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Volume 39 Issue 11
Nov.  2023
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(11): 1047-1056
Chen HL,Li MJ,Luo YM,et al.Application of a standard communication system-based continuous home remote visit mode in the management of visits to severely burned patients in the post-pandemic era of coronavirus disease 2019[J].Chin J Burns,2021,37(11):1070-1077.DOI: 10.3760/cma.j.cn501120-20210315-00088.
Citation: Duan DQ,Chen Y,Deng HA,et al.Multicenter retrospection and analysis of influencing factors on blood transfusion in patients with extensive burns[J].Chin J Burns Wounds,2023,39(11):1047-1056.DOI: 10.3760/cma.j.cn501225-20230417-00128.
shu

Multicenter retrospection and analysis of influencing factors on blood transfusion in patients with extensive burns

doi: 10.3760/cma.j.cn501225-20230417-00128
  • 1.

    Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China

  • 2.

    Department of Burn and Wound Repair, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China

  • 3.

    Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

Funds:

Regional Science Foundation Program of National Natural Science Foundation of China 30960401, 82360450

Natural Science Foundation of Jiangxi Province of China 20181BAB205041

More Information
  • Corresponding author: Zhang Hongyan, Email: zhycn2008@163.com
  • Received Date: 2023-04-17
    Abstract
  •   Objective   To retrospect the blood transfusion status of patients with extensive burns in multiple centers and analyze its influencing factors.   Methods   A retrospective case series study was conducted. Clinical data of 455 patients with extensive burns who met the inclusion criteria and were admitted to the burn centers of 3 hospitals from January 2016 to June 2022 were collected, including 202 patients from the First Affiliated Hospital of Nanchang University, 179 patients from the Second Affiliated Hospital of Zhejiang University School of Medicine, and 74 patients from the First Affiliated Hospital of Anhui Medical University. The following data were collected from patients during their hospitalization, including infusion of red blood cells, plasma, and platelets during hospitalization; age, gender, body mass index, combined underlying diseases, cause of injury, time of admission after injury, type of admission, total burn area, full-thickness burn area, combination of inhalation injury, combination of other trauma, and combination of pulmonary edema; the blood lactic acid, serum creatinine, total bilirubin, and albumin values within 24 h of admission; combination of bloodstream, wound, lung, and urinary tract infection, and combination of sepsis; the number of escharectomy or tangential excision and skin grafting surgery (hereinafter referred to as surgery) and total surgical blood loss volume; occurrence of hemoglobin<70 g/L, admission to intensive care unit (ICU), conduction of mechanical ventilation and continuous renal replacement therapy (CRRT), length of hospital stay, and prognosis were recorded. In 602 surgeries of patients within 14 days after injury, data including area of escharectomy or tangential excision and skin graft harvesting, duration of operation, and surgical blood loss volume per surgery, operation site, and use of tourniquet and wound graft were collected. Data were statistically analyzed with Mann-Whitney U test, Kruskal-Wallis H test, and Spearman correlation analysis. Combined with the results of single factor analysis and clinical significance, multiple linear regression analysis was performed to screen the independent influencing factors of red blood cell infusion volume and plasma infusion volume, as well as blood loss volume per surgery.   