Factors impacting the likelihood of death in patients with small TBSA burns.

MedStar author(s):
Citation: Journal of Burn Care & Research. 36(1):203-12, 2015 Jan-Feb.PMID: 25094012Institution: MedStar Washington Hospital CenterDepartment: Surgery/Burn ServicesForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Burns/mo [Mortality] | *Burns/pa [Pathology] | Adult | Aged | Aged, 80 and over | Burn Units | Burns/co [Complications] | Databases, Factual | Female | Hospitalization/sn [Statistics & Numerical Data] | Humans | Logistic Models | Male | Middle Aged | Odds Ratio | Retrospective Studies | Risk Factors | Sensitivity and Specificity | Survival Rate | United StatesYear: 2015Local holdings: Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - presentISSN:
  • 1559-047X
Name of journal: Journal of burn care & research : official publication of the American Burn AssociationAbstract: Survival rates of burn patients have increased greatly over the past several decades. There are, however, still patients with relatively small burns who do not survive their hospitalizations. This work aimed to elucidate factors common to this select subset of patients. The NBR Main dataset was queried for record numbers associated with TBSA between 0.1 and 10 and a discharge status indicating death. Using SAS statistical software, the patients were matched for age, sex, and TBSA. Chi-square analyses of independence on categorical variables and unpaired, two-tailed Students' t-tests with unequal variance on continuous variables were used to identify fields of further interest. SAS was then used to build multivariate logistic regression models examining variables affecting discharge status. The NBR complications child dataset was queried and categorized for the types of complications for analysis. Multivariate logistic regression for discharge status, comorbidities, and complications showed that the presence of a complication significantly impacted discharge status. The presence of an identified complication (other than death) increased the odds ratio of a discharge status of death by a factor of 3.023 (95% confidence interval [2.306, 3.964], P < .0001). Pulmonary and infection-related complications were the most frequently seen across all the records analyzed, but infection-related complications did not reach statistical significance in relation to discharge status. Multivariate logistic regression of complications in a model for discharge status identified four categories as statistically significant: neurologic, cardiovascular, pulmonary, and renal. In patients with small TBSA burns, the presence of complications significantly increases the odds ratio of death as judged by the NBR data. The complications which appear to be of particular interest are cardiovascular, neurologic, renal, and pulmonary, and those patients who are likely most susceptible to these complications are those with inhalation injury in addition to their cutaneous burns.All authors: Jordan MH, Moffatt LT, Shupp JW, Travis TEFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2016-01-13
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 25094012 Available 25094012

Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present

Survival rates of burn patients have increased greatly over the past several decades. There are, however, still patients with relatively small burns who do not survive their hospitalizations. This work aimed to elucidate factors common to this select subset of patients. The NBR Main dataset was queried for record numbers associated with TBSA between 0.1 and 10 and a discharge status indicating death. Using SAS statistical software, the patients were matched for age, sex, and TBSA. Chi-square analyses of independence on categorical variables and unpaired, two-tailed Students' t-tests with unequal variance on continuous variables were used to identify fields of further interest. SAS was then used to build multivariate logistic regression models examining variables affecting discharge status. The NBR complications child dataset was queried and categorized for the types of complications for analysis. Multivariate logistic regression for discharge status, comorbidities, and complications showed that the presence of a complication significantly impacted discharge status. The presence of an identified complication (other than death) increased the odds ratio of a discharge status of death by a factor of 3.023 (95% confidence interval [2.306, 3.964], P < .0001). Pulmonary and infection-related complications were the most frequently seen across all the records analyzed, but infection-related complications did not reach statistical significance in relation to discharge status. Multivariate logistic regression of complications in a model for discharge status identified four categories as statistically significant: neurologic, cardiovascular, pulmonary, and renal. In patients with small TBSA burns, the presence of complications significantly increases the odds ratio of death as judged by the NBR data. The complications which appear to be of particular interest are cardiovascular, neurologic, renal, and pulmonary, and those patients who are likely most susceptible to these complications are those with inhalation injury in addition to their cutaneous burns.

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