Estrogen Treatment Lowers the Risk of Complications in Menopausal Women with Mild Burn Injury.

Abstract

Background and Objectives: Postmenopausal women are often treated with exogenous female hormones to alleviate physical symptoms and support mental health. We posit that women treated with estrogen fare better following burn injury. Materials and Methods: De-identified patient data were obtained from TriNetX, a global healthcare research network. Adult postmenopausal women were enrolled if they were diagnosed with burn injury within 10 years after menopause onset. Patients with pre-existing abnormal uterine bleeding, gynecologic cancer, and chronic liver or heart disease were excluded. The population was grouped into those who received and those who did not receive estrogen treatment (ET) for evaluation of subsequent complications. Cohort balancing was performed using the exact match approach of Inverse Probability Treatment Weighting (IPTW). The average treatment effects (ATEs) and confidence intervals were computed for these balanced cohorts. Results: Postmenopausal women with ET had a lower risk of endometrial hyperplasia and malignancy 3 months (ATE = -0.005, -0.006) and 3 years (-0.007, -0.008) after mild burn injury (less than 20% of total body surface area) (p < 0.05), regardless of age. At the 3-month timepoint, postmenopausal women aged 45-65 with ET exhibited preventive effects against acute kidney injury (-0.0332), cerebral infarction (-0.0279), breast cancer (-0.0278) and severe sepsis (-0.011) after mild burn injury (p < 0.05) compared to women who did not receive ET. After 3 years, 45-65-year-old women with ET exhibited decreased rates of breast cancer (-0.0479) and endometrial hyperplasia (-0.0116) (p < 0.05) compared to those without ET. Conclusions: Estrogen treatment decreases the risk probabilities of breast cancer and other complications in postmenopausal women from 3 months to 3 years after mild burn injury.