Results   During the whole hospitalization period, 437 (96.0%) patients received blood transfusion therapy, including 435 (95.6%) patients, 410 (90.1%) patients, and 73 (16.0%) patients who received transfusion of plasma, red blood cells, and platelets, respectively. The patients were mainly male, aged 18 to 92 years. There were statistically significant differences in the plasma infusion volume among patients with different combination of underlying disease, combination of inhalation injury, combination of other trauma, combination of pulmonary edema, combination of bloodstream infection, combination of wound infection, combination of lung infection, combination of urinary tract infection, combination of sepsis, occurrence of hemoglobin value <70 g/L, admission to ICU, conduction of mechanical ventilation, and conduction of CRRT (with Z values of -2.06, -4.67, -2.11, -6.13, -9.56, -4.93, -8.08, -4.78, -9.12, -6.55, -9.37, -11.46, and -7.17, respectively, P<0.05). The total burn area, full-thickness burn area, blood lactic acid value within 24 h of admission, serum creatinine value within 24 h of admission, albumin value within 24 h of admission, number of surgeries, and total surgical blood loss volume were correlated with the plasma infusion volume of patients (with r values of 0.39, 0.51, 0.14, 0.28, -0.13, 0.47, and 0.56, respectively, P<0.05).There were statistically significant differences in the red blood cell infusion volume among patients with different gender, combination of inhalation injury, combination of other trauma, combination of pulmonary edema, combination of bloodstream infection, combination of wound infection, combination of lung infection, combination of urinary tract infection, combination of sepsis, occurrence of hemoglobin value <70 g/L, admission to ICU, conduction of mechanical ventilation, and conduction of CRRT (with Z values of -2.00, -4.34, -3.10, -4.22, -8.24, -7.66, -8.62, -4.75, -7.42, -9.36, -6.12, and -8.31, -6.64, respectively, P<0.05). The age, total burn area, full-thickness burn area, blood lactic acid value within 24 h of admission, serum creatinine value within 24 h of admission, total bilirubin value within 24 h of admission, number of surgeries, and total surgical blood loss volume were correlated with the red blood cell infusion volume of patients (with rvalues of 0.12, 0.22, 0.49, 0.09, 0.18, 0.13, -0.15, 0.69, and 0.77, respectively, P<0.05). Combined underlying diseases, full-thickness burn area, combined pulmonary edema, serum creatinine value within 24 h of admission, combined sepsis, conduction of CRRT, number of surgeries, and total surgical blood loss volume were the independent influencing factors for plasma infusion volume during hospitalization in patients with extensive burns (with standardized regression coefficients of 0.09, 0.16, 0.12, 0.07, 0.11, 0.15, 0.31, and 0.26, respectively, P<0.05). Female, full-thickness burn area, serum creatinine value within 24 h of admission, combined sepsis, occurrence of hemoglobin value <70 g/L, conduction of CRRT, and total surgical blood loss volume were the independent influencing factors for red blood cell infusion volume during hospitalization in patients with extensive burns (with standardized regression coefficients of 0.10, 0.12, 0.10, 0.11, 0.05, 0.19, and 0.54, respectively, P<0.05). There were statistically significant differences in blood loss volume per surgery of patients with different surgical site and wound graft (with Z values of -2.54 and -2.27, respectively, P<0.05). The area of escharectomy or tangential excision and skin graft harvesting and duration of operation were correlated with the blood loss volume per surgery of patients (with r values of 0.40 and 0.21, respectively, P<0.05). The area of escharectomy or tangential excision and skin graft harvesting, duration of operation, and active wound grafts were the independent influencing factors for blood loss volume per surgery of patients with extensive burns (with standardized regression coefficients of 0.41, 0.16, and 0.12, respectively, P<0.05).   Conclusions   The major factors influencing blood transfusion status in patients with extensive burns are female, combined underlying diseases, full-thickness burn area, serum creatinine value within 24 h of admission, combined pulmonary edema, occurrence of hemoglobin value <70 g/L, combined sepsis, conduction of CRRT, number of surgery, and total surgical blood loss volume. In addition, the area of escharectomy or tangential excision and skin graft harvesting, duration of operation, and active wound grafts indirectly affect the patient's blood transfusion status by affecting the blood loss volume per surgery.

     

