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Volume 40 Issue 9
Sep.  2024
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2024  >  40(9): 857-865
Weng TT,Cai CH,Han CM,et al.Research advances on biomaterials for the delivery of growth factors to regulate wound repair[J].Chin J Burns Wounds,2022,38(7):691-696.DOI: 10.3760/cma.j.cn501225-20220430-00166.
Citation: Jiang NH,Xie WG,Wang DY,et al.Analysis of risk factors for atrial fibrillation in adult patients with critically severe burns after the first surgery[J].Chin J Burns Wounds,2024,40(9):857-865.DOI: 10.3760/cma.j.cn501225-20240329-00111.
shu

Analysis of risk factors for atrial fibrillation in adult patients with critically severe burns after the first surgery

doi: 10.3760/cma.j.cn501225-20240329-00111

  • Department of Burns, Tongren Hospital of Wuhan UniversityWuhan Third Hospital, Wuhan 430060, China

Funds:

Action Plan for Science and Technology in Major Disease Prevention and Control 2018-ZX-01S-001

Medical Scientific Research Projects of Wuhan Municipal Health Commission WX23Z02

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  • Corresponding author: Xie Weiguo, Email: wgxie@hotmail.com
  • Received Date: 2024-03-29
    Abstract
  •   Objective  To explore the risk factors for atrial fibrillation in adult patients with critically severe burns after the first surgery.  Methods  This study was a retrospective case series study. From January 1, 2018 to March 31, 2023, 211 adult patients with critically severe burns were admitted to the Department of Burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital and met the inclusion criteria, including 158 males and 53 females, aged 24-81 years. According to whether atrial fibrillation occurred after the first surgery, the patients were divided into postoperative atrial fibrillation (POAF) group (23 cases) and non-POAF group (188 cases). The following indexes of patients in POAF group were collected, including the onset time, duration, treatment method, and number of patients with more than once of atrial fibrillation after the first surgery. The following data of the two groups of patients were collected, including general data, such as gender, age, burn type, total burn area, full-thickness burn area, inhalation injury, underlying diseases, mechanical ventilation, and sepsis; electrolyte imbalance and blood index level before the first surgery; the first surgery-related information such as surgical length and surgical method; volume changes and vital signs during the first surgery, such as total volume of fluid infusion, total volume of blood transfusion, volume of blood loss, hypotension, and hypothermia; postoperative hypothermia; inflammatory index levels before the first surgery and on the first day after the first surgery, such as procalcitonin levels, white blood cell count, neutrophil count, lymphocyte count, platelet count, neutrophil to lymphocyte ratio (NLR), platelet count to lymphocyte ratio (PLR); mortality within 30 days of admission. The independent risk factors for occurrence of atrial fibrillation in adult patients with critically severe burns after the first surgery were screened.  Results  The onset time of atrial fibrillation of patients in POAF group was 2 (2, 4) hours after the first surgery, and the duration of atrial fibrillation was 16 (6, 26) hours. Twenty-one patients were treated with intravenous injection of amiodarone, two patients were treated with cardiac electrical cardioversion, and atrial fibrillation of all patients converted to sinus rhythm after treatment. Three patients experienced atrial fibrillation more than once. The age was 59 (42, 70) years and the total burn area was 90% (70%, 94%) total body surface area (TBSA) in patients in POAF group, which were significantly higher than 48 (38, 56) years and 70% (60%, 83%) TBSA in non-POAF group (with Z values of -2.64 and -3.56, respectively, P<0.05). Compared with those in non-POAF group, the incidence rate of inhalation injury of patients in POAF group was significantly higher (χ2=4.45, P<0.05), the total volumes of fluid infusion and blood transfusion during the first surgery were significantly increased (with Z values of -3.98 and -3.75, respectively, P<0.05), the incidence rates of hypothermia during the first surgery and hypothermia after the first surgery were significantly increased (with χ2 values of 8.24 and 18.72, respectively, P<0.05), the levels of procalcitonin before the first surgery and on the first day after the first surgery, as well as the NLR on the first day after the first surgery were significantly increased (with Z values of -3.03, -2.19, and -2.18, respectively, P<0.05), the lymphocyte count (with Z values of -2.07 and -2.60, respectively, P<0.05) and platelet count (with Z values of -3.35 and -3.58, respectively, P<0.05) were significantly reduced before the first surgery and on the first day after the first surgery, and the mortality rate within 30 days of admission was significantly higher (χ2=4.03, P<0.05). There were no statistically significant differences in other indexes between the two groups of patients (P>0.05). Multivariate logistic regression analysis showed that age, total burn area, and intraoperative hypothermia were independent risk factors for the occurrence of atrial fibrillation in adult patients with critically severe burns after the first surgery (with odds ratios of 1.08, 1.07, and 4.18, 95% confidence intervals of 1.03-1.12, 1.03-1.11, and 1.48-11.80, respectively, P<0.05).  Conclusions  Age, total burn area, and intraoperative hypothermia are independent risk factors for the occurrence of atrial fibrillation in adult patients with critically severe burns after the first surgery. Patients with atrial fibrillation have an increased risk of death.

