Pub Date : 2025-12-26DOI: 10.1016/j.burns.2025.107844
Ronald M. Cornely , Sara C. Chaker , Andrew J. James , Ariel Vinson , Barite Gutama , Ronnie N. Mubang , Elizabeth Slater , William Lineaweaver
Background
The COVID-19 pandemic caused major societal disruptions, including shifts in childcare, remote learning, and parental work-from-home responsibilities, potentially altering pediatric burn incidence. This study compares pediatric burn admission numbers, etiology, and severity at a regional burn center to national trends before and during the pandemic.
Methods
A retrospective cohort study analyzed pediatric burn admissions and reported their proportion of total burns from a regional burn center and the American Burn Association National Burn Repository (2017–2022). Patient demographics, burn etiology, and total body surface area burned were examined. Chi-squared tests and logistic regression assessed differences between pre-pandemic (2017–2019) and pandemic (2020–2022) cohorts.
Results
Among 618 pediatric burn patients, regional admissions increased by 26 % in 2020, whereas national data demonstrated a 41 % decline. Thermal burns remained the most common etiology, though non-thermal burns increased. Burn admissions rose in infants (<1 year) and school-aged children (5–18 years) but declined in toddlers (1–5 years). Older pediatric age (p = 0.03) and thermal burns (p < 0.01) were significant risk factors.
Conclusions
Regional pediatric burn admissions rose during the pandemic despite a national decline, underscoring the need for targeted prevention strategies and improved burn center preparedness for future public health crises.
{"title":"Comparative analysis of changes in pediatric burn epidemiology between national burn registry and regional burn center data during the COVID-19 pandemic","authors":"Ronald M. Cornely , Sara C. Chaker , Andrew J. James , Ariel Vinson , Barite Gutama , Ronnie N. Mubang , Elizabeth Slater , William Lineaweaver","doi":"10.1016/j.burns.2025.107844","DOIUrl":"10.1016/j.burns.2025.107844","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic caused major societal disruptions, including shifts in childcare, remote learning, and parental work-from-home responsibilities, potentially altering pediatric burn incidence. This study compares pediatric burn admission numbers, etiology, and severity at a regional burn center to national trends before and during the pandemic.</div></div><div><h3>Methods</h3><div>A retrospective cohort study analyzed pediatric burn admissions and reported their proportion of total burns from a regional burn center and the American Burn Association National Burn Repository (2017–2022). Patient demographics, burn etiology, and total body surface area burned were examined. Chi-squared tests and logistic regression assessed differences between pre-pandemic (2017–2019) and pandemic (2020–2022) cohorts.</div></div><div><h3>Results</h3><div>Among 618 pediatric burn patients, regional admissions increased by 26 % in 2020, whereas national data demonstrated a 41 % decline. Thermal burns remained the most common etiology, though non-thermal burns increased. Burn admissions rose in infants (<1 year) and school-aged children (5–18 years) but declined in toddlers (1–5 years). Older pediatric age (p = 0.03) and thermal burns (p < 0.01) were significant risk factors.</div></div><div><h3>Conclusions</h3><div>Regional pediatric burn admissions rose during the pandemic despite a national decline, underscoring the need for targeted prevention strategies and improved burn center preparedness for future public health crises.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107844"},"PeriodicalIF":2.9,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-25DOI: 10.1016/j.burns.2025.107846
Bastian Garmroudi , Thomas Haider , Carmen Haider , Philipp Hacker , Gregor Werba , Hendrik Jan Ankersmit , Stefan Hacker
Background
Severe burn injuries trigger a complex systemic response, including dysregulated inflammation and immunosuppression. Heat shock proteins (HSPs) regulate cellular stress responses and have immunomodulatory functions when released into the extracellular compartment. Our aim was to investigate the release of systemic HSP27 and 70 in patients suffering from severe burn injury.
Methods
We analyzed serum HSP27 and HSP70 concentrations in 32 burn patients admitted to our burn intensive care unit with a total body surface area (TBSA) affected of > 10 % in comparison to eight healthy control probands. HSP27 and 70 concentrations were determined serially for four weeks using enzyme-linked immunosorbent assays (ELISA).
