title: Establishment and assessment of new formulas for energy consumption estimation in adult burn patients.
abstract: OBJECTIVE
  An accurate knowledge of energy consumption in burn patients is a prerequisite for rational nutrition therapy. This study sought to create a formula that accounts for the metabolic characteristics of adult burn patients to accurately estimate energy consumption of patients with different areas and extents of burn and at different times after injury.
  
  
  METHODS
  Resting energy expenditure (REE) data on 66 burn patients, with total body surface area (TBSA) of burns ranging from 4% to 96%, were evaluated at different times after injury. REE values were determined in patients using indirect calorimetry at days 1, 2, 3, 7, 14, 21, and 28 after injury. We then constructed a mathematical model of REE changes post-burn. Next, established two new formulas (one non-linear and the other linear) for energy consumption estimation using model-based analytical solution and regression analysis. The new formulas were compared with measured REE and commonly used formulas including those of Carlson, Xie, Curreri, and Milner to determine accuracy and reliability.
  
  
  RESULTS
  Comparative analysis showed that the new formulas offered significantly higher accuracy and reliability than the Milner formula, which is considered the most accurate of commonly used burn energy consumption estimate formulas. The accuracy of the new nonlinear formula (94.29%) and that of the linear formula (91.43%) were significantly higher than that of Milner formula (72.86%) when compared to measured REE (χ2  =  11.706, P  =  0.001; χ2  =  8.230, P  =  0.004, respectively). The reliabilities of the new estimation formulas were both 100% and that of Milner formula was 74.24% (χ2  =  19.513, P  =  0.000).
  
  
  CONCLUSIONS
  The new formulas constructed in this study provide reliable simulation of the impact of the degree of burn and post-burn days on energy consumption and offer notably higher accuracy and reliability than other formulas. These formulas will help determine nutritional needs of burn patients.
  
  
  BACKGROUND
  The study was registered on Chinese Clinical Trial Registry as ChiCTR-TRC-13003806.
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burns of PLA, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China.
authors.forename: Peng
authors.initials: P
authors.lastname: Xi
authors.affiliation: Department of Mathematics, School of Biomedical Engineering, Third Military Medical University, Chongqing, P.R. China.
authors.forename: Wang
authors.initials: W
authors.lastname: Kaifa
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burns of PLA, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Yong
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burns of PLA, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Hong
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burns of PLA, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China.
authors.forename: Wang
authors.initials: W
authors.lastname: Chao
authors.affiliation: Department of Mathematics, School of Biomedical Engineering, Third Military Medical University, Chongqing, P.R. China.
authors.forename: Song
authors.initials: S
authors.lastname: Lijuan
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burns of PLA, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China.
authors.forename: Wang
authors.initials: W
authors.lastname: Hongyu
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burns of PLA, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China.
authors.forename: Wu
authors.initials: W
authors.lastname: Dan
authors.affiliation: Department of Computational Mathematics and Biostatistics, Metabolomics and Multidisciplinary Laboratory for Trauma Research, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Hua
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burns of PLA, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China.
authors.forename: Wang
authors.initials: W
authors.lastname: Shiliang
mesh_terms: D000293:Adolescent; D000328:Adult; D001830:Body Surface Area; D002056:Burns / Q000378:metabolism* / Q000473:pathology; D002153:Calorimetry, Indirect; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D011379:Prognosis; D012044:Regression Analysis