Citation

Knowlin L, Reid T, Williams F, Cairns B, Charles A. Burns 2017; 43(5): 949-955.

Affiliation

Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States. Electronic address: anthchar@med.unc.edu.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.burns.2017.01.026

PMID

28189352

Abstract

INTRODUCTION: Burn shock, a complex process, which develops following burn leads to severe and unique derangement of cardiovascular function. Patients with preexisting comorbidities such as cardiovascular diseases may be more susceptible. We therefore sought to examine the impact of preexisting cardiovascular disease on burn outcomes.

METHODS: A retrospective analysis of patients admitted to a regional burn center from 2002 to 2012. Independent variables analyzed included basic demographics, burn mechanism, presence of inhalation injury, TBSA, pre-existing comorbidities, and length of ICU/hospital stay. Bivariate analysis was performed and Poisson regression modeling was utilized to estimate the incidence of being in the ICU and mortality.

RESULTS: There were a total of 5332 adult patients admitted over the study period. 6% (n=428) had a preexisting cardiovascular disease. Cardiovascular disease patients had a higher mortality rate (16%) compared to those without cardiovascular disease (3%, p<0.001). The adjusted Poisson regression model to estimate incidence risk of being in intensive care unit in patients with cardiovascular disease was 33% higher compared to those without cardiovascular disease (IRR=1.33, 95% CI=1.22-1.47). The risk for mortality is 42% higher (IRR=1.42, 95% CI=1.10-1.84) for patients with pre-existing cardiovascular disease compared to those without cardiovascular disease after controlling for other covariates.

CONCLUSION: Preexisting cardiovascular disease significantly increases the risk of intensive care unit admission and mortality in burn patients. Given the increasing number of Americans with cardiovascular diseases, there will likely be a greater number of individuals at risk for worse outcomes following burn. This knowledge can help with burn prognostication.

Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Language: en

Keywords

Burn; Burn mortality; Burn prognostication; Cardiovascular disease; Comorbidities