Sofa Score For Patients With Severe Burns Complicated With Sepsis Assessment Significance

Obiective: To retrospectively study the relationship between the SOFA score and sepsis in patients with severe burns,and to determine the average SOFA threshold for patients with severe burns.To find the influencing factors of sepsis in patients,provide a reference for clinical individualized treatment of patients with severe burns and timely and effective prevention and treatment of sepsis.Method: The clinical data of 117 patients with severe burns who were hospitalized in the Department of Burn and Plastic Surgery,the First Affiliated Hospital of Nanhua University from January 2004 to December 2018,were retrospectively analyzed.The patient's gender,age,total body surface area(TBSA),presence or absence of inhalation injury were recorded,and the oxygenation index(PaO2/FiO2)and platelet count were recorded on the 1st,3rd,7th,10 th,14th and 21 st day of hospitalization.(Platelet,PLT),bilirubin value,Mean Arterial Pressure(MAP),Glasgow Coma Scale(GCS),serum creatinine value,24-hour urine volume,according to Sequential Organ Failure Score(Sequential Organ Failure Assessment,SOFA)standard statistical SOFA value.According to the 21 st day,the prognosis was divided into sepsis group(test group)and nonsepsis group(control group);according to the patient's age,it was divided into young adult group(18-40 years old)and middle-aged group(41-60 years old).The paired t test was used to analyze the difference between the SOFA value and the test group and the control group.The LSD-t test analyzed the difference in SOFA values within the group.The SOC value ROC curve was drawn,and the relationship between the mean value of SOFA and the patient's sepsis was analyzed according to the results of AUC,P value,critical value,sensitivity,specificity and 95% CI.Pearson correlation analysis was performed on SOFA values and patients with sepsis.Univariate analysis was performed on the four variables of gender,age,burn area and inhalation injury to find out the influencing factors of sepsis.The influencing factors obtained by univariate analysis were analyzed by Logistic analysis.According to the regression coefficient,OR value and P value,the risk factors of sepsis were obtained when the influencing factors were present,and independent risk factors were obtained.Results: Among the 117 patients with severe burns after 21 days of treatment,52 patients(44.4%)had sepsis and 65 patients(55.6%)had non-sepsis.The SOFA values at six time points on the 1st,3rd,7th,10 th,14th,and 21 st day after admission(see Table 3.1-1),and the average SOFA on the 1st day(2.38±1.94)in the sepsis group.3 days(4.54 ± 3.45),7 days(2.41 ± 1.97),10 days(1.53 ± 1.34),14 days(1.27 ± 1.15),and 21 days(1.09 ± 1.12).The average value of SOFA in the non-sepsis group was 1 day(1.19±0.23),3rd day(2.16±1.75),day 7(1.15±0.97),day 10(0.71±0.54),day 14(0.58±).0.77),day 21(0.55 ± 0.12).Paired t-test was used for comparison between groups.The average SOFA of the sepsis group and the non-sepsis group was the average SOFA on the first day(2.38±1.94 vs.1.19±0.23,P<0.05),and the average SOFA on the third day.Value(4.54±3.45 vs.2.16±1.75,P<0.05),SOFA average on day 7(2.41±1.97 vs.1.15±0.97,P<0.05),average SOFA value on day 10(1.53±1.34 vs.0.71)±0.54,P<0.05),the average value of SOFA on day 14(1.27±1.15 vs.0.58±0.77,P<0.05),and the average value of SOFA on day 21(1.09±1.12 vs.0.55±0.12,P<0.05),The average value of SOFA in the experimental group was higher than that in the control group(3.73±2.479 VS.0.98±1.136,P<0.05).The average value of SOFA in the group was compared by LSD-t test,and the average value of SOFA on day 1,3,7,and 10 of sepsis group was obtained(2.38±1.94 vs.4.54±3.45 vs.2.41±1.97 vs.1.53±1.34).,p<0.05),comparison of SOFA mean values on days 14 and 21(1.27±1.15 vs.1.09±1.12,P>0.05);comparison of SOFA mean values on days 1,3 and 7 of non-sepsis group(1.19±0.23)Vs.2.16±1.75 vs.1.15±0.97,p<0.05),the average of SOFA values on days 10,14,and 20(0.71±0.54 vs.0.58±0.77 vs.0.55±0.12,P>0.05).The SOFA value ROC curve results were obtained,SOFA values AUC: 0.91,P < 0.05,cut-off value 2.1,sensitivity 86.7%,specificity 91.7%,95% CI(0.87-0.91).Correlation analysis between the SOFA mean and the patient with sepsis Pearson gave r=0.82,P<0.05.In this study,multi-factor analysis of patients with sepsis showed that the incidence of sepsis was high in patients with age,burn surface area and inhalation injury,P<0.05.Logistic analysis of age,burn area and inhalation injury showed that the burn area and inhalation injury were P<0.05.Conclusions: The mean value of SOFA was positively correlated with sepsis in patients with severe burns(r=0.82,P<0.05).When the mean SOFA was >2.1,the risk of sepsis was increased.The mean SOFA was higher in the sepsis group than in the non-sepsis group.After hospitalization,the average SOFA of the sepsis group and the non-sepsis group gradually increased on days 1-3,gradually decreased on days 3-21,and the sepsis group stabilized after 14 days.After 10 days in the nonsepsis group.becoming steady.Age,burn area,and inhalation injury are the influencing factors of sepsis in patients with severe burns.Burn area and inhalation injury are independent risk factors.