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    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 1.6 %其他: 1.6 %其他: 0.1 %其他: 0.1 %Central District: 0.1 %Central District: 0.1 %China: 0.2 %China: 0.2 %Kennedy Town: 0.0 %Kennedy Town: 0.0 %Solapur: 0.0 %Solapur: 0.0 %[]: 0.0 %[]: 0.0 %三明: 0.6 %三明: 0.6 %三门峡: 1.5 %三门峡: 1.5 %上海: 1.4 %上海: 1.4 %东莞: 0.0 %东莞: 0.0 %临汾: 0.2 %临汾: 0.2 %丽水: 0.9 %丽水: 0.9 %乐山: 0.6 %乐山: 0.6 %亳州: 0.0 %亳州: 0.0 %佛山: 0.3 %佛山: 0.3 %保定: 0.6 %保定: 0.6 %六安: 0.7 %六安: 0.7 %兰州: 0.1 %兰州: 0.1 %加特契纳: 0.1 %加特契纳: 0.1 %包头: 0.5 %包头: 0.5 %北京: 0.8 %北京: 0.8 %北方邦: 0.1 %北方邦: 0.1 %十堰: 0.0 %十堰: 0.0 %南京: 0.5 %南京: 0.5 %南宁: 0.1 %南宁: 0.1 %南平: 1.7 %南平: 1.7 %南通: 0.7 %南通: 0.7 %厦门: 0.2 %厦门: 0.2 %合肥: 0.8 %合肥: 0.8 %吉林: 0.8 %吉林: 0.8 %周口: 0.0 %周口: 0.0 %呼和浩特: 0.3 %呼和浩特: 0.3 %咸阳: 0.6 %咸阳: 0.6 %哈尔滨: 0.1 %哈尔滨: 0.1 %哥伦布: 0.1 %哥伦布: 0.1 %唐山: 0.3 %唐山: 0.3 %嘉兴: 1.1 %嘉兴: 1.1 %大连: 2.1 %大连: 2.1 %天津: 0.5 %天津: 0.5 %太原: 0.1 %太原: 0.1 %宁德: 1.8 %宁德: 1.8 %宁波: 1.2 %宁波: 1.2 %安庆: 0.1 %安庆: 0.1 %安康: 1.4 %安康: 1.4 %宜宾: 0.0 %宜宾: 0.0 %宿迁: 4.4 %宿迁: 4.4 %常州: 0.0 %常州: 0.0 %常德: 0.7 %常德: 0.7 %广元: 0.3 %广元: 0.3 %广安: 0.3 %广安: 0.3 %广州: 3.4 %广州: 3.4 %张家口: 0.6 %张家口: 0.6 %张家界: 0.0 %张家界: 0.0 %徐州: 0.8 %徐州: 0.8 %德阳: 0.1 %德阳: 0.1 %怀化: 0.2 %怀化: 0.2 %成都: 0.3 %成都: 0.3 %扬州: 0.8 %扬州: 0.8 %抚州: 1.2 %抚州: 1.2 %抚顺: 0.5 %抚顺: 0.5 %拉贾斯坦邦: 0.1 %拉贾斯坦邦: 0.1 %日照: 0.6 %日照: 0.6 %昆明: 0.2 %昆明: 0.2 %景德镇: 0.9 %景德镇: 0.9 %朝阳: 0.5 %朝阳: 0.5 %杭州: 1.6 %杭州: 1.6 %格兰特县: 0.0 %格兰特县: 0.0 %桂林: 0.0 %桂林: 0.0 %榆林: 0.1 %榆林: 0.1 %武汉: 0.2 %武汉: 0.2 %汉中: 0.8 %汉中: 0.8 %汕头: 0.4 %汕头: 0.4 %池州: 0.7 %池州: 0.7 %沈阳: 1.2 %沈阳: 1.2 %泉州: 1.9 %泉州: 1.9 %泰州: 1.6 %泰州: 1.6 %洛阳: 0.1 %洛阳: 0.1 %济南: 1.1 %济南: 1.1 %济宁: 0.0 %济宁: 0.0 %海东: 0.0 %海东: 0.0 %海得拉巴: 