiouBUqnN0EeOW5Cca8gmdV4rJRtb1Cv29hd7swWHjBh-jn0acJryZ4uyT6fEfnzZ4DtMMIQd4z6cAJg0wpnhI746fmGOAfo8PZ-WJs0n-WOjCNOTqHH3EfsTrjR_NNb7BAVLIA8EmvwMc0-L2V-isM32Ez6_xEr3c3_1aPxbPPx-e1jfPhWWVSgUXvCWEV9ZYLiRjtDaW0KZxTnV1B6xthTKdEMx2IFre1Y0wvKFSmlZaZ2R1ib6d5mZuvxeISWf2FvrejDAtUVeUCK4YJzRDqxPU5mNjgE7PwQ8m7DUl-mCE3uqjEfpghCZSZyNy19fXBUs7gHvveVM-A36cAJBp7jwEHW2Wy4LzISui3eT_u-Af-0CfWA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3105492401</pqid></control><display><type>article</type><title>Delayed admission to hospital with proper prehospital treatments prevents severely burned patients from sepsis in China: A retrospective study</title><source>Elsevier ScienceDirect Journals Complete</source><creator>Huang, Runzhi ; Li, Yuanan ; Xian, Shuyuan ; Zhang, Wei ; Liu, Yifan ; Xie, Sujie ; Xu, Dayuan ; Zhu, Yushu ; Sun, Hanlin ; Yan, Jiale ; Guo, Xinya ; Li, Yixu ; Lu, Jianyu ; Tong, Xirui ; Yao, Yuntao ; Qian, Weijin ; Lu, Bingnan ; Shi, Jiaying ; Ding, Xiaoyi ; Li, Junqiang ; Xiao, Shichu ; Ji, Shizhao</creator><creatorcontrib>Huang, Runzhi ; Li, Yuanan ; Xian, Shuyuan ; Zhang, Wei ; Liu, Yifan ; Xie, Sujie ; Xu, Dayuan ; Zhu, Yushu ; Sun, Hanlin ; Yan, Jiale ; Guo, Xinya ; Li, Yixu ; Lu, Jianyu ; Tong, Xirui ; Yao, Yuntao ; Qian, Weijin ; Lu, Bingnan ; Shi, Jiaying ; Ding, Xiaoyi ; Li, Junqiang ; Xiao, Shichu ; Ji, Shizhao</creatorcontrib><description>Sepsis is one of the major causes of morbidity and mortality in burn patients. However, the optimal timing of admission which can minimize the probability of sepsis is still unclear. This study aims to determine the optimal time period of admission for severely burned patients and find out the possible reasons for it.
185 victims to the Kunshan factory aluminum dust explosion accident, which happened on August 2nd, 2014, were studied. The optimal cutpoint for continuous variables in survival models was determined by means of the maximally selected rank statistic. Univariate and multivariate analyses were further conducted to verify that admission time was not a risk factor for sepsis. Subgroup analyses were performed to find out possible contributing factors for the result.
The cutoff point for admission time was determined as seven hours, which was supported by the survival curve (p < 0.001). Multivariate analysis showed that, in our study population, delayed admission time was not a risk factor for sepsis (HR = 0.610, 95 %CI = 0.415 - 0.896, p = 0.012). Subgroup analyses showed that “Tracheotomy before admission” (p = 0.002), “Whole blood transfusion” (p < 0.001), “Hemodynamic instability before admission” (p = 0.02), “Has a burn department in the hospital” (p = 0.009), “Has a burn ICU in the hospital” (p < 0.001), “Acute heart failure (AHF)” (p = 0.05), “acute respiratory distress syndrome (ARDS)” (p = 0.05) and “GI bleeding” (p = 0.04) were all statistically significant.
In our study population, we found that delayed admission time was not a risk factor associated with a reduced incidence of sepsis among severely burned patients. This might be attributed to variations in prehospital treatments (whole blood transfusion and tracheotomy), whether the hospital had a burn department/ICU, and certain complications (AHF, ARDS and GI bleeding). It can be inferred that early prehospital care plays a crucial role in reducing sepsis risk among severe burn patients.
