Abstract
530 Osteomyelitis Increases the Rate of Amputation in Patients with Type 2 Diabetes and Lower Extremity Burns
Journal of burn care & research, Vol.41(Supplement_1), pp.S102-S103
03/03/2020
DOI: 10.1093/jbcr/iraa024.159
Abstract
Abstract
Introduction
In patients with type 2 diabetes (DM2), amputation rates exceed 30% when lower extremity osteomyelitis is present. We sought to determine the rate of osteomyelitis and any subsequent amputation in our patients with DM2 and lower extremity burns.
Methods
We performed a single site, retrospective review at our burn center using the institutional Burn Center registry with links to clinical and administrative data. Adults (≥18 years old) with DM2 admitted from January 1, 2014 to December 31, 2018 for isolated lower extremity burns were eligible for inclusion. We evaluated demographics, burn characteristics, comorbidities, admission laboratory values, presence of radiologically-confirmed osteomyelitis, length of stay (LOS), inpatient hospitalization costs, and amputation rate at 3 months and 12 months after injury. Statistical analysis was performed with Students’ t-test, chi-squared, and Fischer’s exact test.
Results
For 103 patients identified with DM2 and isolated lower extremity burns, the average age was 54 years old. The majority of patients were male (78.6%) and white (55.3%). The average total body surface area (TBSA) of burn was 1.8% and 53.4% were scald burns. Thirty percent of patients had a history of heart disease and 22% were current smokers. The average hemoglobin A1c was 9.19 and average creatinine was 2.01. Overall rates of any amputation were 14.6% at 3 months and 18.4% at 12 months.
Fifteen patients (14.6%) had radiologically-confirmed osteomyelitis within 90 days of the burn injury. Compared to patients without osteomyelitis, this subset of patients had significantly increased LOS (average LOS 22.7 days vs 12.1 days, p=0.0041), inpatient hospitalization costs (average $135,345 vs $62,237, p=0.0008), amputation rate within 3 months (66.7% vs 5.70%, p< 0.00001), and amputation rate within 12 months (66.7% vs 10.2%, p< 0.0001). There were no significant differences in other characteristics between patients with osteomyelitis and those without.
Conclusions
Patients with DM2 and lower extremity burns incurred increased LOS, higher inpatient hospitalization costs, and increased amputation rates if radiologically-confirmed osteomyelitis was present.
Applicability of Research to Practice
Osteomyelitis in diabetic patients with lower extremity burns may predict need for amputation within one year of burn injury. Further study could aid in development of protocols for early identification and aggressive treatment of osteomyelitis in burn patients, which may improve LOS, cost, and amputation rates.
Details
- Title: Subtitle
- 530 Osteomyelitis Increases the Rate of Amputation in Patients with Type 2 Diabetes and Lower Extremity Burns
- Creators
- Rabia Nizamani - University of North Carolina at Chapel HillStephen Heisler - University of North Carolina at Chapel HillLori Chrisco - University of North Carolina at Chapel HillHarold Campbell - Mountain Area Health Education CenterSamuel W Jones - Mountain Area Health Education CenterBruce Cairns - University of North Carolina at Chapel HillFelicia N Williams - Mountain Area Health Education Center
- Resource Type
- Abstract
- Publication Details
- Journal of burn care & research, Vol.41(Supplement_1), pp.S102-S103
- Publisher
- Oxford University Press
- DOI
- 10.1093/jbcr/iraa024.159
- ISSN
- 1559-047X
- eISSN
- 1559-0488
- Alternative title
- American Burn Association 52nd Annual Meeting
- Language
- English
- Date published
- 03/03/2020
- Academic Unit
- Surgery
- Record Identifier
- 9984757275302771
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