by Lijun Jiang, Qian Yu, Hui Li, Fudong Wang, Feng Liu, Zhenxing Xu
ObjectiveTo determine the association between blood pressure variability (BPV), coagulation indexes, and germinal matrix-intraventricular hemorrhage (GMH-IVH) in preterm infants with gestational age ≤ 32 weeks. In addition, we aimed to determine whether the combination can predict the occurrence and outcome of GMH-IVH.
MethodsThis retrospective study included 106 preterm infants. According to the presence of GMH-IVH, the preterm infants were divided into GMH-IVH (51 patients) and no GMH-IVH (55 patients) groups. Furthermore, according to the short-term prognoses, the GMH-IVH group was subdivided into good outcome (30 patients) and poor outcome (21 patients) groups. Coagulation function and BPV indexes were collected at admission. Univariate analysis, logistic regression model, and receiver operating characteristic curve were used to analyze the relationship between indexes and the occurrence and outcome of GMH-IVH in preterm infants.
ResultsUnivariate analysis showed that the difference between maximum and minimum (Max-Min); standard deviation (SD); coefficient of variation (CV) of BPV, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and proportion of premature rupture of membranes (PROM) were higher in the GMH-IVH group than the no GMH-IVH group (P ). Logistic regression analysis showed that INR and DBP SD were directly correlated with GMH-IVH, and the joint curve had the largest area under the curve (AUC) (82.4% sensitivity and 79.7% specificity). BPV SD, BPV CV, APTT, and INR were higher in the poor outcome group than in the good outcome group (P ). Logistic regression analysis showed that INR and DBP SD were directly correlated with poor outcomes in preterm infants with GMH-IVH. The joint curve had the largest AUC (sensitivity 76.2% and specificity 90.0%).
ConclusionIncreased INR and DBP SD are directly associated factors for the developement and poor short-term outcome of GMH-IVH, and combined monitoring of INR and DBP SD has certain reference value for the early identification and prognosis evaluation of GMH-IVH in preterm infants with gestational age ≤ 32 weeks.
Severe burns lead to malformations and higher mortality and have long-term social consequences. We aimed to analyse the epidemiologic characteristics and clinical outcomes of severe burn patients hospitalized in a major burn centre in Eastern China. This study included severe burns patients hospitalized in our hospital from 2017 to 2022. We extracted all data from electronic medical records for retrospective analysis. Burn scoring systems were calculated for all patients. The median age of the patients was 49.00 years, with 62.13% of them aged between 30 and 59 years. Of the 375 adult patients, 256 were male and 119 were female. The major cause of burns was flame (46.1%), followed by explosion (35.2%). The median total body surface area was 40%. Sixty-three percent of patients suffered an inhalation injury and 125 patients (33.3%) developed complications during hospitalization. The average mortality was 5.3%. Higher mortality rates are associated with advanced age, flame burns, larger full-thickness burns area and total body surface area, inhalation injuries and combined burn complications. Severe burns often occur in middle-aged men. Governments and companies need to improve the safety of living and working environments. It is essential to develop treatment strategies based on risk factors for burn deaths and improve the quality of medical care.
This meta-analysis aimed to explore the effects of quality nursing intervention on wound healing in patients with burns. A computerised search was conducted for randomised controlled trials (RCTs) on the effect of quality nursing intervention on wound healing in patients with burns in the PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases from the date of database inception to November 2023. Two researchers independently screened the literature, extracted data and performed quality assessment based on the inclusion and exclusion criteria. Stata 17.0 software was used for the data analysis. Twenty-nine RCTs involving 2637 patients with burns were included. The meta-analysis revealed that compared with conventional nursing, the implementation of quality nursing intervention in patients with burns significantly shortened the wound healing time (standardised mean difference [SMD] = −2.93, 95% confidence interval [CI]: −3.44 to −2.42, p < 0.001). The incidence of wound infections (odds ratio [OR] = 0.14, 95% CI: 0.07–0.27, p < 0.001) and complications (OR = 0.16, 95% CI: 0.11–0.23, p < 0.001) was also reduced significantly. This meta-analysis shows that applying quality nursing interventions in patients with burns can significantly shorten the wound healing time and reduce the incidence of wound infection and complications, thus promoting early patient recovery.
To evaluate the effect of predictive nursing interventions on pressure ulcers in elderly bedridden patients by meta-analysis. Applied computer searches of PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for randomised controlled trials (RCTs) on the effect of predictive nursing in preventing pressure ulcers in elderly bedridden patients from the database inception to November 2023. Two researchers independently screened the literature, extracted data and performed quality assessment based on inclusion and exclusion criteria. Stata 17.0 software was utilised for data analysis. Eighteen RCTs involving 6504 patients were finally included. The analysis revealed the implementation of predictive nursing interventions had a significant advantage in reducing the incidence of pressure ulcers in elderly bedridden patients compared with conventional nursing (odds ratio [OR] = 0.20, 95% confidence interval [CI]: 0.15–0.28, p < 0.001), while the patients' satisfaction with nursing care was higher (OR = 3.70, 95% CI: 2.99–4.57, p < 0.001). This study shows that the implementation of a predictive nursing interventions for elderly bedridden patients can effectively reduce the occurrence of pressure ulcers and significantly improve patients' satisfaction with nursing care, which is worthy of clinical promotion and application.
Whether prophylactic abdominal drainage tube is routinely placed in patients after hepatobiliary surgery remains controversial. To evaluate the effect of prophylactic abdominal drainage tube placement after hepatobiliary surgery on postoperative infection. Randomized controlled trials on the placement of prophylactic abdominal drainage tube after hepatobiliary surgery were collected through a computerized search of PubMed, Embase, Conchrane Library and Web of Science databases, with a time range from the establishment of the database to August 2023. After two researchers independently screened the literature, extracted information, and evaluated the quality of the included studies. Finally, 13 studies were included, including 3620 patients, and the results showed that there was no statistically significant difference in postoperative infection rate between the drainage group (1840 patients and the non-drainage group [1783 patients] [relative risk, RR = 1.17, 95% confidence interval, CI: 0.94–1.47, p = 0.16]. Compared with the drainage group, the incidence of infectious abdominal fluid in the non-drainage group was lower (RR = 2.09, 95% CI: 1.57–2.80, p < 0.00001), and the incidence of postoperative bile leakage was lower (RR = 1.77, 95% CI: 1.27–2.47, p < 0.001) and shorter hospital stays after surgery (mean difference = 1.27, 95% CI: 0.32–2.22, p = 0.009). In conclusion, placing a prophylactic abdominal drainage tube after hepatobiliary surgery does not reduce postoperative infection rates compared with no drainage.