•Seven hours post-injury is key to reducing sepsis risk in severe burn cases.•Hospital facilities, especially burn units, crucially impact sepsis prognosis.•Complications such as AHF, ARDS, and GI bleeding significantly affect sepsis risk.</description><identifier>ISSN: 0305-4179</identifier><identifier>ISSN: 1879-1409</identifier><identifier>EISSN: 1879-1409</identifier><identifier>DOI: 10.1016/j.burns.2024.07.029</identifier><identifier>PMID: 39278766</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Admission time ; Blood transfusion ; Burn injury ; Burns ; Kunshan explosion ; Prehospital care ; Sepsis ; Tracheotomy</subject><ispartof>Burns, 2024-11, Vol.50 (8), p.1977-1990</ispartof><rights>2024 Elsevier Ltd and International Society of Burns Injuries</rights><rights>Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c239t-454b0043cac4572216ac0188dd9f6fe2bb59af552cfe5b4f685a48177ab7cda73</cites><orcidid>0000-0002-5083-288X ; 0009-0006-7289-6514</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.burns.2024.07.029$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39278766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Runzhi</creatorcontrib><creatorcontrib>Li, Yuanan</creatorcontrib><creatorcontrib>Xian, Shuyuan</creatorcontrib><creatorcontrib>Zhang, Wei</creatorcontrib><creatorcontrib>Liu, Yifan</creatorcontrib><creatorcontrib>Xie, Sujie</creatorcontrib><creatorcontrib>Xu, Dayuan</creatorcontrib><creatorcontrib>Zhu, Yushu</creatorcontrib><creatorcontrib>Sun, Hanlin</creatorcontrib><creatorcontrib>Yan, Jiale</creatorcontrib><creatorcontrib>Guo, Xinya</creatorcontrib><creatorcontrib>Li, Yixu</creatorcontrib><creatorcontrib>Lu, Jianyu</creatorcontrib><creatorcontrib>Tong, Xirui</creatorcontrib><creatorcontrib>Yao, Yuntao</creatorcontrib><creatorcontrib>Qian, Weijin</creatorcontrib><creatorcontrib>Lu, Bingnan</creatorcontrib><creatorcontrib>Shi, Jiaying</creatorcontrib><creatorcontrib>Ding, Xiaoyi</creatorcontrib><creatorcontrib>Li, Junqiang</creatorcontrib><creatorcontrib>Xiao, Shichu</creatorcontrib><creatorcontrib>Ji, Shizhao</creatorcontrib><title>Delayed admission to hospital with proper prehospital treatments prevents severely burned patients from sepsis in China: A retrospective study</title><title>Burns</title><addtitle>Burns</addtitle><description>Sepsis is one of the major causes of morbidity and mortality in burn patients. However, the optimal timing of admission which can minimize the probability of sepsis is still unclear. This study aims to determine the optimal time period of admission for severely burned patients and find out the possible reasons for it.
185 victims to the Kunshan factory aluminum dust explosion accident, which happened on August 2nd, 2014, were studied. The optimal cutpoint for continuous variables in survival models was determined by means of the maximally selected rank statistic. Univariate and multivariate analyses were further conducted to verify that admission time was not a risk factor for sepsis. Subgroup analyses were performed to find out possible contributing factors for the result.
The cutoff point for admission time was determined as seven hours, which was supported by the survival curve (p < 0.001). Multivariate analysis showed that, in our study population, delayed admission time was not a risk factor for sepsis (HR = 0.610, 95 %CI = 0.415 - 0.896, p = 0.012). Subgroup analyses showed that “Tracheotomy before admission” (p = 0.002), “Whole blood transfusion” (p < 0.001), “Hemodynamic instability before admission” (p = 0.02), “Has a burn department in the hospital” (p = 0.009), “Has a burn ICU in the hospital” (p < 0.001), “Acute heart failure (AHF)” (p = 0.05), “acute respiratory distress syndrome (ARDS)” (p = 0.05) and “GI bleeding” (p = 0.04) were all statistically significant.
In our study population, we found that delayed admission time was not a risk factor associated with a reduced incidence of sepsis among severely burned patients. This might be attributed to variations in prehospital treatments (whole blood transfusion and tracheotomy), whether the hospital had a burn department/ICU, and certain complications (AHF, ARDS and GI bleeding). It can be inferred that early prehospital care plays a crucial role in reducing sepsis risk among severe burn patients.
