Does obesity affect outcomes of adult burn patients?

Juliet J. Ray, Shevonne S. Satahoo, Jonathan P. Meizoso, Casey J. Allen, Laura F. Teisch, Kenneth G Proctor, Louis R Pizano, Nicholas Namias, Carl I Schulman

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Obesity negatively affects outcomes after trauma and surgery; results after burns are more limited and controversial. The purpose of this study was to determine the effect of obesity on clinical and economic outcomes after thermal injury. Methods The National Inpatient Sample was queried for adults from 2005-2009 with International Classification of Diseases-9 codes for burn injury. Demographics and clinical outcomes of obese and nonobese cohorts were compared. Univariate and multivariate analysis using logistic regression models were performed. Data are expressed as median (interquartile range) or mean ± standard deviation and compared at P < 0.05. Results In 14,602 patients, 3.3% were obese (body mass index ≥30 kg/m<sup>2</sup>). The rate of obesity increased significantly by year (P < 0.001). Univariate analysis revealed significant differences between obese and nonobese patients in incidence of wound infection (7.2% versus 5.0%), urinary tract infection (7.2% versus 4.6%), deep vein thrombosis in total body surface area (TBSA) ≥10% (3.1% versus 1.1%), pulmonary embolism in TBSA ≥10% (2.3% versus 0.6%), length of stay [6 d (8) versus 5 d (9)], and hospital costs ($10,122.12 [$18,074.72] versus $7892.07 [$17,191.96]) (all P < 0.05). Death occurred less frequently in the obese group (1.9% versus 4%, P = 0.021). Significant predictors of grouped adverse events (urinary tract infection, wound infection, deep vein thrombosis, and pulmonary embolism) on multivariate analysis include obesity, TBSA ≥20%, age, and black race (all P < 0.05). Conclusions Obesity is an independent predictor of adverse events after burn injury; however, obesity is associated with decreased mortality. Our findings highlight the potential clinical and economic impact of the obesity epidemic on burn patients nationwide.

Original languageEnglish (US)
Pages (from-to)450-455
Number of pages6
JournalJournal of Surgical Research
Volume198
Issue number2
DOIs
StatePublished - Oct 1 2015

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Obesity
Body Surface Area
Wounds and Injuries
Wound Infection
Pulmonary Embolism
Urinary Tract Infections
Venous Thrombosis
Multivariate Analysis
Logistic Models
Economics
Hospital Costs
International Classification of Diseases
Burns
Inpatients
Length of Stay
Hot Temperature
Demography
Mortality
Incidence

Keywords

  • BMI
  • DVT
  • Morbidity
  • Mortality
  • Obesity
  • Outcomes
  • Overweight
  • PE
  • TBSA
  • Thermal injury

ASJC Scopus subject areas

  • Surgery

Cite this

Does obesity affect outcomes of adult burn patients? / Ray, Juliet J.; Satahoo, Shevonne S.; Meizoso, Jonathan P.; Allen, Casey J.; Teisch, Laura F.; Proctor, Kenneth G; Pizano, Louis R; Namias, Nicholas; Schulman, Carl I.

In: Journal of Surgical Research, Vol. 198, No. 2, 01.10.2015, p. 450-455.

Research output: Contribution to journalArticle

Ray JJ, Satahoo SS, Meizoso JP, Allen CJ, Teisch LF, Proctor KG et al. Does obesity affect outcomes of adult burn patients? Journal of Surgical Research. 2015 Oct 1;198(2):450-455. https://doi.org/10.1016/j.jss.2015.03.049
Ray, Juliet J. ; Satahoo, Shevonne S. ; Meizoso, Jonathan P. ; Allen, Casey J. ; Teisch, Laura F. ; Proctor, Kenneth G ; Pizano, Louis R ; Namias, Nicholas ; Schulman, Carl I. / Does obesity affect outcomes of adult burn patients?. In: Journal of Surgical Research. 2015 ; Vol. 198, No. 2. pp. 450-455.
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abstract = "Background Obesity negatively affects outcomes after trauma and surgery; results after burns are more limited and controversial. The purpose of this study was to determine the effect of obesity on clinical and economic outcomes after thermal injury. Methods The National Inpatient Sample was queried for adults from 2005-2009 with International Classification of Diseases-9 codes for burn injury. Demographics and clinical outcomes of obese and nonobese cohorts were compared. Univariate and multivariate analysis using logistic regression models were performed. Data are expressed as median (interquartile range) or mean ± standard deviation and compared at P < 0.05. Results In 14,602 patients, 3.3{\%} were obese (body mass index ≥30 kg/m2). The rate of obesity increased significantly by year (P < 0.001). Univariate analysis revealed significant differences between obese and nonobese patients in incidence of wound infection (7.2{\%} versus 5.0{\%}), urinary tract infection (7.2{\%} versus 4.6{\%}), deep vein thrombosis in total body surface area (TBSA) ≥10{\%} (3.1{\%} versus 1.1{\%}), pulmonary embolism in TBSA ≥10{\%} (2.3{\%} versus 0.6{\%}), length of stay [6 d (8) versus 5 d (9)], and hospital costs ($10,122.12 [$18,074.72] versus $7892.07 [$17,191.96]) (all P < 0.05). Death occurred less frequently in the obese group (1.9{\%} versus 4{\%}, P = 0.021). Significant predictors of grouped adverse events (urinary tract infection, wound infection, deep vein thrombosis, and pulmonary embolism) on multivariate analysis include obesity, TBSA ≥20{\%}, age, and black race (all P < 0.05). Conclusions Obesity is an independent predictor of adverse events after burn injury; however, obesity is associated with decreased mortality. Our findings highlight the potential clinical and economic impact of the obesity epidemic on burn patients nationwide.",
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AU - Meizoso, Jonathan P.

