Malnutrition in Burns: A Prospective, Single-Center Study.
Nancy Caldis-Coutris1,2, Justin P Gawaziuk2, Saul Magnusson2
1Department of Nutrition and Food Services, Health Sciences Centre, Winnipeg, Manitoba, Canada.
Summary
Malnutrition significantly increases hospital resource use in burn patients, indicated by longer lengths of stay. Early nutrition assessment using Subjective Global Assessment (SGA) is crucial for identifying and managing malnutrition in these critically ill individuals.
Area of Science:
- Critical Care Medicine
- Nutritional Science
- Burn Surgery
Background:
- Burn injuries trigger extreme hypermetabolic responses, the highest among critically ill patients.
- Preexisting malnutrition exacerbates resource utilization in burn patients due to increased metabolic demands.
Purpose of the Study:
- To determine the prevalence of malnutrition in adult burn patients.
- To assess the impact of malnutrition on hospital resource utilization, specifically length of stay.
Main Methods:
- Prospective data collection from 49 adult burn patients (≥18 years, ≥10% TBSA burn).
- Nutrition assessment using Subjective Global Assessment (SGA) within 24-48 hours of admission.
- Analysis of demographics, %TBSA, comorbidities, length of stay (LOS), and standardized LOS (LOS/%TBSA) using multivariable regression.
Main Results:
- 28.6% of burn patients were identified as malnourished (SGA B/C).
- Malnourished patients exhibited significantly longer median LOS (21.0 vs 11.0 days) and LOS/%TBSA (1.69 vs 0.83).
- Malnutrition was an independent predictor of above-median LOS/%TBSA (OR 5.61, P=.027).
Conclusions:
- The high rate of malnutrition in burn patients significantly increases hospital resource requirements.
- Early identification of malnutrition via SGA on admission is vital for optimizing nutrition interventions and managing resource utilization.
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