•Seven hours post-injury is key to reducing sepsis risk in severe burn cases.•Hospital facilities, especially burn units, crucially impact sepsis prognosis.•Complications such as AHF, ARDS, and GI bleeding significantly affect sepsis risk.</description><subject>Admission time</subject><subject>Blood transfusion</subject><subject>Burn injury</subject><subject>Burns</subject><subject>Kunshan explosion</subject><subject>Prehospital care</subject><subject>Sepsis</subject><subject>Tracheotomy</subject><issn>0305-4179</issn><issn>1879-1409</issn><issn>1879-1409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9UctuHCEQRFGseG3nCyJFHHOZCTAwDJZysNZPyVIu8Rkx0KNlNa8As9H-RL457K7tY7g06q5-VBVCXygpKaH1923ZLmGMJSOMl0SWhKkPaEUbqQrKifqIVqQiouBUqnN0EeOW5Cca8gmdV4rJRtb1Cv29hd7swWHjBh-jn0acJryZ4uyT6fEfnzZ4DtMMIQd4z6cAJg0wpnhI746fmGOAfo8PZ-WJs0n-WOjCNOTqHH3EfsTrjR_NNb7BAVLIA8EmvwMc0-L2V-isM32Ez6_xEr3c3_1aPxbPPx-e1jfPhWWVSgUXvCWEV9ZYLiRjtDaW0KZxTnV1B6xthTKdEMx2IFre1Y0wvKFSmlZaZ2R1ib6d5mZuvxeISWf2FvrejDAtUVeUCK4YJzRDqxPU5mNjgE7PwQ8m7DUl-mCE3uqjEfpghCZSZyNy19fXBUs7gHvveVM-A36cAJBp7jwEHW2Wy4LzISui3eT_u-Af-0CfWA</recordid><startdate>20241101</startdate><enddate>20241101</enddate><creator>Huang, Runzhi</creator><creator>Li, Yuanan</creator><creator>Xian, Shuyuan</creator><creator>Zhang, Wei</creator><creator>Liu, Yifan</creator><creator>Xie, Sujie</creator><creator>Xu, Dayuan</creator><creator>Zhu, Yushu</creator><creator>Sun, Hanlin</creator><creator>Yan, Jiale</creator><creator>Guo, Xinya</creator><creator>Li, Yixu</creator><creator>Lu, Jianyu</creator><creator>Tong, Xirui</creator><creator>Yao, Yuntao</creator><creator>Qian, Weijin</creator><creator>Lu, Bingnan</creator><creator>Shi, Jiaying</creator><creator>Ding, Xiaoyi</creator><creator>Li, Junqiang</creator><creator>Xiao, Shichu</creator><creator>Ji, Shizhao</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5083-288X</orcidid><orcidid>https://orcid.org/0009-0006-7289-6514</orcidid></search><sort><creationdate>20241101</creationdate><title>Delayed admission to hospital with proper prehospital treatments prevents severely burned patients from sepsis in China: A retrospective study</title><author>Huang, Runzhi ; 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However, the optimal timing of admission which can minimize the probability of sepsis is still unclear. This study aims to determine the optimal time period of admission for severely burned patients and find out the possible reasons for it.
185 victims to the Kunshan factory aluminum dust explosion accident, which happened on August 2nd, 2014, were studied. The optimal cutpoint for continuous variables in survival models was determined by means of the maximally selected rank statistic. Univariate and multivariate analyses were further conducted to verify that admission time was not a risk factor for sepsis. Subgroup analyses were performed to find out possible contributing factors for the result.
The cutoff point for admission time was determined as seven hours, which was supported by the survival curve (p < 0.001). Multivariate analysis showed that, in our study population, delayed admission time was not a risk factor for sepsis (HR = 0.610, 95 %CI = 0.415 - 0.896, p = 0.012). Subgroup analyses showed that “Tracheotomy before admission” (p = 0.002), “Whole blood transfusion” (p < 0.001), “Hemodynamic instability before admission” (p = 0.02), “Has a burn department in the hospital” (p = 0.009), “Has a burn ICU in the hospital” (p < 0.001), “Acute heart failure (AHF)” (p = 0.05), “acute respiratory distress syndrome (ARDS)” (p = 0.05) and “GI bleeding” (p = 0.04) were all statistically significant.
In our study population, we found that delayed admission time was not a risk factor associated with a reduced incidence of sepsis among severely burned patients. This might be attributed to variations in prehospital treatments (whole blood transfusion and tracheotomy), whether the hospital had a burn department/ICU, and certain complications (AHF, ARDS and GI bleeding). It can be inferred that early prehospital care plays a crucial role in reducing sepsis risk among severe burn patients.
•Seven hours post-injury is key to reducing sepsis risk in severe burn cases.•Hospital facilities, especially burn units, crucially impact sepsis prognosis.•Complications such as AHF, ARDS, and GI bleeding significantly affect sepsis risk.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>39278766</pmid><doi>10.1016/j.burns.2024.07.029</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-5083-288X</orcidid><orcidid>https://orcid.org/0009-0006-7289-6514</orcidid></addata></record> |
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| source | Elsevier ScienceDirect Journals Complete |
| subjects | Admission time Blood transfusion Burn injury Burns Kunshan explosion Prehospital care Sepsis Tracheotomy |
| title | Delayed admission to hospital with proper prehospital treatments prevents severely burned patients from sepsis in China: A retrospective study |
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