NGHIÊN CỨU MỐI LIÊN QUAN CỦA GIẢM TIỂU CẦU TRONG TUẦN ĐẦU SAU BỎNG VỚI KẾT QUẢ ĐIỀU TRỊ BỆNH NHÂN BỎNG NẶNG

Abstract

Objectives: Evaluate the mortality prediction value of platelets on the first week after burn in severe burn patients. Subjects and methods: Retrospective, descriptive study on 229 severe burn patients from 18 years old, no comorbidity and combined injury, burn extent ≥ 30% TBSA, hospitalized within 24 hours burns at the Viet Nam National Burn Hospital from January 1, 2021 - October 31, 2022. Thrombocytopenia was defined as platelet count < 150 G/L. The indicators were compared between the two groups: survival and mortality. Results: The mortality rate was 26.2%. On the 3^rd day after burn, the number of patients with thrombocytopenia was the largest (66.38%). The number of patients with thrombocytopenia on days 3rd and 7th after burns in the mortality group was significantly higher than in the survival group (83.33% vs. 60.36%, p = 0.001; 56.67% vs. 13.02%, p = 0.000). Multivariate analysis showed that thrombocytopenia on the 7^th day after burn along with increasing age, deep burn area and inhalation injury were independently associated with mortality; each unit thrombocytopenia on day 7^th increases the risk of mortality by 3.09 times. The prognostic value of thrombocytopenia on day 7^th after burn in severe burn patients was quite good (AUC = 0.72). When combining age increase, deep burn area, inhalation injury and thrombocytopenia on day 7^th, the predictive value of mortality were very good (AUC = 0.92) with sensitivity 83.33% and specificity 91.72%, the difference is significant compared to each individual parameter (p < 0.05). Conclusion: The thrombocytopenia on day 7^th after burn were independently associated with mortality in severe burn patients. When combining thrombocytopenia on day 7^th after burn with age increase, deep burn area and inhalation injury, the prognostic value of mortality were very good.