title: Burn mortality in patients with preexisting cardiovascular disease.
abstract: BACKGROUND
  Burn shock, a complex process, which develops following burn leads to severe and unique derangement of cardiovascular function. Patients with preexisting comorbidities such as cardiovascular diseases may be more susceptible. We therefore sought to examine the impact of preexisting cardiovascular disease on burn outcomes.
  
  
  METHODS
  A retrospective analysis of patients admitted to a regional burn center from 2002 to 2012. Independent variables analyzed included basic demographics, burn mechanism, presence of inhalation injury, TBSA, pre-existing comorbidities, and length of ICU/hospital stay. Bivariate analysis was performed and Poisson regression modeling was utilized to estimate the incidence of being in the ICU and mortality.
  
  
  RESULTS
  There were a total of 5332 adult patients admitted over the study period. 6% (n=428) had a preexisting cardiovascular disease. Cardiovascular disease patients had a higher mortality rate (16%) compared to those without cardiovascular disease (3%, p<0.001). The adjusted Poisson regression model to estimate incidence risk of being in intensive care unit in patients with cardiovascular disease was 33% higher compared to those without cardiovascular disease (IRR=1.33, 95% CI=1.22-1.47). The risk for mortality is 42% higher (IRR=1.42, 95% CI=1.10-1.84) for patients with pre-existing cardiovascular disease compared to those without cardiovascular disease after controlling for other covariates.
  
  
  CONCLUSIONS
  Preexisting cardiovascular disease significantly increases the risk of intensive care unit admission and mortality in burn patients. Given the increasing number of Americans with cardiovascular diseases, there will likely be a greater number of individuals at risk for worse outcomes following burn. This knowledge can help with burn prognostication.
authors.affiliation: Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States.
authors.forename: Laquanda
authors.initials: L
authors.lastname: Knowlin
authors.affiliation: Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States.
authors.forename: Trista
authors.initials: T
authors.lastname: Reid
authors.affiliation: Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States.
authors.forename: Felicia
authors.initials: F
authors.lastname: Williams
authors.affiliation: Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States.
authors.forename: Bruce
authors.initials: B
authors.lastname: Cairns
authors.affiliation: Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States. Electronic address: anthchar@med.unc.edu.
authors.forename: Anthony
authors.initials: A
authors.lastname: Charles
mesh_terms: D000293:Adolescent; D000328:Adult; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000150:complications* / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012769:Shock / Q000150:complications; D015208:Smoke Inhalation Injury / Q000401:mortality; D055815:Young Adult
keywords: Burn; Burn mortality; Burn prognostication; Cardiovascular disease; Comorbidities