Burn mortality in patients with preexisting cardiovascular disease

Laquanda Knowlin, Trista Reid, Felicia Williams, Bruce Cairns, Anthony Charles

Research output: Research - peer-reviewArticle

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.

LanguageEnglish (US)
Pages949-955
Number of pages7
JournalBurns
Volume43
Issue number5
DOIs
StatePublished - Aug 1 2017

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Preexisting Condition Coverage
Cardiovascular Diseases
Mortality
Intensive Care Units
Comorbidity
Incidence
insulin receptor-related receptor
Burn Units
Inhalation
Shock
Length of Stay
Demography
Wounds and Injuries

Keywords

  • Burn
  • Burn mortality
  • Burn prognostication
  • Cardiovascular disease
  • Comorbidities

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Burn mortality in patients with preexisting cardiovascular disease. / Knowlin, Laquanda; Reid, Trista; Williams, Felicia; Cairns, Bruce; Charles, Anthony.

In: Burns, Vol. 43, No. 5, 01.08.2017, p. 949-955.

Research output: Research - peer-reviewArticle

Knowlin L, Reid T, Williams F, Cairns B, Charles A. Burn mortality in patients with preexisting cardiovascular disease. Burns. 2017 Aug 1;43(5):949-955. Available from, DOI: 10.1016/j.burns.2017.01.026
Knowlin, Laquanda ; Reid, Trista ; Williams, Felicia ; Cairns, Bruce ; Charles, Anthony. / Burn mortality in patients with preexisting cardiovascular disease. In: Burns. 2017 ; Vol. 43, No. 5. pp. 949-955
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N2 - 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.

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