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RISS 인기검색어
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- 저자 : 김근숙 ( Gun Sook Kim ) (검색결과 1 건)
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김성욱 ( Sung Wook Kim ),민영훈 ( Young Hoon Min ),진희종 ( Hui Jong Chin ),이태유 ( Tae Yu Lee ),최창순 ( Chang Soon Choi ),정연손 ( Youn Son Chung ),김근숙 ( Gun Sook Kim ),김근호 ( Gheun Ho Kim ),김종현 ( Jong Hyun Kim ),박윤규 대한내과학회 2002 대한내과학회지 Vol.63 No.5
N/A Background : Acute renal failure (ARF) is not a rare occurrence in severe burns and is an important complication leading to an increase in mortality. This study was undertaken to characterize the ARF occurring in major burn patients and to investigate the impact of burn size and initial serum albumin concentration on the occurrence of ARF and patient survival in major burns. Methods : The clinical characteristics of 147 adult patients with second- and third-degree burns covering 30% or more of their body surface area were analyzed retrospectively. All patients were admitted over a 1-year period to a single burn intensive care unit in Seoul, Korea. Logistic regression was used to estimate of the relative risks of ARF and mortality associated with the larger burn size and the lower serum albumin level at admission. Results : Mean burned body surface was 60.0±21.8% (range, 30 to 100%). Twenty-eight (19.0%) out of 147 patients experienced ARF, defined as a serum creatinine > 2 mg/dL, during the admission. The ARF was preceded by significant hypotension (burn shock), rhabdomyolysis, sepsis or use of aminoglycosides. The occurrence of ARF was not associated with age, sex or burn type. The patients with ARF had larger burn size (79.5±15.4% vs. 55.3±20.5%, p<0.0001) and lower serum albumin concentration at admission (1.92±0.66 g/dL vs. 2.48±0.82 g/dL, p<0.0005) compared with those without ARF. All patients with ARF expired, whereas 29.4% (35/119) of the patients without ARF died. The burn size > 65% was associated with a risk of ARF that was 9.9 times and with a risk of death that was 14.2 times as high as that for the burn size < 65%. The initial serum albumin level < 2.5 g/dL was associated with a risk of death that was 2.7 times as high as that for the initial serum albumin level > 2.5 g/dL. Conclusion : When major burns are complicated by ARF, the mortality increases very high. Burn size is an independent predictor of ARF occurring in major burns. Initially depressed serum albumin level is associated with an increase in mortality in the major burn patients. (Korean J Med 63:539-545, 2002) Key Words : Acute renal failure, Burn, Albumin, Burn size, Mortality
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