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AU - Teisch, Laura F.

AU - Proctor, Kenneth G

AU - Pizano, Louis R

AU - Namias, Nicholas

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N2 - Background Obesity negatively affects outcomes after trauma and surgery; results after burns are more limited and controversial. The purpose of this study was to determine the effect of obesity on clinical and economic outcomes after thermal injury. Methods The National Inpatient Sample was queried for adults from 2005-2009 with International Classification of Diseases-9 codes for burn injury. Demographics and clinical outcomes of obese and nonobese cohorts were compared. Univariate and multivariate analysis using logistic regression models were performed. Data are expressed as median (interquartile range) or mean ± standard deviation and compared at P < 0.05. Results In 14,602 patients, 3.3% were obese (body mass index ≥30 kg/m2). The rate of obesity increased significantly by year (P < 0.001). Univariate analysis revealed significant differences between obese and nonobese patients in incidence of wound infection (7.2% versus 5.0%), urinary tract infection (7.2% versus 4.6%), deep vein thrombosis in total body surface area (TBSA) ≥10% (3.1% versus 1.1%), pulmonary embolism in TBSA ≥10% (2.3% versus 0.6%), length of stay [6 d (8) versus 5 d (9)], and hospital costs ($10,122.12 [$18,074.72] versus $7892.07 [$17,191.96]) (all P < 0.05). Death occurred less frequently in the obese group (1.9% versus 4%, P = 0.021). Significant predictors of grouped adverse events (urinary tract infection, wound infection, deep vein thrombosis, and pulmonary embolism) on multivariate analysis include obesity, TBSA ≥20%, age, and black race (all P < 0.05). Conclusions Obesity is an independent predictor of adverse events after burn injury; however, obesity is associated with decreased mortality. Our findings highlight the potential clinical and economic impact of the obesity epidemic on burn patients nationwide.

AB - Background Obesity negatively affects outcomes after trauma and surgery; results after burns are more limited and controversial. The purpose of this study was to determine the effect of obesity on clinical and economic outcomes after thermal injury. Methods The National Inpatient Sample was queried for adults from 2005-2009 with International Classification of Diseases-9 codes for burn injury. Demographics and clinical outcomes of obese and nonobese cohorts were compared. Univariate and multivariate analysis using logistic regression models were performed. Data are expressed as median (interquartile range) or mean ± standard deviation and compared at P < 0.05. Results In 14,602 patients, 3.3% were obese (body mass index ≥30 kg/m2). The rate of obesity increased significantly by year (P < 0.001). Univariate analysis revealed significant differences between obese and nonobese patients in incidence of wound infection (7.2% versus 5.0%), urinary tract infection (7.2% versus 4.6%), deep vein thrombosis in total body surface area (TBSA) ≥10% (3.1% versus 1.1%), pulmonary embolism in TBSA ≥10% (2.3% versus 0.6%), length of stay [6 d (8) versus 5 d (9)], and hospital costs ($10,122.12 [$18,074.72] versus $7892.07 [$17,191.96]) (all P < 0.05). Death occurred less frequently in the obese group (1.9% versus 4%, P = 0.021). Significant predictors of grouped adverse events (urinary tract infection, wound infection, deep vein thrombosis, and pulmonary embolism) on multivariate analysis include obesity, TBSA ≥20%, age, and black race (all P < 0.05). Conclusions Obesity is an independent predictor of adverse events after burn injury; however, obesity is associated with decreased mortality. Our findings highlight the potential clinical and economic impact of the obesity epidemic on burn patients nationwide.

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