TY - JOUR
AU - Wagner,, A
AB - Abstract Introduction Sex dimorphisms exist following thermal injury, with increased mortality among females. Females are known to have distinct inflammatory, coagulopathic response to injury yet how this translates into outcomes following burn has not been well-established. We hypothesize that among severely burned, females have a higher rate of complications. Methods This is a retrospective analysis of all severely burned (total body surface area [TBSA] ≥ 20%) patients who presented to an American Burn Association-verified burn center from 2012–2017. Baseline demographics, burn characteristics (TBSA, Baux score), degree of shock (systolic blood pressure [SBP], lactate and base deficit) and admission laboratory values were compared between males and females, as well as resuscitation (total crystalloid and product units transfused in the first 24 hours), length of stay (LOS), ventilator requirement, complications and mortality. Complications included venous thromboembolism, acute respiratory distress syndrome, pneumonia, multi-organ failure, urinary tract infection (UTI), wound infection, graft loss, sepsis and burn wound cellulitis. Propensity scored matching was then performed, matching males and females by age and TBSA. Results Overall, 129 patients were included. 73% (94) were male, median TBSA was 29.2% (29.0% in females, 29.8% in males) and median Baux score was 78 (87 in females, 74 in males). On univariate analysis, females were more likely to be older and present with a lower SBP and hemoglobin. There was no difference in burn etiology, Baux score, shock, crystalloid or product requirement, LOS, ventilator requirement or mortality. There was no difference in overall complication rate (71.4% vs. 77.7%, p=0.33), though females had a higher UTI rate (34.3% vs. 8.5%, p=0.001). However, on propensity matching for age and TBSA, males had a significantly higher rate of overall complications at 94.1% versus 73.5% in females (p=0.04). Males also had a significantly higher rate of cellulitis at 41.2% (vs. 5.9%, p=0.002), whereas females still had a higher UTI rate (35.3% vs. 5.9%, p=0.01)(Fig 1). Conclusions Sex dimorphisms are present after severe burn injury. Severely burned females have a lower rate of complications, although mortality is the same. Types of infections were different between males and females. Applicability of Research to Practice Male burn patients should be viewed as a higher risk population for overall complications and infection prevention strategies should be sex-specific. 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 - 83 Sex Dimorphisms After Thermal Injury: Female Sex Confers Decreased Complication Rates
JF - Journal of Burn Care & Research
DO - 10.1093/jbcr/irz013.085
DA - 2019-03-09
UR - https://www.deepdyve.com/lp/oxford-university-press/83-sex-dimorphisms-after-thermal-injury-female-sex-confers-decreased-g0NZLNlVVo
SP - S55
VL - 40
IS - Supplement_1
DP - DeepDyve
ER -