TY - JOUR
AU - Shupp,, J
AB - Abstract Introduction Body mass index (BMI) has been established as a risk factor for increased morbidity and mortality in multiple clinical settings. While patients with elevated BMI often present with multiple associated comorbidities, low BMI predisposes patients to poor wound healing and injury recovery. The purpose of this study was to evaluate the association between BMI and clinical outcomes after thermal injury at a national level via the National Burn Repository (NBR). Methods The NBR (version 8.0) was queried for entries inclusive of codes for BMI. Data collected included patient demographics, BMI, injury mechanism and characteristics and clinical outcomes including hospital and intensive care unit length of stay, total ventilator days and mortality. Based on BMI, patients were categorized as underweight, normal weight, overweight, obese, super obese or morbidly obese. Chi-square and student t-tests were used for descriptive analysis, and logistic regression was performed to assess the impact of BMI on clinical outcomes. Results Of 172,640 patients in the NBR, BMI data were identified for 388, with 6.4% underweight, 15.7% normal weight, 14.2% overweight, 21.9% obese, 16.0% super obese, and 25.8% morbidly obese. Mean TBSA%, incidence of inhalation injury, length of mechanical ventilation, length of ICU stay, or length of hospital stay did not significantly differ by BMI. Only underweight status (BMI <19) was significantly associated with increased mortality (p < 0.001). Conclusions Although a small minority of entries in the NBR have BMI documentation, this analysis importantly identifies low BMI, rather than obesity, as a significant risk factor for mortality following burn injury. Obese patient habitus may prove challenging from a nursing and surgical standpoint, but may not pose as significant of a risk as many might assume. Malnutrition, exacerbated by pre-injury underweight status, poses a serious challenge for wound closure. Careful monitoring and appropriate supplementation may mitigate associated risk. Given the implications of low BMI on clinical outcomes, additional emphasis should be placed on BMI documentation in the NBR. Applicability of Research to Practice Practices focused on early and aggressive nutritional supplementation for underweight patients may improve survivability following burn injury. This content is only available as a PDF. © American Burn Association 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
TI - 231 Underweight Patients have an Increased Mortality Following Burn Injury: Clinical Outcomes Reported in the National Burn Repository
JO - Journal of Burn Care & Research
DO - 10.1093/jbcr/irz013.159
DA - 2019-03-09
UR - https://www.deepdyve.com/lp/oxford-university-press/231-underweight-patients-have-an-increased-mortality-following-burn-XBv0j6IDj3
SP - S95
VL - 40
IS - Supplement_1
DP - DeepDyve
ER -