title: Determinants of Outcome in Burn ICU Patients with Septic Shock.
abstract: Infectious complications remain one of the most challenging concerns for the burn team. The goal of this study was to evaluate the diagnostic and therapeutic approaches and prognosis in burn patients with septic shock. This retrospective study included patients with severe burn injury who were admitted to a burn intensive care unit (ICU). Demographic and clinical data were recorded for each patient. The diagnostic and prognostic value of a number of clinical and laboratory parameters and various treatment options were evaluated. Sixty-four of the 378 patients (16.9%) were identified as having experienced a septic shock during ICU stay. The mortality rate of patients with septic shock was 46.9%. The main bacterial strains responsible for infection were Gram-negative bacteria (78.1%). Factors associated with outcome of septic shock on logistic regression analysis were presence of stage III of acute kidney injury (odds ratio [95% confidence interval] 2.03 [1.06-3.84]; P = 0.019), and lactate levels > 4 mmol/L during the first 48 hours of shock (odds ratio 1.92; 95% confidence interval: 1.02-3.62; P = 0.043). Prognosis of septic shock remains poor in burn patients with septic shock. The main causative pathogens of septic shock identified in our burn ICU were Gram-negative species. The main prognostic factors identified in this study were the presence of AKI, stage III, and high lactate levels early after the onset of septic shock.
authors.affiliation: From the Papanikolaou General Hospital, Burn ICU, Thessaloniki, Greece.
authors.forename: Athina
authors.initials: A
authors.lastname: Lavrentieva
authors.forename: Vasileios
authors.initials: V
authors.lastname: Voutsas
authors.forename: Maria
authors.initials: M
authors.lastname: Konoglou
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Karali
authors.forename: Pagona
authors.initials: P
authors.lastname: Koukiasa
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Loridas
authors.forename: Maria
authors.initials: M
authors.lastname: Papaioannou
authors.forename: Georgia
authors.initials: G
authors.lastname: Vasileiadou
authors.forename: Militsa
authors.initials: M
authors.lastname: Bitzani
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002056:Burns / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002423:Cause of Death; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods*; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006115:Greece; D017052:Hospital Mortality; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012772:Shock, Septic / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D018709:Statistics, Nonparametric; D015996:Survival Rate
chemical_list: D000900:Anti-Bacterial Agents; D006854:Hydrocortisone