Results
The mean TBSA was 32.5 % ± 19.6 %, and in-hospital mortality occurred in six patients (18.8 %). HSP27 and HSP70 concentrations were significantly elevated in burn patients compared to controls, with peak concentrations on the day of admission (HSP27: 590 ± 335 vs. 83 ± 42 pg/mL, p < 0.001; HSP70: 1961 ± 2214 vs. 189 ± 130 pg/mL, p < 0.001). HSP70 concentrations were significantly higher in non-survivors (1143 vs. 946 pg/mL, p < 0.05) and were significantly higher in patients with more than 29 % TBSA compared to patients with lower TBSA (p < 0.01). Receiver operating characteristic curve analysis identified HSP70 measured on the day of admission as a significant predictor of patient mortality.
Conclusion
Severe thermal trauma results in elevated HSP27 and HSP70 concentrations. Increased HSP70 levels are associated with higher in-hospital mortality in burn patients, suggesting potential use as a prognostic biomarker.
{"title":"Increased systemic heat-shock protein 27 and 70 following severe burn injury","authors":"Bastian Garmroudi , Thomas Haider , Carmen Haider , Philipp Hacker , Gregor Werba , Hendrik Jan Ankersmit , Stefan Hacker","doi":"10.1016/j.burns.2025.107846","DOIUrl":"10.1016/j.burns.2025.107846","url":null,"abstract":"<div><h3>Background</h3><div>Severe burn injuries trigger a complex systemic response, including dysregulated inflammation and immunosuppression. Heat shock proteins (HSPs) regulate cellular stress responses and have immunomodulatory functions when released into the extracellular compartment. Our aim was to investigate the release of systemic HSP27 and 70 in patients suffering from severe burn injury.</div></div><div><h3>Methods</h3><div>We analyzed serum HSP27 and HSP70 concentrations in 32 burn patients admitted to our burn intensive care unit with a total body surface area (TBSA) affected of > 10 % in comparison to eight healthy control probands. HSP27 and 70 concentrations were determined serially for four weeks using enzyme-linked immunosorbent assays (ELISA).</div></div><div><h3>Results</h3><div>The mean TBSA was 32.5 % ± 19.6 %, and in-hospital mortality occurred in six patients (18.8 %). HSP27 and HSP70 concentrations were significantly elevated in burn patients compared to controls, with peak concentrations on the day of admission (HSP27: 590 ± 335 vs. 83 ± 42 pg/mL, p < 0.001; HSP70: 1961 ± 2214 vs. 189 ± 130 pg/mL, p < 0.001). HSP70 concentrations were significantly higher in non-survivors (1143 vs. 946 pg/mL, p < 0.05) and were significantly higher in patients with more than 29 % TBSA compared to patients with lower TBSA (p < 0.01). Receiver operating characteristic curve analysis identified HSP70 measured on the day of admission as a significant predictor of patient mortality.</div></div><div><h3>Conclusion</h3><div>Severe thermal trauma results in elevated HSP27 and HSP70 concentrations. Increased HSP70 levels are associated with higher in-hospital mortality in burn patients, suggesting potential use as a prognostic biomarker.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107846"},"PeriodicalIF":2.9,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-25DOI: 10.1016/j.burns.2025.107843
Qinyuan Wang, Chao Sun, Meihong Zhang
{"title":"Comment on \"Clinical study comparing full-thickness skin columns and split-thickness skin graft donor sites in terms of pain and healing outcomes\"","authors":"Qinyuan Wang, Chao Sun, Meihong Zhang","doi":"10.1016/j.burns.2025.107843","DOIUrl":"10.1016/j.burns.2025.107843","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107843"},"PeriodicalIF":2.9,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-25DOI: 10.1016/j.burns.2025.107845
Nicole J.M. Schweizer , Thomas C. Scheier , Philipp K. Buehler , Bong-Sung Kim , Mauro Vasella , Chun-Chi Chang , Silvio D. Brugger , Pascal M. Frey , Daniel A. Hofmaenner
Background
Burn injuries are associated with significant morbidity and mortality, with infections being a major factor influencing outcomes. Given evidence of sex-related differences in infection risk, we investigated whether such disparities extend to bacteremia in critically ill burn patients.
Methods
We conducted a single-centre cohort study of critically ill patients with severe burn injuries admitted to the Burn Center at the University Hospital Zurich between January 2017 and December 2021. The primary outcome was the association between sex and the development of a first bacteremia episode, analysed using a competing risk regression model accounting for the competing risk of death. Secondary outcomes included the association between sex and ICU mortality, assessed with Cox regression, and the variation of pathogens causing bacteremia by sex.
