| 1. |
- Heyland, Daren K., et al.
(författare)
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A Randomized Trial of Enteral Glutamine for Treatment of Burn Injuries
- 2022
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Ingår i: New England Journal of Medicine. - : Massachusetts Medical Society. - 0028-4793 .- 1533-4406. ; 387:11, s. 1001-1010
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDGlutamine is thought to have beneficial effects on the metabolic and stress response to severe injury. Clinical trials involving patients with burns and other critically ill patients have shown conflicting results regarding the benefits and risks of glutamine supplementation.METHODSIn a double-blind, randomized, placebo-controlled trial, we assigned patients with deep second-or third-degree burns (affecting >= 10% to >= 20% of total body-surface area, depending on age) within 72 hours after hospital admission to receive 0.5 g per kilogram of body weight per day of enterally delivered glutamine or placebo. Trial agents were given every 4 hours through a feeding tube or three or four times a day by mouth until 7 days after the last skin grafting procedure, discharge from the acute care unit, or 3 months after admission, whichever came first. The primary outcome was the time to discharge alive from the hospital, with data censored at 90 days. We calculated subdistribution hazard ratios for discharge alive, which took into account death as a competing risk.RESULTS A total of 1209 patients with severe burns (mean burn size, 33% of total body-surface area) underwent randomization, and 1200 were included in the analysis (596 patients in the glutamine group and 604 in the placebo group). The median time to discharge alive from the hospital was 40 days (interquartile range, 24 to 87) in the glutamine group and 38 days (interquartile range, 22 to 75) in the placebo group (subdistribution hazard ratio for discharge alive, 0.91; 95% confidence interval [CI], 0.80 to 1.04; P = 0.17). Mortality at 6 months was 17.2% in the glutamine group and 16.2% in the placebo group (hazard ratio for death, 1.06; 95% CI, 0.80 to 1.41). No substantial between-group differences in serious adverse events were observed.CONCLUSIONSIn patients with severe burns, supplemental glutamine did not reduce the time to discharge alive from the hospital.
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| 2. |
- Panayi, Adriana C., et al.
(författare)
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Bridging frailty and burns: Defining acute burn injury as a cause of long-term frailty
- 2024
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Ingår i: Maturitas. - : ELSEVIER IRELAND LTD. - 0378-5122 .- 1873-4111. ; 187
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Tidskriftsartikel (refereegranskat)abstract
- Although our understanding of frailty has evolved and multiple indices have been developed, the impact of burn injuries on long-term health has been overlooked. With over 11 million annual cases globally, burns affect all demographics, although socioeconomic disparities are evident. With survival rates improved, morbidity among survivors is becoming more evident, and shows similarity to predictors of frailty. Some of the chronic effects of burns, including mental health issues and increased risks of disease, mirror frailty markers. Studies show burn survivors have lower life expectancy, independent of burn severity. Integrating burn history into frailty assessments and establishing specialized long-term care can mitigate this frailty risk. Improved interdisciplinary follow-up and research are vital for enhancing burn survivors' quality of life and longevity.
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| 3. |
- Panayi, Adriana C., et al.
(författare)
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The Epidemiology and Outcomes of Perineal and Genital Burn Injury in Low- and Middle-Income Countries: A Global Burn Registry Study
- 2024
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Ingår i: Journal of Plastic, Reconstructive & Aesthetic Surgery. - : ELSEVIER SCI LTD. - 1748-6815 .- 1878-0539. ; 95, s. 17-20
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The epidemiology, care, and outcomes of perineal and genital burns (PG ) in high -income countries have been previously described, but an analysis of this topic in LMICs has yet to be performed. We use the World Health Organization 's Global Burn Registry to fill this gap. Methods: The GBR was searched from inception to November 2023 to identify all burn patients, excluding cases from high -income countries. Demographics and mechanism of injury were re - trieved. Primary outcomes were length of hospital stay (LOHS ), surgical intervention, discharge with physical impairment, and mortality. A multivariate regression analysis was performed controlling for burnt total body surface area (TBSA ), age, sex, inhalation injury, mechanism of burn and care center characteristics.
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| 4. |
- Smolle, Christian, et al.
(författare)
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Recent trends in burn epidemiology worldwide : A systematic review
- 2017
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Ingår i: Burns. - : Elsevier BV. - 0305-4179 .- 1879-1409. ; 43:2, s. 249-257
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Forskningsöversikt (refereegranskat)abstract
- Burns have been more prevalent among low socioeconomic populations and in less developed regions. Incredible advances in burn care and social development over the recent decades, however, should have placed the incidence and severity of burns in a downwards trend. The aim of this review was to give an overview on current trends in burn epidemiology across the world. Also the socioeconomic development in countries that have published epidemiological data used in this study has been taken into account when comparing the results. There was a worldwide downwards trend of burn incidence, burn severity, length of hospital stay, and mortality rate. These findings were particularly pronounced in very highly developed countries. Data from highly and medium developed countries were more heterogeneous. No studies could be obtained from low and middle income countries. Comparisons between the different studies were compromised by the fact that studies emerged from specialized facilities on one hand and general hospitals on the other. Analyzed studies were also frequently focusing on limited patient populations such as "children" or "elderly". Our findings indicate the need for an international burn database with a minimal data-set in order to obtain objective and comparable results in respect of burn epidemiology.
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