0.1 %海得拉巴: 0.1 %淮北: 0.2 %淮北: 0.2 %淮南: 0.1 %淮南: 0.1 %淮安: 0.7 %淮安: 0.7 %深圳: 0.1 %深圳: 0.1 %温州: 1.5 %温州: 1.5 %渭南: 0.4 %渭南: 0.4 %湖州: 1.4 %湖州: 1.4 %湘潭: 0.1 %湘潭: 0.1 %湘西: 0.7 %湘西: 0.7 %湛江: 0.1 %湛江: 0.1 %滨州: 0.0 %滨州: 0.0 %漯河: 0.1 %漯河: 0.1 %漳州: 0.9 %漳州: 0.9 %濮阳: 0.1 %濮阳: 0.1 %烟台: 0.6 %烟台: 0.6 %盐城: 0.6 %盐城: 0.6 %盘锦: 0.1 %盘锦: 0.1 %石家庄: 0.6 %石家庄: 0.6 %福州: 0.6 %福州: 0.6 %绍兴: 0.0 %绍兴: 0.0 %绵阳: 0.3 %绵阳: 0.3 %自贡: 0.2 %自贡: 0.2 %舟山: 1.1 %舟山: 1.1 %芒廷维尤: 8.6 %芒廷维尤: 8.6 %芜湖: 0.6 %芜湖: 0.6 %芝加哥: 0.1 %芝加哥: 0.1 %苏州: 1.0 %苏州: 1.0 %荆门: 0.4 %荆门: 0.4 %莆田: 2.4 %莆田: 2.4 %营口: 0.9 %营口: 0.9 %葫芦岛: 0.7 %葫芦岛: 0.7 %蚌埠: 0.2 %蚌埠: 0.2 %衡水: 0.4 %衡水: 0.4 %衡阳: 0.0 %衡阳: 0.0 %衢州: 2.4 %衢州: 2.4 %襄阳: 0.8 %襄阳: 0.8 %西宁: 0.9 %西宁: 0.9 %西安: 2.2 %西安: 2.2 %西雅图: 0.1 %西雅图: 0.1 %辽阳: 1.6 %辽阳: 1.6 %运城: 0.0 %运城: 0.0 %连云港: 0.6 %连云港: 0.6 %遵义: 0.3 %遵义: 0.3 %邵阳: 0.2 %邵阳: 0.2 %郑州: 0.3 %郑州: 0.3 %郴州: 1.1 %郴州: 1.1 %鄂木斯克: 0.2 %鄂木斯克: 0.2 %重庆: 3.2 %重庆: 3.2 %金华: 1.7 %金华: 1.7 %铁岭: 1.0 %铁岭: 1.0 %铜陵: 1.5 %铜陵: 1.5 %锦州: 1.1 %锦州: 1.1 %长春: 0.0 %长春: 0.0 %长沙: 0.5 %长沙: 0.5 %青岛: 0.1 %青岛: 0.1 %鞍山: 2.1 %鞍山: 2.1 %韶关: 0.0 %韶关: 0.0 %香港: 0.0 %香港: 0.0 %马鞍山: 0.0 %马鞍山: 0.0 %鹰潭: 0.5 %鹰潭: 0.5 %黄山: 0.1 %黄山: 0.1 %黄石: 0.1 %黄石: 0.1 %黔西南: 0.5 %黔西南: 0.5 %其他其他Central DistrictChinaKennedy TownSolapur[]三明三门峡上海东莞临汾丽水乐山亳州佛山保定六安兰州加特契纳包头北京北方邦十堰南京南宁南平南通厦门合肥吉林周口呼和浩特咸阳哈尔滨哥伦布唐山嘉兴大连天津太原宁德宁波安庆安康宜宾宿迁常州常德广元广安广州张家口张家界徐州德阳怀化成都扬州抚州抚顺拉贾斯坦邦日照昆明景德镇朝阳杭州格兰特县桂林榆林武汉汉中汕头池州沈阳泉州泰州洛阳济南济宁海东海得拉巴淮北淮南淮安深圳温州渭南湖州湘潭湘西湛江滨州漯河漳州濮阳烟台盐城盘锦石家庄福州绍兴绵阳自贡舟山芒廷维尤芜湖芝加哥苏州荆门莆田营口葫芦岛蚌埠衡水衡阳衢州襄阳西宁西安西雅图辽阳运城连云港遵义邵阳郑州郴州鄂木斯克重庆金华铁岭铜陵锦州长春长沙青岛鞍山韶关香港马鞍山鹰潭黄山黄石黔西南

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      沈阳化工大学材料科学与工程学院 沈阳 110142

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