@article{ref1,
title="Impact of elevated body mass index on burn injury-associated mortality in a representative US sample",
journal="Surgery",
year="2023",
author="Dhanasekara, Chathurika S. and Cole, Travis J. and Bayouth, Joseph and Shaw, Chip and Dissanaike, Sharmila",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: The impact of obesity on burn-related mortality is inconsistent and incongruent; despite being a risk factor for numerous comorbidities that would be expected to increase complications and worsen outcomes, there is evidence of a survival advantage for patients with high body mass index-the so-called obesity paradox. We used a national data set to explore further the relationship between body mass index and burn-related mortality. <br><br>METHODS: Deidentified data from patients with second and third-degree burns between 2014 and 2018 were obtained from the Cerner Health Facts Database. Univariate and multivariate regression models were created to identify potential factors related to burn-related mortality. A restricted cubic spline model was built to assess the nonlinear association between body mass index and burn-related mortality. All statistical analyses were conducted using R (R Foundation for Statistical Computing). <br><br>RESULTS: The study included 9,405 adult burn patients. Univariate and multivariate analyses revealed that age (odds ratio = 2.189 [1.771, 2.706], P <.001), total burn surface area (odds ratio = 1.824 [1.605, 2.074], P <.001), full-thickness burns (odds ratio = 1.992 [1.322, 3.001], P <.001), and comorbidities (odds ratio = 2.03 [1.367, 3.014], P <.001) were associated with increased mortality. Sensitivity analysis showed similar results. However, a restricted cubic spline indicated a U-shaped relation between body mass index and burn-related mortality. The nadir of body mass index was 28.92 kg/m(2), with the lowest mortality. This association persisted even after controlling for age, total burn surface area, full-thickness burns, and comorbidities, which all remained significant. <br><br>CONCLUSION: This study confirms a U-shaped association between body mass index and burn-related mortality along with age, total burn surface area, full-thickness burns, and comorbidities as risk factors.<p /> <p>Language: en</p>",
language="en",
issn="0039-6060",
doi="10.1016/j.surg.2023.02.014",
url="http://dx.doi.org/10.1016/j.surg.2023.02.014"
}