Burn Injuries in Patients with Paralysis: A National Perspective on Injury Patterns and Outcomes.
Burn Injuries in Patients with Paralysis: A National Perspective on Injury Patterns and Outcomes.
- 2017
Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present
The affect of paralysis-related comorbidities on outcomes in burn-injured patients has not been explored. We hypothesize that comorbid paralysis is associated with increased morbidity in this population. All burned patients with prior diagnoses of paralysis were identified from the National Burn Repository (Version 8.0). One-to-one matching of nonparalyzed burn-injured patients was performed, and nonparametric analysis was used to compare the groups. We identified 432 paralyzed patients, who were predominantly male (70.6%) and Caucasian (57.6%), with an average age of 40.8 +/- 19.0 years. The identified level of disability was distinguished as paraplegia (59.5%), hemiplegia (16.9%), quadriplegia (13.9%), or other (9.8%). A majority of injuries occurred in the home (75.2%), primarily due to scalds (48.1%). More than half sustained small injuries with affected total body surface area <5%. Lower extremities were frequently injured (72.2%), with 41.0% affecting exclusively the lower extremities. While the paralysis population had significantly longer hospital lengths of stay, nonparalyzed patients had longer intensive care unit length of stay and ventilator days (P < .001). There was no statistically significant difference in mortality rate between paralyzed and nonparalyzed patients (4.4% vs 4.9%, P = .550). Patients with paralysis are susceptible to small scald injuries in the home. Comorbid paralysis places patients at risk for longer, more indolent hospital stays, when compared with matched nonparalyzed patients with more critical illness. Further investigation is needed regarding the pathophysiologic mechanisms predisposing paralyzed burn patients to increased morbidity.
English
1559-047X
10.1093/jbcr/irx003 [doi] 4683478 [pii]
*Burns/ep [Epidemiology]
*Disabled Persons/sn [Statistics & Numerical Data]
*Paralysis/ep [Epidemiology]
Accidents, Home/sn [Statistics & Numerical Data]
Adult
Diabetes Mellitus/ep [Epidemiology]
Female
Humans
Length of Stay/sn [Statistics & Numerical Data]
Lower Extremity/in [Injuries]
Male
Matched-Pair Analysis
Middle Aged
Patient Discharge
Pneumonia/ep [Epidemiology]
Registries
Respiration, Artificial/sn [Statistics & Numerical Data]
Respiratory Distress Syndrome, Adult/ep [Epidemiology]
Smoke Inhalation Injury/ep [Epidemiology]
Smoking/ep [Epidemiology]
United States/ep [Epidemiology]
Wound Infection/ep [Epidemiology]
MedStar Health Research Institute
MedStar Washington Hospital Center
Firefighters' Burn and Surgical Research Laboratory
Surgery/Burn Services
Journal Article
Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present
The affect of paralysis-related comorbidities on outcomes in burn-injured patients has not been explored. We hypothesize that comorbid paralysis is associated with increased morbidity in this population. All burned patients with prior diagnoses of paralysis were identified from the National Burn Repository (Version 8.0). One-to-one matching of nonparalyzed burn-injured patients was performed, and nonparametric analysis was used to compare the groups. We identified 432 paralyzed patients, who were predominantly male (70.6%) and Caucasian (57.6%), with an average age of 40.8 +/- 19.0 years. The identified level of disability was distinguished as paraplegia (59.5%), hemiplegia (16.9%), quadriplegia (13.9%), or other (9.8%). A majority of injuries occurred in the home (75.2%), primarily due to scalds (48.1%). More than half sustained small injuries with affected total body surface area <5%. Lower extremities were frequently injured (72.2%), with 41.0% affecting exclusively the lower extremities. While the paralysis population had significantly longer hospital lengths of stay, nonparalyzed patients had longer intensive care unit length of stay and ventilator days (P < .001). There was no statistically significant difference in mortality rate between paralyzed and nonparalyzed patients (4.4% vs 4.9%, P = .550). Patients with paralysis are susceptible to small scald injuries in the home. Comorbid paralysis places patients at risk for longer, more indolent hospital stays, when compared with matched nonparalyzed patients with more critical illness. Further investigation is needed regarding the pathophysiologic mechanisms predisposing paralyzed burn patients to increased morbidity.
English
1559-047X
10.1093/jbcr/irx003 [doi] 4683478 [pii]
*Burns/ep [Epidemiology]
*Disabled Persons/sn [Statistics & Numerical Data]
*Paralysis/ep [Epidemiology]
Accidents, Home/sn [Statistics & Numerical Data]
Adult
Diabetes Mellitus/ep [Epidemiology]
Female
Humans
Length of Stay/sn [Statistics & Numerical Data]
Lower Extremity/in [Injuries]
Male
Matched-Pair Analysis
Middle Aged
Patient Discharge
Pneumonia/ep [Epidemiology]
Registries
Respiration, Artificial/sn [Statistics & Numerical Data]
Respiratory Distress Syndrome, Adult/ep [Epidemiology]
Smoke Inhalation Injury/ep [Epidemiology]
Smoking/ep [Epidemiology]
United States/ep [Epidemiology]
Wound Infection/ep [Epidemiology]
MedStar Health Research Institute
MedStar Washington Hospital Center
Firefighters' Burn and Surgical Research Laboratory
Surgery/Burn Services
Journal Article