title: The impact of oxandrolone on length of stay following major burn injury: a clinical practice evaluation.
abstract: BACKGROUND
  The anabolic agent oxandrolone (OX) has been found to decrease length of stay (LOS) following 20-60% total body surface area (TBSA) burn injury. This study uses the Comprehensive Severity Index (CSI) to control for severity of illness and explores the relationship between OX and LOS in a more broadly selected sample of burn patients and a natural practice setting.
  
  
  METHODS
  A practice-based evidence study was conducted at a single regional burn center. Maximum severity of illness (MCSIC) was measured using a burn-specific version of CSI. Data on 167 consecutive surviving patients with TBSA≥15% were analyzed using case-control matching for MCSIC, TBSA, and age. Thirty-eight patients received OX.
  
  
  RESULTS
  Median patient age for the entire patient sample was 42.7 years. Using a 1:1 match based upon MCSIC, TBSA, then age, mean LOS for patients who received OX was 33.6 days, as opposed to 43.4 days for those who were not managed with OX (p=0.03). If patients were matched >1:1 for controls: cases, mean LOS was 40.9 days (controls) versus 31.6 days (cases).
  
  
  CONCLUSIONS
  OX is associated with shorter LOS after controlling for MCSIC, TBSA, and age. Future comparative effectiveness studies should better define which patients derive the greatest benefits from receipt of OX during their recovery from major burn injury.
authors.affiliation: University of Utah, Department of Surgery, Burn Center at the University of Utah, United States. Electronic address: amalia.cochran@hsc.utah.edu.
authors.forename: Amalia
authors.initials: A
authors.lastname: Cochran
authors.forename: Wiley
authors.initials: W
authors.lastname: Thuet
authors.forename: Brennen
authors.initials: B
authors.lastname: Holt
authors.forename: Iris
authors.initials: I
authors.lastname: Faraklas
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Smout
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
mesh_terms: D000328:Adult; D000368:Aged; D045930:Anabolic Agents / Q000627:therapeutic use*; D002056:Burns / Q000188:drug therapy*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010074:Oxandrolone / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D045930:Anabolic Agents; D010074:Oxandrolone
keywords: Burns; Clinical practice improvement; Length of stay; Oxandrolone; Severity of illness