Cardiovascular risk profile in burn survivors

Leung, Becky; Younger, J.; Stockton, Kellie; Müller, Michael; Paratz, Jennifer

doi:10.1016/j.burns.2017.07.010

Cited by 10 publications

(13 citation statements)

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“…Population-based longitudinal studies 15,21 found increased hospital admission rates for cardiovascular disease postburn injury compared with both a nonburn trauma and a noninjury group. Previous work involving a cross-sectional study found abnormal lipid levels (increased triglycerides and decreased high-density lipoprotein) in subjects with a mean age of 36.5 years up to 16 years postburn injury, correlating to severity of burn 14 …”

Section: Discussionmentioning

confidence: 91%

“…[4][5][6][7][8][9][10][11][12][13] In a cross-sectional study in adult burns patients, an adverse lipid profile was found up to 16 years postburn, correlated with the magnitude of the burn. 14 Increased hospital admission rates for cardiovascular disease postburn injury were also observed in a population-based longitudinal study. 15 The aim of this paper was to investigate the association of burns and cardiovascular mortality, with adjustment for age and sex, in a large cohort over a 20-year follow-up period.…”

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confidence: 81%

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Cardiovascular mortality post burn injury

Paratz

Warren

Paratz

et al. 2022

J Trauma Acute Care Surg

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BACKGROUND:Burn injury is responsible for both acute and ongoing inflammation, resulting in systematic changes impacting the cardiovascular, hepatobiliary, endocrine, and metabolic systems, but there is minimal investigation into long-term clinical outcomes. This study aimed to investigate mortality due to cardiovascular related long-term postburn injury. METHODS:This was a retrospective cohort study linking a burns unit database with mortality outcomes from a Registry of Births, Deaths and Marriages. Data were extracted from the Australian Institute of Health and Welfare and stratified into three age groups: 15 to 44 years, 45 to 64 years, and 65+ years. Mortality rate ratios (MRRs) and 95% confidence interval (CI) were calculated to compare the burns cohort mortality incidence rates with the national mortality incidence rates for each of the three age groups. Logistic regression was used to identify demographic and clinical factors associated with cardiovascular mortality. RESULTS:A total of 4,134 individuals in the database were analyzed according to demographic and clinical variables. The 20-year agestandardized cardiovascular mortality rate for the burns cohort was significantly higher compared with the Australian population (250.6 per 100,000 person-years vs. 207.9 per 100,000 person-years) (MRR, 1.21; 95% CI, 1.001-1.45). Cardiovascular mortality was significantly higher in males aged 15-44 and 45-64 years had a cardiovascular mortality rate significantly higher than the Australian population (MRR = 10.06, 95% CI 3.49-16.63), and (MRR = 2.40, 95% CI 1.42-3.38) respectively. Those who died of cardiovascular disease were more frequently intubated postburn injury ( p = 0.01), admitted to intensive care (p < 0.0001), and had preexisting comorbid physical conditions (60.9% vs. 15.0%, p < 0.0001). CONCLUSION:Survivors from burn injury, especially young males, are at increased long-term risk of death from cardiovascular disease. Increased screening and counseling pertaining to lifestyle factors should be standard management postburn injury. Longitudinal observation of physiological changes, investigation of mechanistic factors, and investigation of interventional strategies should be instituted.

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Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 81%

Cardiovascular mortality post burn injury

Paratz

Warren

Paratz

et al. 2022

J Trauma Acute Care Surg

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“…Triacylglycerol, glycerol heads of phospholipids, and monosaturated fatty acids were found by Cohen et al to be the most discriminating markers for identifying survivors from non-survivor’s trauma patients at submission time [ 34 ]. It is interesting to note that individuals with burn injuries had high triglycerides and low HDL, yet there was no change in their total estimated risk of cardiovascular disease [ 35 ]. We found that the TAGs level does not correlate with troponin T concentrations, and therefore does not appear to be a distinct risk factor for heart injury in polytrauma patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of IL-33R and Galectin-3 as New Biomarkers of Cardiac Damage after Polytrauma—Association with Cardiac Comorbidities and Risk Factors

Weber

Voth

Rottluff

et al. 2022

JCM

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Polytrauma is one of the disorders with the greatest economic impact on healthcare in society and one predictor for poor outcome is cardiac damage. Interleukin 33 receptors (IL-33R) and galectin-3 are two new potential cardiac trauma biomarkers that are the subjects of this investigation. Additionally, this study assesses pre-existing cardiac damage or risk factors as predictors of cardiac damage after polytrauma. This retrospective study includes 107 polytraumatized patients with an ISS ≥16 admitted in a Level 1 Trauma Centre. Plasma samples were taken at admission. IL-33R and galectin-3 concentrations were detected in plasma samples by ELISA. Both did not correlate with the cardiac damage measured by troponin. Next to troponin, IL-33R was increased in patients with pre-existing cardiac comorbidities. In the subgroup of patients with cardiac comorbidities, the BMI and the initial blood sugar level were significantly increased compared to patients without cardiac comorbidities. Galectin-3 and IL-33R were shown to not correlate with cardiac damage. However, our data suggests that IL-33R protein should be revised in future studies as a marker of cardiac comorbidities. Further, our data indicate that patients with cardiac comorbidities represent a separate group of polytrauma patients characterized by higher concentrations of troponin, IL-33R, BMI and initial sugar level.

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“…Все они обладают вазоактивным действием и значительно увеличивают проницаемость сосудистой стенки. У ожоговых больных метаболический дисбаланс наряду с расстройствами эндокринной, респираторной систем и психоэмоционального статуса оказывают негативное влияние на сердечно-сосудистую систему [11].…”

Section: патофизиологияunclassified