Burn injury in obesity: Examination of the Burn Care Quality Platform's (BCQP) available data on obese patients to determine burn-related outcomes

Edward J Kelly; Shane K Mathew; Bonnie C Carney; Lauren T Moffatt; Jeffrey W Shupp; Shawn Tejiram

doi:10.1016/j.burns.2024.09.015

Burn injury in obesity: Examination of the Burn Care Quality Platform's (BCQP) available data on obese patients to determine burn-related outcomes

Burns. 2024 Sep 25;51(1):107276. doi: 10.1016/j.burns.2024.09.015. Online ahead of print.

Authors

Edward J Kelly¹, Shane K Mathew¹, Bonnie C Carney², Lauren T Moffatt², Jeffrey W Shupp³, Shawn Tejiram⁴

Affiliations

¹ The Burn Center, MedStar Washington Hospital Center, Washington DC, United States; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington DC, United States.
² Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington DC, United States; Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington DC, United States; Department of Surgery, Georgetown University School of Medicine, Washington DC, United States.
³ The Burn Center, MedStar Washington Hospital Center, Washington DC, United States; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington DC, United States; Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington DC, United States; Department of Surgery, Georgetown University School of Medicine, Washington DC, United States; Department of Plastic Surgery, Georgetown University School of Medicine, Washington DC, United States.
⁴ The Burn Center, MedStar Washington Hospital Center, Washington DC, United States; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington DC, United States; Department of Surgery, Georgetown University School of Medicine, Washington DC, United States; Department of Plastic Surgery, Georgetown University School of Medicine, Washington DC, United States. Electronic address: shawn.tejiram@medstar.net.

PMID: 39579582
DOI: 10.1016/j.burns.2024.09.015

Abstract

Introduction: Literature examining the impact of obesity on burn injury remains mixed. Previous examination of the National Burn Repository, now the BCQP, in obesity-related burn research is limited. The aim of this work was to provide an assessment of the BCQP dataset to examine the effect of obesity on burn-related outcomes.

Materials and methods: A retrospective review of the BCQP dataset from 2015-2018 was conducted. The primary outcome measure was mortality. Secondary outcomes included overall length of stay (LOS), ICU LOS, and total hospital costs. Patients were grouped as obese or non-obese and were further stratified by total body surface area burned (TBSA) for comparison purposes. Multiple logistic regression (MLG) was used to compare the effect of several independent variables on mortality, ICU LOS > 7days, hospital LOS > 10 days, and total hospital costs > $200,000.

Results: Of 41,031 patients in the analysis, 3845 (9.37 %) were obese. Obese patients had a higher mean TBSA (p = 0.01), longer overall LOS (p < 0.001), ICU LOS (p < 0.001), and total hospital costs (p < 0.001). MLG found obesity to be an independent predictor of ICU LOS > 7 days, hospital LOS > 10 days, and total hospital costs > $200,000. Obesity was not an independent predictor of mortality in burn patients, even when stratified by burn size.

Conclusions: The presence of obesity in this dataset was not found to be a predictor of mortality for any burn size, but was a predictor of overall LOS, ICU LOS, and total hospital costs. Including obesity-related variables in databases may improve analysis in obesity-related burn research.

Keywords: BCQP; Burn Injury; Hospital Costs; Mortality; National Burn Repository; Obesity.