Journal article
Sex-Based Differences in Inpatient Burn Mortality
World journal of surgery, Vol.43(12), pp.3035-3043
12/2019
DOI: 10.1007/s00268-019-05165-x
PMCID: PMC6871510
PMID: 31511940
Abstract
Background Among burn patients, research is conflicted, but may suggest that females are at increased risk of mortality, despite the opposite being true in non-burn trauma. Our objective was to determine whether sex-based differences in burn mortality exist, and assess whether patient demographics, comorbid conditions, and injury characteristics explain said differences.
Methods Adult patients admitted with burn injury-including inhalation injury only-between 2004 and 2013 were included. Inverse probability of treatment weights (IPTW) and inverse probability of censor weights (IPCW) were calculated using admit year, patient demographics, comorbid conditions, and injury characteristics to adjust for potential confounding and informative censoring. Standardized Kaplan-Meier survival curves, weighted by both IPTW and IPCW, were used to estimate the 30-day and 60-day risk of inpatient mortality across sex.
Results Females were older (median age 44 vs. 41 years old, p<0.0001) and more likely to be Black (32% vs. 25%, p<0.0001), have diabetes (14% vs. 10%, p<0.0001), pulmonary disease (14% vs. 7%, p<0.0001), heart failure (4% vs. 2%, p=0.001), scald burns (45% vs. 26%, p<0.0001), and inhalational injuries (10% vs. 8%, p=0.04). Even after weighting, females were still over twice as likely to die after 60 days (RR 2.87, 95% CI 1.09, 7.51).
Conclusion Female burn patients have a significantly higher risk of 60-day mortality, even after accounting for demographics, comorbid conditions, burn size, and inhalational injury. Future research efforts and treatments to attenuate mortality should account for these sex-based differences.
Details
- Title: Subtitle
- Sex-Based Differences in Inpatient Burn Mortality
- Creators
- Felicia N. Williams - University of North Carolina at Chapel HillPaula D. Strassle - University of North Carolina at Chapel HillLaquanda Knowlin - Howard UniversitySonia Napravnik - University of North Carolina at Chapel HillDavid van Duin - University of North Carolina at Chapel HillAnthony Charles - University of North Carolina at Chapel HillRabia Nizamani - Univ N Carolina, Dept Surg, Sch Med, Chapel Hill, NC 27599 USASamuel W. Jones - Univ N Carolina, Dept Surg, Sch Med, Chapel Hill, NC 27599 USABruce A. Cairns - Univ N Carolina, Dept Surg, Sch Med, Chapel Hill, NC 27599 USA
- Resource Type
- Journal article
- Publication Details
- World journal of surgery, Vol.43(12), pp.3035-3043
- DOI
- 10.1007/s00268-019-05165-x
- PMID
- 31511940
- PMCID
- PMC6871510
- NLM abbreviation
- World J Surg
- ISSN
- 0364-2313
- eISSN
- 1432-2323
- Publisher
- Springer Nature
- Number of pages
- 9
- Grant note
- T32GM008450 / NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of General Medical Sciences (NIGMS) UL1TR001111 / National Center for Advancing Translational Sciences (NCATS), National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) UL1TR001111 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS)
- Language
- English
- Date published
- 12/2019
- Academic Unit
- Surgery
- Record Identifier
- 9984755387702771
Metrics
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