Results
269 patients were included, of whom 69 (26 %) were female. Median age was 50 years (interquartile range [IQR] 33–65), and the affected median total body surface area was 19 % (IQR 11–30). A first bacteremia occurred in 61 patients (23 %) after a median of 7 days (IQR 5–13), including 21 of 69 female patients (30 %) and 40 of 200 male patients (20 %, p = 0.10). In the fully adjusted competing risk regression model, female sex was associated with the development of bacteremia (subhazard ratio [SHR] 1.98, 95 % CI 1.06–3.70, p = 0.03). Overall ICU mortality was 15 % (n = 40). Although crude mortality was higher among female patients (25 % vs. 12 %, p = 0.01), this difference was not significant after adjustment. Among those with bacteremia (n = 61), the most frequently identified pathogens were Staphylococcus aureus (19 %), Klebsiella pneumoniae (8 %), and Streptococcus mitis/oralis (8 %), with no difference in pathogen distribution between sexes (p = 0.21).
Conclusion
Female sex was associated with a higher bacteremia risk, suggesting sex-specific vulnerability that warrants further investigation. These findings support more tailored infection monitoring and diagnostic strategies in female burn patients during ICU care.
{"title":"Impact of sex on the development of bacteremia in critically ill burn patients: A retrospective cohort study","authors":"Nicole J.M. Schweizer , Thomas C. Scheier , Philipp K. Buehler , Bong-Sung Kim , Mauro Vasella , Chun-Chi Chang , Silvio D. Brugger , Pascal M. Frey , Daniel A. Hofmaenner","doi":"10.1016/j.burns.2025.107845","DOIUrl":"10.1016/j.burns.2025.107845","url":null,"abstract":"<div><h3>Background</h3><div>Burn injuries are associated with significant morbidity and mortality, with infections being a major factor influencing outcomes. Given evidence of sex-related differences in infection risk, we investigated whether such disparities extend to bacteremia in critically ill burn patients.</div></div><div><h3>Methods</h3><div>We conducted a single-centre cohort study of critically ill patients with severe burn injuries admitted to the Burn Center at the University Hospital Zurich between January 2017 and December 2021. The primary outcome was the association between sex and the development of a first bacteremia episode, analysed using a competing risk regression model accounting for the competing risk of death. Secondary outcomes included the association between sex and ICU mortality, assessed with Cox regression, and the variation of pathogens causing bacteremia by sex.</div></div><div><h3>Results</h3><div>269 patients were included, of whom 69 (26 %) were female. Median age was 50 years (interquartile range [IQR] 33–65), and the affected median total body surface area was 19 % (IQR 11–30). A first bacteremia occurred in 61 patients (23 %) after a median of 7 days (IQR 5–13), including 21 of 69 female patients (30 %) and 40 of 200 male patients (20 %, p = 0.10). In the fully adjusted competing risk regression model, female sex was associated with the development of bacteremia (subhazard ratio [SHR] 1.98, 95 % CI 1.06–3.70, p = 0.03). Overall ICU mortality was 15 % (n = 40). Although crude mortality was higher among female patients (25 % vs. 12 %, p = 0.01), this difference was not significant after adjustment. Among those with bacteremia (n = 61), the most frequently identified pathogens were <em>Staphylococcus aureus</em> (19 %), <em>Klebsiella pneumoniae</em> (8 %), and <em>Streptococcus mitis/oralis</em> (8 %), with no difference in pathogen distribution between sexes (p = 0.21).</div></div><div><h3>Conclusion</h3><div>Female sex was associated with a higher bacteremia risk, suggesting sex-specific vulnerability that warrants further investigation. These findings support more tailored infection monitoring and diagnostic strategies in female burn patients during ICU care.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107845"},"PeriodicalIF":2.9,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-23DOI: 10.1016/j.burns.2025.107842
Thomas Langer
{"title":"Ringer’s lactate alone or combined with isotonic sodium bicarbonate for burn resuscitation: Does acid–base correction translate into clinical benefit?","authors":"Thomas Langer","doi":"10.1016/j.burns.2025.107842","DOIUrl":"10.1016/j.burns.2025.107842","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107842"},"PeriodicalIF":2.9,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-23DOI: 10.1016/j.burns.2025.107841
Charlotte I. Cords , Margriet E. van Baar , Ymke Lucas , Sonja M.H.J. Scholten , Marianne K. Nieuwenhuis , Matthea Stoop , Anouk Pijpe , Francesco U.S. Mattace-Raso , Michiel H.J. Verhofstad , Cornelis H. van der Vlies , FRAIL group, Dutch Burn Repository group, FRAIL group , Dutch Burn Repository group , Burn Centre Rotterdam , Burn Centre Groningen , Alliance of Dutch Burn Care
Introduction
Frailty is frequently seen in burn patients aged ≥ 50 years and can negatively influence outcomes, yet performance of available screening tools in specialized burn care remains unclear. This study evaluated feasibility, reliability, and validity of the Clinical Frailty Scale (CFS), Burn Frailty Index (BFI), and Groningen Frailty Indicator (GFI), and determined the prevalence of frailty among patients with burns.