     

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    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 2.4 %其他: 2.4 %其他: 0.3 %其他: 0.3 %Bacoor: 0.1 %Bacoor: 0.1 %China: 0.3 %China: 0.3 %United States: 0.1 %United States: 0.1 %[]: 0.1 %[]: 0.1 %三明: 0.6 %三明: 0.6 %三门峡: 0.5 %三门峡: 0.5 %上海: 1.7 %上海: 1.7 %东莞: 0.5 %东莞: 0.5 %临汾: 0.1 %临汾: 0.1 %丽水: 0.9 %丽水: 0.9 %乐山: 0.3 %乐山: 0.3 %佛山: 1.0 %佛山: 1.0 %佳木斯: 0.1 %佳木斯: 0.1 %保定: 0.6 %保定: 0.6 %信阳: 0.1 %信阳: 0.1 %六安: 0.4 %六安: 0.4 %六盘水: 0.2 %六盘水: 0.2 %兰州: 0.3 %兰州: 0.3 %兴安: 0.1 %兴安: 0.1 %兴安盟: 0.1 %兴安盟: 0.1 %内江: 0.2 %内江: 0.2 %凉山彝族自治州: 0.1 %凉山彝族自治州: 0.1 %包头: 0.1 %包头: 0.1 %北京: 1.5 %北京: 1.5 %北方邦: 0.1 %北方邦: 0.1 %南京: 0.7 %南京: 0.7 %南宁: 0.2 %南宁: 0.2 %南平: 1.4 %南平: 1.4 %南昌: 0.3 %南昌: 0.3 %南通: 0.8 %南通: 0.8 %台州: 0.2 %台州: 0.2 %合肥: 0.4 %合肥: 0.4 %吉林: 0.6 %吉林: 0.6 %呼和浩特: 0.3 %呼和浩特: 0.3 %哈尔滨: 0.1 %哈尔滨: 0.1 %哥伦布: 0.1 %哥伦布: 0.1 %唐山: 0.5 %唐山: 0.5 %嘉兴: 0.8 %嘉兴: 0.8 %大克罗伊茨: 0.3 %大克罗伊茨: 0.3 %大庆: 0.1 %大庆: 0.1 %大连: 1.2 %大连: 1.2 %天津: 0.4 %天津: 0.4 %威海: 0.1 %威海: 0.1 %宁德: 2.4 %宁德: 2.4 %宁波: 0.5 %宁波: 0.5 %安康: 1.7 %安康: 1.7 %宜春: 0.1 %宜春: 0.1 %宿迁: 2.9 %宿迁: 2.9 %常州: 0.1 %常州: 0.1 %常德: 0.2 %常德: 0.2 %广元: 0.2 %广元: 0.2 %广安: 0.1 %广安: 0.1 %广州: 1.3 %广州: 1.3 %廊坊: 0.1 %廊坊: 0.1 %延安: 3.2 %延安: 3.2 %延边朝鲜族自治州: 0.1 %延边朝鲜族自治州: 0.1 %张家口: 1.0 %张家口: 1.0 %徐州: 1.1 %徐州: 1.1 %德阳: 1.1 %德阳: 1.1 %怀化: 0.2 %怀化: 0.2 %悉尼: 0.1 %悉尼: 0.1 %意法半: 0.1 %意法半: 0.1 %成都: 0.4 %成都: 0.4 %扬州: 0.5 %扬州: 0.5 %拉贾斯坦邦: 0.5 %拉贾斯坦邦: 0.5 %无锡: 0.1 %无锡: 0.1 %日照: 0.7 %日照: 0.7 %昆明: 0.6 %昆明: 0.6 %朝阳: 0.1 %朝阳: 0.1 %杭州: 2.3 %杭州: 2.3 %桂林: 0.1 %桂林: 0.1 %榆林: 0.1 %榆林: 0.1 %武汉: 0.6 %武汉: 0.6 %汉中: 0.9 %汉中: 0.9 %汕头: 0.4 %汕头: 0.4 %江门: 0.6 %江门: 0.6 %池州: 0.6 %池州: 0.6 %沈阳: 1.7 %沈阳: 1.7 %沧州: 0.1 %沧州: 0.1 %泉州: 1.2 %泉州: 1.2 %泰州: 1.5 %泰州: 1.5 %洛阳: 0.5 %洛阳: 0.5 %济南: 1.1 %济南: 1.1 %海口: 0.1 %海口: 