title: Hypertension after injury among burned combat veterans: A retrospective cohort study.
abstract: BACKGROUND
  The long-term health effects of burn are poorly understood. We sought to evaluate the relationship between burn and the subsequent development of hypertension.
  
  
  METHODS
  Retrospective cohort study of patients admitted to our burn center from 2003 to 2010. Data collected included demographic variables, burn size, injury severity score, presence of inhalation injury, serum creatinine, need for renal replacement therapy, as well as days spent in the hospital, in the intensive care unit and on mechanical ventilation. Data for the subsequent diagnosis of hypertension was obtained from medical records. Cox proportional hazard regression models were performed to determine what factors were associated with hypertension.
  
  
  RESULTS
  Of the 711 patients identified, 670 were included for analysis after exclusions. After adjustment, only age (HR 1.06 per one year increase, 95% confidence interval 1.03-1.08; p<0.001), percentage of total body surface area burned (HR 1.11 per 5% increase, 95% confidence interval 1.04-1.19; p=0.002) and acute kidney injury (HR 1.68, 95% confidence interval 1.05-2.69; p=0.03) were associated with hypertension.
  
  
  CONCLUSIONS
  Burn size is independently associated with the subsequent risk of hypertension in combat casualties. Clinical support for primary prevention techniques to reduce the incidence of hypertension specific to burn patients may be warranted.
authors.affiliation: David Grant USAF Medical Center, Clinical Investigation Facility, 101 Bodin Circle, Travis AFB, CA 94535, United States; Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, United States. Electronic address: ian.stewart@us.af.mil.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Stewart
authors.affiliation: Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, United States; San Antonio Military Medical Center, 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78219, United States.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Sosnov
authors.affiliation: Wright-Patterson Medical Center, Wright-Patterson AFB, 4881 Sugar Maple Dr., OH 45433, United States.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Snow
authors.affiliation: Mike O'Callaghan Federal Medical Center, 4700 N Las Vegas Blvd, Nellis AFB, NV 89191, United States.
authors.forename: Augen
authors.initials: A
authors.lastname: Batou
authors.affiliation: U. S. Army Institute of Surgical Research, Fort Sam Houston, 3698 Chambers Rd., TX 78234, United States.
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Howard
authors.affiliation: U. S. Army Institute of Surgical Research, Fort Sam Houston, 3698 Chambers Rd., TX 78234, United States.
authors.forename: Jud C
authors.initials: JC
authors.lastname: Janak
authors.affiliation: South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Bollinger
authors.affiliation: Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, United States; U. S. Army Institute of Surgical Research, Fort Sam Houston, 3698 Chambers Rd., TX 78234, United States.
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Chung
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D000328:Adult; D001830:Body Surface Area; D002053:Burn Units; D002056:Burns / Q000453:epidemiology*; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008889:Military Personnel; D016016:Proportional Hazards Models; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D015208:Smoke Inhalation Injury / Q000453:epidemiology; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D000067398:War-Related Injuries / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D003404:Creatinine
keywords: Acute kidney injury; Burns; Hypertension; Veterans; War