Methodology
A multicentre prospective cohort study was conducted in Dutch burn centres in patients aged ≥ 50 years. Feasibility, inter-rater reliability, predictive validity, known-group validity, convergent validity, and prevalence of frailty and its association with patient characteristics and clinical outcomes were assessed.
Results
Among 145 patients (median age 66 years, median TBSA burned 6.4 %), the CFS and GFI were highly feasible (completion rate up to 97 %), while the BFI was less feasible. Inter-rater reliability was moderate to good for CFS and BFI. Frailty (CFS, BFI, GFI) predicted non-home discharge, but not complications or length of stay. Frail patients were more likely to be older (CFS, BFI), have more comorbidity (CFS, BFI, GFI), and have polypharmacy (CFS, GFI). Frailty scores correlated moderately with reference standards. Frailty prevalence varied: 42.1 % (GFI), 19.4 % (CFS), and 6.2 % (BFI).
Conclusion
Systematic frailty screening can play an important role in acute burn care for older patients, with the CFS emerging as most feasible, reliable, and valid option for clinical implementation.
{"title":"Frailty assessment in middle-aged and older patients with burn injuries, a prospective comparative study on the clinimetric properties of existing screening tools","authors":"Charlotte I. Cords , Margriet E. van Baar , Ymke Lucas , Sonja M.H.J. Scholten , Marianne K. Nieuwenhuis , Matthea Stoop , Anouk Pijpe , Francesco U.S. Mattace-Raso , Michiel H.J. Verhofstad , Cornelis H. van der Vlies , FRAIL group, Dutch Burn Repository group, FRAIL group , Dutch Burn Repository group , Burn Centre Rotterdam , Burn Centre Groningen , Alliance of Dutch Burn Care","doi":"10.1016/j.burns.2025.107841","DOIUrl":"10.1016/j.burns.2025.107841","url":null,"abstract":"<div><h3>Introduction</h3><div>Frailty is frequently seen in burn patients aged ≥ 50 years and can negatively influence outcomes, yet performance of available screening tools in specialized burn care remains unclear. This study evaluated feasibility, reliability, and validity of the Clinical Frailty Scale (CFS), Burn Frailty Index (BFI), and Groningen Frailty Indicator (GFI), and determined the prevalence of frailty among patients with burns.</div></div><div><h3>Methodology</h3><div>A multicentre prospective cohort study was conducted in Dutch burn centres in patients aged ≥ 50 years. Feasibility, inter-rater reliability, predictive validity, known-group validity, convergent validity, and prevalence of frailty and its association with patient characteristics and clinical outcomes were assessed.</div></div><div><h3>Results</h3><div>Among 145 patients (median age 66 years, median TBSA burned 6.4 %), the CFS and GFI were highly feasible (completion rate up to 97 %), while the BFI was less feasible. Inter-rater reliability was moderate to good for CFS and BFI. Frailty (CFS, BFI, GFI) predicted non-home discharge, but not complications or length of stay. Frail patients were more likely to be older (CFS, BFI), have more comorbidity (CFS, BFI, GFI), and have polypharmacy (CFS, GFI). Frailty scores correlated moderately with reference standards. Frailty prevalence varied: 42.1 % (GFI), 19.4 % (CFS), and 6.2 % (BFI).</div></div><div><h3>Conclusion</h3><div>Systematic frailty screening can play an important role in acute burn care for older patients, with the CFS emerging as most feasible, reliable, and valid option for clinical implementation.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107841"},"PeriodicalIF":2.9,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-22DOI: 10.1016/j.burns.2025.107838
Mengfan Zhai, Hui Wang
{"title":"Comment on “Evaluating the association between bronchoscopic severity of burns-related smoke inhalation injury and clinical outcomes: A systematic review and meta-analysis”","authors":"Mengfan Zhai, Hui Wang","doi":"10.1016/j.burns.2025.107838","DOIUrl":"10.1016/j.burns.2025.107838","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107838"},"PeriodicalIF":2.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to investigate the correlation between hemoglobin (Hb) levels and 1-year mortality in burn patients in intensive care units.