0.1 %海得拉巴: 0.2 %海得拉巴: 0.2 %淄博: 0.1 %淄博: 0.1 %淮北: 0.1 %淮北: 0.1 %淮安: 0.2 %淮安: 0.2 %深圳: 0.4 %深圳: 0.4 %温州: 2.2 %温州: 2.2 %渭南: 0.3 %渭南: 0.3 %湖州: 1.4 %湖州: 1.4 %湘潭: 0.1 %湘潭: 0.1 %湘西: 0.3 %湘西: 0.3 %湘西土家族苗族自治州: 0.3 %湘西土家族苗族自治州: 0.3 %湛江: 0.1 %湛江: 0.1 %滁州: 0.4 %滁州: 0.4 %漯河: 0.1 %漯河: 0.1 %漳州: 0.8 %漳州: 0.8 %潍坊: 0.1 %潍坊: 0.1 %烟台: 0.3 %烟台: 0.3 %爱丁堡: 0.1 %爱丁堡: 0.1 %珠海: 0.2 %珠海: 0.2 %白山: 0.3 %白山: 0.3 %盐城: 0.1 %盐城: 0.1 %盘锦: 0.9 %盘锦: 0.9 %石嘴山: 0.2 %石嘴山: 0.2 %石家庄: 0.3 %石家庄: 0.3 %福州: 0.2 %福州: 0.2 %秦皇岛: 0.4 %秦皇岛: 0.4 %绵阳: 0.3 %绵阳: 0.3 %自贡: 0.3 %自贡: 0.3 %舟山: 0.4 %舟山: 0.4 %芒廷维尤: 7.0 %芒廷维尤: 7.0 %芝加哥: 0.2 %芝加哥: 0.2 %苏州: 0.8 %苏州: 0.8 %荆门: 0.9 %荆门: 0.9 %莆田: 2.1 %莆田: 2.1 %营口: 1.1 %营口: 1.1 %葫芦岛: 0.1 %葫芦岛: 0.1 %蚌埠: 0.1 %蚌埠: 0.1 %衡水: 0.3 %衡水: 0.3 %衢州: 1.7 %衢州: 1.7 %西宁: 2.0 %西宁: 2.0 %西安: 1.4 %西安: 1.4 %西雅图: 0.1 %西雅图: 0.1 %赣州: 0.1 %赣州: 0.1 %辽阳: 1.2 %辽阳: 1.2 %达州: 0.1 %达州: 0.1 %运城: 0.1 %运城: 0.1 %连云港: 0.3 %连云港: 0.3 %通辽: 0.2 %通辽: 0.2 %遵义: 0.1 %遵义: 0.1 %邵阳: 0.1 %邵阳: 0.1 %郑州: 1.0 %郑州: 1.0 %郴州: 0.8 %郴州: 0.8 %鄂尔多斯: 0.7 %鄂尔多斯: 0.7 %重庆: 4.3 %重庆: 4.3 %金华: 0.8 %金华: 0.8 %金昌: 0.1 %金昌: 0.1 %铁岭: 0.1 %铁岭: 0.1 %铜川: 0.2 %铜川: 0.2 %铜陵: 1.1 %铜陵: 1.1 %银川: 0.1 %银川: 0.1 %锦州: 1.7 %锦州: 1.7 %长春: 0.1 %长春: 0.1 %长沙: 4.2 %长沙: 4.2 %长治: 0.1 %长治: 0.1 %阜新: 0.1 %阜新: 0.1 %阜阳: 0.1 %阜阳: 0.1 %青岛: 0.9 %青岛: 0.9 %鞍山: 2.1 %鞍山: 2.1 %马德里: 0.1 %马德里: 0.1 %黄石: 0.5 %黄石: 0.5 %其他其他BacoorChinaUnited States[]三明三门峡上海东莞临汾丽水乐山佛山佳木斯保定信阳六安六盘水兰州兴安兴安盟内江凉山彝族自治州包头北京北方邦南京南宁南平南昌南通台州合肥吉林呼和浩特哈尔滨哥伦布唐山嘉兴大克罗伊茨大庆大连天津威海宁德宁波安康宜春宿迁常州常德广元广安广州廊坊延安延边朝鲜族自治州张家口徐州德阳怀化悉尼意法半成都扬州拉贾斯坦邦无锡日照昆明朝阳杭州桂林榆林武汉汉中汕头江门池州沈阳沧州泉州泰州洛阳济南海口海得拉巴淄博淮北淮安深圳温州渭南湖州湘潭湘西湘西土家族苗族自治州湛江滁州漯河漳州潍坊烟台爱丁堡珠海白山盐城盘锦石嘴山石家庄福州秦皇岛绵阳自贡舟山芒廷维尤芝加哥苏州荆门莆田营口葫芦岛蚌埠衡水衢州西宁西安西雅图赣州辽阳达州运城连云港通辽遵义邵阳郑州郴州鄂尔多斯重庆金华金昌铁岭铜川铜陵银川锦州长春长沙长治阜新阜阳青岛鞍山马德里黄石

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