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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  >  > Accepted Manuscript
Duan Deqing,Wu Zongyan,Chen Yong,et al.Analysis of risk factors for the occurrence of early dysfunction of blood coagulation in elderly patients with severe burns[J].Chin J Burns Wounds,2026,42(10):1-8.DOI: 10.3760/cma.j.cn501225-20250507-00209.
Citation: Duan Deqing,Wu Zongyan,Chen Yong,et al.Analysis of risk factors for the occurrence of early dysfunction of blood coagulation in elderly patients with severe burns[J].Chin J Burns Wounds,2026,42(10):1-8.DOI: 10.3760/cma.j.cn501225-20250507-00209.
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Analysis of risk factors for the occurrence of early dysfunction of blood coagulation in elderly patients with severe burns

doi: 10.3760/cma.j.cn501225-20250507-00209

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

Funds:

Reginal Science Fund Program of National Natural Science Foundation of China 82360450

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  • Corresponding author: Zhang Hongyan, Email: zhycn2008@163.com
  • Received Date: 2025-05-07
    Available Online: 2026-09-28
    Abstract
  •   Objective  To investigate the risk factors for the occurrence of early dysfunction of blood coagulation in elderly patients with severe burns.  Methods  This study was a retrospective case-control study. From June 2015 to June 2025, 158 elderly patients with severe burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Nanchang University, including 94 males and 64 females, aged 60 to 97 years. The patients were divided into early dysfunction of blood coagulation group (45 cases) and non-early dysfunction of blood coagulation group (113 cases) according to the presence or absence of early dysfunction of blood coagulation. Gender, age, total burn area, full-thickness burn area, admission time after injury, cause of burn, combination of inhalation injury, combination of underlying diseases, modified Baux score, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, body temperature, blood pH value, platelet count, and base excess, lactic acid, hemoglobin, serum sodium, serum potassium, serum calcium, plasma fibrinogen (FIB) levels on admission, length of hospital stay, and clinical prognosis between the two groups of patients were compared. The risk factors and independent risk factors affecting the occurrence of early dysfunction of blood coagulation in elderly patients with severe burns were screened, and the prediction model was constructed according to the independent risk factors. The receiver operating characteristic curve was used to evaluate the predictive value of the prediction model and each independent risk factor for the occurrence of early dysfunction of blood coagulation in aforementioned elderly patients with severe burns.  Results  There were statistically significant differences in the total burn area, full-thickness burn area, on admission modified Baux score, APACHEⅡ score, platelet count, serum calcium level, blood pH value, plasma FIB level, combination of inhalation injury, and clinical prognosis between the two groups of patients (with t values of 2.270, 7.615, 5.975, 2.319, -2.172, and -7.861, respectively, Z values of -2.168 and -2.568, respectively, χ2 values of 20.090 and 10.286, respectively, P<0.05). There were no statistically significant differences in the other indicators between the two groups of patients (P>0.05). The results of univariate logistic regression analysis showed that the total burn area, full-thickness burn area, combination of inhalation injury, modified Baux score, APACHEⅡ score, platelet count, serum calcium level, and plasma FIB level on admission were all risk factors for early dysfunction of blood coagulation in elderly patients with severe burns (with ORs of 1.022, 1.074, 0.141, 1.045, 1.070, 0.996, <0.001, and 0.568, respectively, 95% CIs of 1.003-1.042, 1.047-1.102, 0.055-0.359, 1.027-1.064, 1.008-1.135, 0.992-0.999, <0.001-0.002, and 0.380-0.849, respectively, P<0.05). The results of multivariate logistic regression analysis showed that the full-thickness burn area, modified Baux score, platelet count, and serum calcium level on admission were independent risk factors for early dysfunction of blood coagulation in elderly patients with severe burns (with ORs of 1.181, 1.254, 0.991, <0.001, respectively, 95% CIs of 1.085-1.287, 1.106-1.423, 0.984-0.998, <0.001-0.009, P<0.05). In terms of predicting early dysfunction of blood coagulation in elderly patients with severe burns, the area under the receiver operating characteristic curve of the prediction model constructed based on the independent risk factors was 0.977 (with a 95% CI of 0.959-0.994), which was higher than 0.844 (with a 95% CI of 0.781-0.908), 0.782 (with a 95% CI of 0.711-0.853), 0.634 (with a 95% CI of 0.526-0.742), and 0.838 (with a 95% CI of 0.770-0.905) of the full-thickness burn area, modified Baux score, platelet count, and serum calcium level on admission, respectively.  Conclusions  Full-thickness burn area, modified Baux score, platelet count, and serum calcium level on admission are independent risk factors for early dysfunction of blood coagulation in elderly patients with severe burns. The prediction model based on these four indicators has a good predictive value for the occurrence of early dysfunction of blood coagulation in elderly patients with severe burns.

     

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