Methods
We conducted a retrospective cohort study, extracting relevant data from the American Intensive Care Unit (ICU) Medical Information Database IV (MIMIC-IV) for burn patients. This data included complete blood counts, biochemistry and coagulation parameters (both maximum and minimum values during ICU hospitalization), Simplified Acute Physiology Score II (SAPSII), Acute Physiology ScoreIII (APSIII), Oxford Acute Severity of Illness Score (Oasis), Sequential Organ Failure Assessment (SOFA), comorbidities, and outcome. A restricted cubic spline model was utilized to illustrate the relationship between Hb levels and 1-year mortality risk. Patients were stratified into three groups based on gender and the relationship curve (Female: Hb<10.0 g/dL, 10.0 g/dL≤Hb<11.5 g/dL, Hb≥11.5 g/dL; Male: Hb<11.0 g/dL, 11.0 g/dL≤Hb<12.5 g/dL, Hb≥12.5 g/dL). Logistic regression models were employed to assess one-year mortality risk in each group, while sensitivity analysis was conducted via subgroup analysis and propensity score matching (PSM) analysis.
Results
A total of 278 burn patients were included in the study, revealing a one-year mortality rate of 12.2 %. Classifying the patients according to their Hb levels in 3 groups, the numerical mortality rates was different (Q1:22.1 %, Q2:8.9 %, Q3:7.0 %). Whether treating Hb as a continuous or categorical variable, both univariate and multivariate logistic regression analyses indicated a gradual decrease in mortality as Hb levels increased. In models adjusted for all confounding factors, the mortality risk for the second and third Hb groups was significantly lower compared to the first group (OR=0.29, 95 % CI=0.10–0.79, p = 0.016; vs. OR=0.36, 95 % CI=0.14–0.93, p = 0.035). Subgroup analysis displayed consistent correlations between reduced Hb levels and increased mortality across various ages, genders, and comorbidities, including chronic pulmonary disease, cerebrovascular disease, liver disease, kidney diseases, and diabetes. After stratifying patients into two groups (Female: Hb<11.0 g/dL and Hb≥11.0 g/dL; Male: Hb<12.0 g/dL and Hb≥12.0 g/dL) and adjusting for potential confounders using Propensity Score Matching (PSM) analysis, as well as applying propensity score adjustment and weighted pairwise analysis (PA), the results remained stable (OR=0.34, CI=0.14–0.83, p = 0.017).
Conclusion
Lower Hb levels in burn patients during ICU hospitalization are associated with higher one-year mortality.
