Articles: sepsis.
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Observational Study
Development and performance evaluation of a clinical prediction model for sepsis risk in burn patients.
Sepsis is a common and severe complication in burn patients and remains one of the leading causes of mortality. This retrospective study aimed to develop a predictive model for the risk of in-hospital sepsis among burn patients treated at Guangzhou Red Cross Hospital between January 2022 and January 2024, with the goal of improving clinical outcomes through early prevention based on risk stratification. A total of 302 eligible patients were randomly divided into training and validation cohorts in a 7:3 ratio for model development and validation, respectively. ⋯ The areas under the receiver operating characteristic curve were 0.875 and 0.861 for the training and validation cohorts, with Youden indexes of 0.634 and 0.600, respectively. The calibration curve and decision curve analysis demonstrated good predictive accuracy and clinical utility of the model. These findings suggest that our developed model exhibits robust predictive performance for the risk of in-hospital sepsis in burn patients, and early prevention strategies based on risk stratification may potentially improve clinical outcomes.
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Thiamine and ascorbic acid have been proposed to mitigate the devastating consequences of sepsis and septic shock. To date, randomized controlled trials have failed to demonstrate a benefit of these therapies and heterogeneity of treatment effect is suspected. In this study, we aimed at assessing the heterogeneity of treatment effect of thiamine (B1) and the combination of B1 plus ascorbic acid (AA + B1) in critically ill patients with sepsis. ⋯ These results reinforce the lack of efficacy of the combination of AA + B1 reported in recent trials and even raise concerns about potential harm in older patients with comorbidities. On the contrary, we reported improved ICU survival associated with B1 supplementation in the most severe patients and those with predominant respiratory failure, supporting the need for further trials in this specific population.
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Sepsis is a life-threatening condition driven by a dysregulated immune response to infection. Identifying the genetic factors underlying sepsis pathogenesis remains a major challenge in developing effective treatments. ⋯ BEND7 was identified as a platelet-specific gene involved in immune regulation during sepsis. Targeting BEND7-positive platelets may present new therapeutic opportunities in sepsis management.