Increased Rate of Long-term Mortality Among Burn Survivors

Mason, Stephanie; Nathens, Avery B.; Byrne, James P.; Diong, Christina; Fowler, Robert; Karanicolas, Paul J.; Moineddin, Rahim; Jeschke, Marc G.

doi:10.1097/sla.0000000000002722

Cited by 44 publications

(21 citation statements)

References 49 publications

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“…(22) Similar to sepsis and trauma, burn survivors have a greater long-term mortality than matched controls, as well as increased mental illness. (23, 24) CCI has been demonstrated after severe acute pancreatitis as well. Yang et al determined that individuals with severe acute pancreatitis with prolonged durations of stay in the ICU had greater morbidity and rates of PICS, which was a risk factor for post-ICU mortality and poor quality of life in these patients.…”

Section: Long-term Outcomes Of CCI and Picsmentioning

confidence: 95%

Persistent inflammation, immunosuppression, and catabolism and the development of chronic critical illness after surgery

Efron

Mohr

Bïhorac

et al. 2018

Surgery

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As early as the 1990s, chronic critical illness, a distinct syndrome of persistent high-acuity illness requiring management in the ICU, was reported under a variety of descriptive terms including the "neuropathy of critical illness," "myopathy of critical illness," "ICU-acquired weakness," and most recently "post-intensive care unit syndrome." The widespread implementation of targeted shock resuscitation, improved organ support modalities, and evidence-based protocolized ICU care has resulted in significantly decreased in-hospital mortality within surgical ICUs, specifically by reducing early multiple organ failure deaths. However, a new phenotype of multiple organ failure has now emerged with persistent but manageable organ dysfunction, high resource utilization, and discharge to prolonged care facilities. This new multiple organ failure phenotype is now clinically associated with the rapidly increasing incidence of chronic critical illness in critically ill surgery patients. Although the underlying pathophysiology driving chronic critical illness remains incompletely described, the persistent inflammation, immunosuppression, and catabolism syndrome has been proposed as a mechanistic framework in which to explain the increased incidence of chronic critical illness in surgical ICUs. The purpose of this review is to provide a historic perspective of the epidemiologic evolution of multiple organ failure into persistent inflammation, immunosuppression, and catabolism syndrome; describe the mechanism that drives and sustains chronic critical illness, and review the long-term outcomes of surgical patients who develop chronic critical illness.

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Section: Long-term Outcomes Of CCI and Picsmentioning

confidence: 95%

Persistent inflammation, immunosuppression, and catabolism and the development of chronic critical illness after surgery

Efron

Mohr

Bïhorac

et al. 2018

Surgery

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“…Burn injuries cause severe damage to the epidermis, dermis, and underlying tissue, often resulting in physical and mental illnesses [ 1 ]. Ideally, burn wound dressings should be infection-resistant, retain moisture, and facilitate tissue regeneration [ 2 ].…”

Section: Introductionsmentioning

confidence: 99%

Cutaneous Regeneration Mechanism of β-Sheet Silk Fibroin in a Rat Burn Wound Healing Model

et al. 2021

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Therapeutic dressings to enhance burn wound repair and regeneration are required. Silk fibroin (SF), a natural protein, induces cell migration and serves as a biomaterial in various dressings. SF dressings usually contain α-helices and β-sheets. The former has been confirmed to improve cell proliferation and migration, but the wound healing effect and related mechanisms of β-sheet SF remain unclear. We investigated the effects of β-sheet SF in vivo and in vitro. Alcohol-treated α-helix SF transformed into the β-sheet form, which promoted granulation formation and re-epithelialization when applied as lyophilized SF dressing (LSFD) in a rat burn model. Our in vitro results showed that β-sheet SF increased human dermal fibroblast (HDF) migration and promoted the expression of extracellular matrix (ECM) proteins (fibronectin and type III collagen), matrix metalloproteinase-12, and the cell adhesion molecule, integrin β1, in rat granulation tissue and HDFs. This confirms the role of crosstalk between integrin β1 and ECM proteins in cell migration. In summary, we demonstrated that β-sheet SF facilitates tissue regeneration by modulating cell adhesion molecules in dermal fibroblasts. LSFD could find clinical application for burn wound regeneration. Moreover, β-sheet SF could be combined with anti-inflammatory materials, growth factors, or antibiotics to develop novel dressings.

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“…Two population-based cohort studies followed burn patients for many years after hospital discharge and revealed increased all-cause mortality compared to matched controls. One study had age limit >45 years and no TBSA limit while the other study had a TBSA limit >10% (34,35). Moreover, younger age and good pre-existing medical A c c e p t e d M a n u s c r i p t condition are associated with long-term survival after burn injury (36).…”

Section: Mortality During Follow-upmentioning

confidence: 99%

Long-Term Outcome After Renal Replacement Therapy in Severe Burns

Rakkolainen

Mustonen

Vuola

2020

Journal of Burn Care &Amp; Research

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Abstract Acute kidney injury is a common sequela after major burn injury, but only a small proportion of patients need renal replacement therapy. In the majority of patients, need for renal replacement therapy subsides before discharge from the burn center but limited literature exists on long-term outcomes. A few studies report an increased risk for chronic renal failure after burn injury. We investigated the long-term outcome of severely burned patients receiving renal replacement therapy during acute burn injury treatment. Data on 68 severely burned patients who received renal replacement therapy in Helsinki Burn Centre between November 1988 and December 2015 were collected retrospectively. Thirty-two patients survived and remained for follow-up after the primary hospital stay until December 31, 2016. About 56.3% of discharged patients were alive at the end of follow-up. In 81.3% of discharged patients, need for renal replacement therapy subsided before discharge. Two patients received renal replacement therapy for longer than 3 months; however, need for renal replacement therapy subsided in both patients. One patient required dialysis several years later on after the need for renal replacement therapy had subsided. This study showed that long-term need for renal replacement therapy is rare after severe burn injury. In the vast majority of patients, need for renal replacement therapy subsided before discharge from primary care. Acute kidney injury in association with burns is a potential but small risk factor for later worsening of kidney function in fragile individuals.

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Increased Rate of Long-term Mortality Among Burn Survivors

Abstract: Burn survivors have a significantly higher rate of long-term mortality than matched controls, particularly related to trauma and mental illness. Burn follow-up should be focused on injury prevention, mental healthcare, and detection and treatment of new disease.

Cited by 44 publications

References 49 publications

Persistent inflammation, immunosuppression, and catabolism and the development of chronic critical illness after surgery

Persistent inflammation, immunosuppression, and catabolism and the development of chronic critical illness after surgery

Cutaneous Regeneration Mechanism of β-Sheet Silk Fibroin in a Rat Burn Wound Healing Model

Long-Term Outcome After Renal Replacement Therapy in Severe Burns

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