MedStar Authors catalog › Details for: Burn Injuries in Patients with Paralysis: A National Perspective on Injury Patterns and Outcomes.
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Burn Injuries in Patients with Paralysis: A National Perspective on Injury Patterns and Outcomes.

by Nosanov, Lauren B; Paul, Jennifer L; Shupp, Jeffrey W; Stiles, Christina E; McLawhorn, Melissa M.
Citation: Journal of Burn Care & Research. 39(1):15-20, 2017 Dec 27.Journal: Journal of burn care & research : official publication of the American Burn Association.Published: 2017ISSN: 1559-047X.Full author list: Stiles CE; McLawhorn MM; Nosanov LB; Paul JL; Shupp JW.UI/PMID: 29596679.Institution(s): MedStar Washington Hospital Center | MedStar Health Research InstituteDepartment(s): Surgery/Burn Services | Firefighters' Burn and Surgical Research LaboratoryActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: (Click here) Abbreviated citation: J Burn Care Res. 39(1):15-20, 2017 Dec 27.Local Holdings: Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present.Abstract: 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.

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