High Risk But Not Always Lethal: The Effect of Cirrhosis on Thermally Injured Adults
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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The aim of this article was to determine the effect of cirrhosis on mortality in thermally injured adult patients. We conducted a retrospective review of patients admitted to our burn center during 2003 to 2010. Eight hundred eight patients were included in this study, of whom 24 had the diagnosis of cirrhosis established from electronic medical records andor autopsy reports. The mortality rate for the cirrhotic patients was 50, and for the noncirrhotic patients it was 14.8. On logistic regression, age odds ratio OR, 1.08 confidence interval CI, 1.06-1.10, TBSA OR, 1.08 CI, 1.06-1.10, inhalation injury OR, 3.17, CI, 1.61-6.25, and cirrhosis OR, 8.78 CI, 2.97-25.98 had independent effects on mortality. Of the 24 cirrhotic patients in this study, the admission Model for End-Stage Liver Disease score for the patients who survived hospitalization was 12.1 plus or minus 4.0, and for the patients who died it was 13.8 plus or minus 6.0 P .4. When comparing patients with 10 to 50 TBSA burn, the mortality rate for cirrhotic patients was 83.3 1012, and for the noncirrhotic patients it was only 12.7 50394, P less than .0001. Adults with cirrhosis are rarely able to survive burn injuries greater than 10 TBSA. Although we did not detect a significant association between admission Model for End-Stage Liver Disease score and death, the presence of cirrhosis is a high premorbid contributor and, therefore, new strategies are needed to improve outcomes.
- Medicine and Medical Research