title: A revised risk analysis of stress ulcers in burn patients receiving ulcer prophylaxis.
abstract: OBJECTIVE
  Most of the literature about Curling's ulcer was published from 1960 through 1980. Therefore, an updated study of Curling's ulcer is needed. We analyzed the risk factors affecting ulcer incidence in burn patients.
  
  
  METHODS
  We retrospectively analyzed the medical records of burn patients who were admitted to two burn centers. We collected information about the general characteristics of patients, burn area size, abbreviated burn severity index, whether surgery was performed, endoscopy results, and the total body surface area (TBSA). We performed a multivariate regression analysis predicting development of Curling's ulcer.
  
  
  RESULTS
  In total, 135 patients (mean age, 49.5±13.5 years) underwent endoscopy. Endoscopy revealed ulcer in 51 patients: 36 (70.6%) with gastric ulcers, 9 (17.6%) with duodenal ulcers, and 6 (11.8%) with both ulcer types. Burn area, burn depth, epigastric pain, melena, intensive care unit admission, burn area >20% of TBSA, and undergoing surgery for the burn were significantly different between the ulcer and non-ulcer groups. Multivariate analysis showed two independent factors significantly associated with ulcer: epigastric pain (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 1.74 to 11.90), major burn (TBSA > 20%)(OR: 4.31 ,95% CI: 1.34 to 13.85).
  
  
  CONCLUSIONS
  For burn patients, presence of epigastric pain and major burn with TBSA > 20% showed significant association with ulcer development.
authors.affiliation: Department of Emergency Medicine, Bestian Hospital, Seoul, Korea.
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Department of Emergency Medicine, Bestian Hospital, Seoul, Korea.
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of General Surgery, Bestian Hospital, Seoul, Korea.
authors.forename: Jae Jun
authors.initials: JJ
authors.lastname: Shin
authors.affiliation: Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Young Soon
authors.initials: YS
authors.lastname: Cho
keywords: Burns; Duodenal ulcer; Stomach ulcer