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Age-dependent influence of premorbid underweight status on mortality in severe burn patients: An administrative
Mizue Matsuo1, Keiji Muramatsu2, Shinya Matsuda3
1Department of Intensive Care Medicine, University Hospital of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8556, Japan.
Insights
Premorbid nutritional status impacts severe burn patient survival differently by age. Underweight young adults had lower mortality, while underweight elderly patients faced higher risks, indicating a need for tailored care strategies.
Area of Science:
- Medical research
- Burn care
- Nutritional epidemiology
Background:
- Severe burn injuries present significant mortality risks.
- Nutritional status is a critical factor in patient outcomes.
- Age-related differences in response to critical illness are well-documented.
Purpose of the Study:
- To investigate the relationship between premorbid nutritional status (BMI) and in-hospital mortality in severe burn patients in Japan.
- To analyze these associations stratified by age groups.
Main Methods:
- Retrospective analysis of 14,345 burn patients (aged 18-84) from the Japanese Diagnosis Procedure Combination database (2014-2018).
- Exclusion of patients with specific critical conditions (e.g., out-of-hospital cardiac arrest, ER death).
- Age-stratified multilevel logistic regression models used to assess associations between premorbid body mass index (BMI) and mortality.
Main Results:
- Analysis included 2968 patients with a burn index ≥10, with 831 elderly patients (75-84 years).
- In patients aged 18-74 years, underweight (BMI < 18.5) was associated with significantly decreased mortality (OR 0.34).
- In elderly patients (75-84 years), underweight (BMI < 18.5) was significantly associated with increased mortality (OR 2.11).
- Overweight (BMI >25) showed a non-significant trend towards increased mortality in both age groups.
Conclusions:
- Premorbidly underweight elderly patients (75-84 years) with severe burns face elevated mortality risks.
- Nutritional status assessment and tailored interventions are crucial for optimizing outcomes in elderly burn patients.
- Further research is warranted to develop specific care strategies for this vulnerable population.
Purpose:
To examine the associations between premorbid nutritional status and in-hospital mortality in severe burn patients according to age in Japan.
Methods:
We retrospectively extracted the data of 14,345 patients aged 18-84 years admitted for burns from April 1, 2014, to March 31, 2018, using the Japanese Diagnosis Procedure Combination database. The exclusion criteria were out-of-hospital cardiac arrest, death in the emergency room, readmission, and planned admission. We collected data on age, sex, height, weight, comorbidities, burn index, and mechanical ventilation use and performed age-stratified multilevel logistic regression analyses to estimate associations between premorbid body mass index (BMI) and in-hospital mortality.
Results:
We analyzed 2968 patients with a burn index ≥10, including 831 elderly aged 75-84 years. In patients aged 18-74 years, being underweight (BMI < 18.5) significantly decreased mortality (0.34 [0.15-0.77]; P = 0.010). In contrast, in patients aged 75-84 years, being underweight significantly increased mortality (2.11 [1.05-4.25]; P = 0.036). Being overweight (BMI >25) increased mortality in both age groups, but not significantly.
Conclusions:
The results suggest that pre-morbidly underweight elderly patients aged 75-84 years with severe burns have high mortality risks. Further research is needed to identify optimal care strategies for this population.
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