Kelly Edward J, Mathew Shane K, Carney Bonnie C, Moffatt Lauren T, Shupp Jeffrey W, Tejiram Shawn
The Burn Center, MedStar Washington Hospital Center, Washington DC, United States; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington DC, United States.
Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington DC, United States; Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington DC, United States; Department of Surgery, Georgetown University School of Medicine, Washington DC, United States.
Burns. 2025 Feb;51(1):107276. doi: 10.1016/j.burns.2024.09.015. Epub 2024 Sep 25.
Literature examining the impact of obesity on burn injury remains mixed. Previous examination of the National Burn Repository, now the BCQP, in obesity-related burn research is limited. The aim of this work was to provide an assessment of the BCQP dataset to examine the effect of obesity on burn-related outcomes.
A retrospective review of the BCQP dataset from 2015-2018 was conducted. The primary outcome measure was mortality. Secondary outcomes included overall length of stay (LOS), ICU LOS, and total hospital costs. Patients were grouped as obese or non-obese and were further stratified by total body surface area burned (TBSA) for comparison purposes. Multiple logistic regression (MLG) was used to compare the effect of several independent variables on mortality, ICU LOS > 7days, hospital LOS > 10 days, and total hospital costs > $200,000.
Of 41,031 patients in the analysis, 3845 (9.37 %) were obese. Obese patients had a higher mean TBSA (p = 0.01), longer overall LOS (p < 0.001), ICU LOS (p < 0.001), and total hospital costs (p < 0.001). MLG found obesity to be an independent predictor of ICU LOS > 7 days, hospital LOS > 10 days, and total hospital costs > $200,000. Obesity was not an independent predictor of mortality in burn patients, even when stratified by burn size.
The presence of obesity in this dataset was not found to be a predictor of mortality for any burn size, but was a predictor of overall LOS, ICU LOS, and total hospital costs. Including obesity-related variables in databases may improve analysis in obesity-related burn research.
关于肥胖对烧伤影响的文献研究结果不一。以往对现在的烧伤质量与预后数据库(BCQP,原国家烧伤资料库)中与肥胖相关的烧伤研究有限。这项工作的目的是评估BCQP数据集,以研究肥胖对烧伤相关结局的影响。
对2015年至2018年的BCQP数据集进行回顾性分析。主要结局指标是死亡率。次要结局包括总住院时长(LOS)、重症监护病房(ICU)住院时长和总住院费用。为便于比较,将患者分为肥胖组和非肥胖组,并根据烧伤总面积(TBSA)进一步分层。采用多元逻辑回归(MLG)比较多个自变量对死亡率、ICU住院时长>7天、住院时长>10天以及总住院费用>20万美元的影响。
在分析的41031例患者中,3845例(9.37%)为肥胖患者。肥胖患者的平均TBSA更高(p = 0.01),总住院时长更长(p < 0.001),ICU住院时长更长(p < 0.001),总住院费用更高(p < 0.001)。MLG发现肥胖是ICU住院时长>7天、住院时长>10天以及总住院费用>20万美元的独立预测因素。即使按烧伤面积分层,肥胖也不是烧伤患者死亡率的独立预测因素。
在该数据集中,未发现肥胖是任何烧伤面积患者死亡率的预测因素,但它是总住院时长、ICU住院时长和总住院费用的预测因素。在数据库中纳入与肥胖相关的变量可能会改善与肥胖相关的烧伤研究分析。