The impact of peripheral nerve injuries on burn outcomes from the Burn Care Quality Platform

The effects of peripheral nerve injury (PNI)-- on patients with burns, to include pain, sensory, and motor deficits, remain largely unexplored. The Burn Care Quality Platform (BCQP), the largest available global database of burn patients, measures rates of PNIs and other important burn outcomes, including length of acute patient stays, wound infection rate, and mortality. However, no study has explored the impact of PNI on these outcomes to date. International Classification of Disease codes were queried from the 2000-2022 BCQP to identify PNIs, such as compression syndromes and direct injury to named peripheral nerves from primary burns. Patients with underlying chronic neuropathic or central nervous injuries were excluded. Binomial logistic and linear regressions were used to analyze the effect of PNI on burn outcomes while controlling for confounding variables, such as demographic factors and burn characteristics. Of all BCQP patients, 0.7% (2131/286,278) had PNI. Compared to patients who did not experience PNIs, patients with PNI had increased risk of skin graft loss (odds ratio: 4.1; 95% confidence interval: 3.3-5.1), longer hospital stays (OR: 7.2; 95% CI: 6.4-7.9), and additional surgical procedures (OR: 0.8; 95% CI: 0.7-0.9; p < 0.001 for all). This study suggests that PNIs are independently associated with adverse outcomes, including higher rates of skin graft loss, longer inpatient stay, and marginally more surgical procedures. While unadjusted analyses demonstrated a higher mortality rate amongst patients with PNI, multivariable regression analysis did not identify PNI as an independent predictor of mortality after adjustment for confounding variables. Further research is required to help improve patient outcomes.