Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China

Qiu-Lan He; Shao-Wei Gao; Ying Qin; Run-Cheng Huang; Cai-Yun Chen; Fei Zhou; Hong-Cheng Lin; Wen-Qi Huang

doi:10.1186/s40779-022-00403-1

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Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China

RESEARCH | Updated：2023-07-21

- Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China
- Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China
- MMR 2023年10卷第3期页码：299-312
- Affiliations：
  
  1.Department of Anesthesiology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  2.Department of Anesthesiology, Zhongshan People's Hospital, Zhongshan 528400, Guangdong, China
  3.Department of Anesthesiology, Dongguan People's Hospital, Dongguan 523059, Guangdong, China
  4.Department of Burn Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  5.Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
- Author bio：
  
  * huangwq@mail.sysu.edu.cn
- Funds：
- DOI：10.1186/s40779-022-00403-1
  中图分类号：
- 纸质出版：2023-06
- Accepted：
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Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China[J]. MMR, 2023,10(3):299-312.

Cite this article as: He QL, Gao SW, Qin Y, Huang RC, Chen CY, Zhou F, et al. Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China. Mil Med Res. 2022;9(1):49.
Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China[J]. MMR, 2023,10(3):299-312. DOI： 10.1186/s40779-022-00403-1.

Cite this article as: He QL, Gao SW, Qin Y, Huang RC, Chen CY, Zhou F, et al. Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China. Mil Med Res. 2022;9(1):49. DOI： 10.1186/s40779-022-00403-1.

摘要

Abstract

Background:

Data on severe and extensive burns in China are limited

as is data on the prevalence of a range of related gastrointestinal (GI) disorders [such as stress ulcers

delayed defecation

opioid-related bowel immotility

and abdominal compartment syndrome (ACS)]. We present a multicentre analysis of coincident GI dysfunction and its effect on burn-related mortality.

Methods:

This retrospective analysis was conducted on patients with severe [≥ 20% total burn surface area (TBSA)] and extensive (>50% TBSA or >25% full-thickness TBSA) burns admitted to three university teaching institutions in China between January 1

2011 and December 31

2020. Both 30- and 90-day mortality were assessed by collating demographic data

burn causes

admission TBSA

% full-thickness TBSA

Baux score

Abbreviated Burn Severity Index (ABSI) score

and Sequential Organ Failure Assessment (SOFA) score

shock at admission and the presence of an inhalation injury. GI dysfunction included abdominal distension

nausea/vomiting

diarrhoea/constipation

GI ulcer/haemorrhage

paralytic ileus

feeding intolerance and ACS. Surgeries

length of intensive care unit (ICU) stay

pain control [in morphine milligram equivalents (MME)] and overall length of hospital stay (LOHS) were recorded.

Results:

We analyzed 328 patients [75.6% male

mean age: (41.6±13.6) years] with a median TBSA of 62.0% (41.0%–80.0%); 256(78.0%) patients presented with extensive burns. The 90-day mortality was 23.2%(76/328)

with 64(84.2%) of these deaths occurring within 30 d and 25(32.9%) occurring within 7 d. GI dysfunction was experienced by 45.4% of patients and had a significant effect on 90-day mortality [odds ratio (

)=14.070

95% confidence interval (CI) 5.886–38.290

0.001]. Multivariate analysis showed that GI dysfunction was associated with admission SOFA score and % full-thickness TBSA. Overall

88.2%(67/76) of deceased patients had GI dysfunction [hazard ratio (

) for death of GI dysfunction=5.951]

with a survival advantage for functional disorders (diarrhoea

constipation

or nausea/vomiting) over GI ulcer/haemorrhage (

0.001).

Conclusion:

Patients with severe burns have an unfavourable prognosis

as nearly one-fifth died within 90 d. Half of our patients had comorbidities related to GI dysfunction

among which GI ulcers and haemorrhages were independently correlated with 90-day mortality. More attention should be given to severe burn patients with GI dysfunction.

关键词

Keywords

references

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