Time course of thrombocytes in burn patients and its predictive value for outcome

被引:47
作者
Marck, Roos Elisabeth [1 ,5 ]
Montagne, Harriet Leonie [4 ,5 ]
Tuinebreijer, Willem Eduard [2 ,5 ]
Breederveld, Roelf Simon [3 ,4 ,5 ]
机构
[1] Assoc Dutch Burn Ctr, Beverwijk, Netherlands
[2] Univ Med Ctr, Erasmus MC, Red Cross Hosp Beverwijk, Dept Surg Traumatol, Rotterdam, Netherlands
[3] Red Cross Hosp Beverwijk, Dept Surg, Beverwijk, Netherlands
[4] Leiden Univ, Med Ctr, Dept Surg, NL-2300 RA Leiden, Netherlands
[5] Red Cross Hosp, Burn Ctr Beverwijk, Beverwijk, Netherlands
关键词
Burns; Thermal injury; Thrombocytes; Platelets; Sepsis; Mortality; Outcome; HEPARIN-INDUCED THROMBOCYTOPENIA; BLOOD-PLATELETS; COAGULATION; THROMBOSIS; SEPSIS; TRAUMA; COUNT; HIT;
D O I
10.1016/j.burns.2013.01.015
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Thrombocytopenia is common in trauma and critically ill patients and is associated with a poor outcomes. The objective of this retrospective study was to investigate the course of thrombocyte concentration changes in burn patients, the influences of various factors on this course, and a possible predictive value of thrombocyte counts on outcome in 244 patients admitted to our burn centre. Their thrombocyte counts were Obtained until 50 days after burn. Data on patient demographics, total percentage burned surface area (%TBSA), sepsis and mortality were collected. Multilevel multivariable analysis was performed to investigate the influence of the variables on the platelet course. Cox regression analysis was performed to analyse the predictive value of the variables for mortality. A distinct pattern of thrombocyte counts was observed, with a nadir at day 3 followed by a peak at day 15 and a temporary thrombocytosis. %TBSA and age (p < 0.05) influence this course. The mean thrombocyte course of septic and non-surviving patients depicts a significant lower nadir. Furthermore, higher age, %TBSA and low thrombocyte counts at the peak are predictive for 50 day mortality (p < 0.05). Platelets follow a distinct course after burn, influenced by %TBSA and age. These factors and a low thrombocyte peak count predict mortality: (c) 2013 Elsevier Ltd and ISBI. All rights reserved.
引用
收藏
页码:714 / 722
页数:9
相关论文
共 32 条
[1]   Time course of platelet counts in critically ill patients [J].
Akca, S ;
Haji-Michael, P ;
de Mendonça, A ;
Suter, P ;
Levi, M ;
Vincent, JL .
CRITICAL CARE MEDICINE, 2002, 30 (04) :753-756
[2]   COAGULATION AND PLATELET CHANGES AFTER THERMAL-INJURY IN MAN [J].
BARTLETT, RH ;
FONG, SW ;
MARRUJO, G ;
HARDEMAN, J ;
ANDERSON, W .
BURNS, 1981, 7 (05) :370-377
[3]   Evaluation of Prophylactic Anticoagulation, Deep Venous Thrombosis, and Heparin-Induced Thrombocytopenia in 21 Burn Centers in Germany, Austria, and Switzerland [J].
Busche, Marc N. ;
Herold, Christian ;
Kraemer, Robert ;
Knobloch, Karsten ;
Vogt, Peter M. ;
Rennekampff, Hans-Oliver .
ANNALS OF PLASTIC SURGERY, 2011, 67 (01) :17-24
[4]   ANALYSIS OF CHANGES IN COAGULATION-FACTORS AFTER POSTOPERATIVE BLOOD-LOSS IN BURN AND NON-BURN PATIENTS [J].
CHANG, P ;
MURRAY, DJ ;
OLSON, JD ;
PENNELL, BJ ;
LEWIS, RW ;
KEALEY, GP .
BURNS, 1995, 21 (06) :432-436
[5]   COMPARATIVE COAGULATION ABNORMALITY PATTERNS IN MODERATELY AND SEVERELY BURNED PATIENTS [J].
CHOCTAW, WT ;
MICHAS, C .
BURNS, 1981, 7 (06) :434-437
[6]   Coagulopathy in trauma patients: importance of thrombocyte function? [J].
Davenport, Ross A. ;
Brohi, Karim .
CURRENT OPINION IN ANESTHESIOLOGY, 2009, 22 (02) :261-266
[7]   Risk factors for thrombosis in patients with immune mediated heparin-induced thrombocytopenia [J].
Fabris, F ;
Luzzatto, G ;
Soini, B ;
Ramon, R ;
Scandellari, R ;
Randi, ML ;
Girolami, A .
JOURNAL OF INTERNAL MEDICINE, 2002, 252 (02) :149-154
[8]   Acute thrombocytopenic crisis following burns complicated by staphylococcal septicaemia [J].
George, A ;
Bang, RL ;
Lari, AR ;
Gang, RK .
BURNS, 2001, 27 (01) :84-88
[9]   American burn association consensus conference to define sepsis and infection in burns [J].
Greenhalgh, David G. ;
Saffle, Jeffrey R. ;
Holmes, James H. ;
Gamelli, Richard L. ;
Palmieri, Tina L. ;
Horton, Jureta W. ;
Tompkins, Ronald G. ;
Traber, Daniel L. ;
Mozingo, David W. ;
Deitch, Edwin A. ;
Goodwin, Cleon W. ;
Herndon, David N. ;
Gallagher, James J. ;
Sanford, Art P. ;
Jeng, James C. ;
Ahrenholz, David H. ;
Neely, Alice N. ;
O'Mara, Michael S. ;
Wolf, Steven E. ;
Purdue, Gary F. ;
Garner, Warren L. ;
Yowler, Charles J. ;
Latenser, Barbara A. .
JOURNAL OF BURN CARE & RESEARCH, 2007, 28 (06) :776-790
[10]   Thrombocytopenia in the Intensive Care Unit Patient [J].
Greinacher, Andreas ;
Selleng, Kathleen .
HEMATOLOGY-AMERICAN SOCIETY OF HEMATOLOGY EDUCATION PROGRAM, 2010, :135-143