{"title":"Correlation of hemoglobin levels and mortality in burn patients","authors":"Qinghua Wu , Jingwei Zhang , Caoyi Liu , Zhiyong Huang","doi":"10.1016/j.burns.2025.107840","DOIUrl":"10.1016/j.burns.2025.107840","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the correlation between hemoglobin (Hb) levels and 1-year mortality in burn patients in intensive care units.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study, extracting relevant data from the American Intensive Care Unit (ICU) Medical Information Database IV (MIMIC-IV) for burn patients. This data included complete blood counts, biochemistry and coagulation parameters (both maximum and minimum values during ICU hospitalization), Simplified Acute Physiology Score II (SAPSII), Acute Physiology ScoreIII (APSIII), Oxford Acute Severity of Illness Score (Oasis), Sequential Organ Failure Assessment (SOFA), comorbidities, and outcome. A restricted cubic spline model was utilized to illustrate the relationship between Hb levels and 1-year mortality risk. Patients were stratified into three groups based on gender and the relationship curve (Female: Hb<10.0 g/dL, 10.0 g/dL≤Hb<11.5 g/dL, Hb≥11.5 g/dL; Male: Hb<11.0 g/dL, 11.0 g/dL≤Hb<12.5 g/dL, Hb≥12.5 g/dL). Logistic regression models were employed to assess one-year mortality risk in each group, while sensitivity analysis was conducted via subgroup analysis and propensity score matching (PSM) analysis.</div></div><div><h3>Results</h3><div>A total of 278 burn patients were included in the study, revealing a one-year mortality rate of 12.2 %. Classifying the patients according to their Hb levels in 3 groups, the numerical mortality rates was different (Q1:22.1 %, Q2:8.9 %, Q3:7.0 %). Whether treating Hb as a continuous or categorical variable, both univariate and multivariate logistic regression analyses indicated a gradual decrease in mortality as Hb levels increased. In models adjusted for all confounding factors, the mortality risk for the second and third Hb groups was significantly lower compared to the first group (OR=0.29, 95 % CI=0.10–0.79, p = 0.016; vs. OR=0.36, 95 % CI=0.14–0.93, p = 0.035). Subgroup analysis displayed consistent correlations between reduced Hb levels and increased mortality across various ages, genders, and comorbidities, including chronic pulmonary disease, cerebrovascular disease, liver disease, kidney diseases, and diabetes. After stratifying patients into two groups (Female: Hb<11.0 g/dL and Hb≥11.0 g/dL; Male: Hb<12.0 g/dL and Hb≥12.0 g/dL) and adjusting for potential confounders using Propensity Score Matching (PSM) analysis, as well as applying propensity score adjustment and weighted pairwise analysis (PA), the results remained stable (OR=0.34, CI=0.14–0.83, p = 0.017).</div></div><div><h3>Conclusion</h3><div>Lower Hb levels in burn patients during ICU hospitalization are associated with higher one-year mortality.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107840"},"PeriodicalIF":2.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-21DOI: 10.1016/j.burns.2025.107839
Yuyan Yang , Mengyuan Zhang , Yixin Sun , Tianhao Li , Junxian Wen , Zhijin Li , Lin Jin , Yakun Bi , Wei Wei , Ang Zeng , Xiaojun Wang , Nanze Yu , Xiao Long
Altered skin bacteriome has been associated with keloid, yet the relation of fungal community to this disease remains unclear. This study aimed to characterize the skin mycobiome in patients with keloid and its correlation to disease severity. A case-control study was designed to investigate the fungal landscape in participants with keloid and healthy controls. Disease severity was assessed using Vancouver Scar Scale. Swabs of the keloid lesion (KL) and non-lesional (KNL) skin of keloid patients and corresponding skin sites of healthy controls (C) were obtained for ITS rRNA sequencing. Our findings revealed decreased richness and evenness in the fungal community within the KL as well as KNL groups compared to C (P < 0.01). Notably, fungal composition was more similar between KNL and C compared to KL (KL-C, ANOSIM: R=0.12, P = 0.004; KL-KNL, ANOSIM: R=0.10, P = 0.021; KNL-C, ANOSIM: R=0.03, P = 0.215). Skin mycobiome in KL was more enriched with Malassezia (P < 0.05), and depleted in Cladosporium, Alternaria, Aspergillus and Debaryomyces (P < 0.05). Correlation analysis identified a positive association between the relative abundance of Malassezia and disease severity (rs=0.56, P = 0.007). The present study shows a decreased fungal diversity and altered fungal composition structure in keloid lesions. The overabundance of Malassezia and its correlation to disease severity highlight a potential role of these fungi in the pathogenesis of keloid and offer insights into novel disease-management approaches.
皮肤细菌群的改变与瘢痕疙瘩有关，但真菌群落与该疾病的关系尚不清楚。本研究旨在表征瘢痕疙瘩患者的皮肤真菌群及其与疾病严重程度的相关性。一项病例对照研究旨在调查有瘢痕疙瘩的参与者和健康对照者的真菌景观。采用温哥华疤痕量表评估疾病严重程度。获取瘢痕疙瘩患者的瘢痕疙瘩病变（KL）和非病变（KNL）皮肤以及健康对照(C)相应皮肤部位的拭子进行ITS rRNA测序。我们的研究结果显示，与C相比，KL和KNL组内真菌群落的丰富度和均匀度降低（P <； 0.01）。值得注意的是，与KL相比，KNL与C之间的真菌组成更为相似（KL-C, ANOSIM: R=0.12, P = 0.004;KL-KNL, ANOSIM: R=0.10, P = 0.021;KNL-C, ANOSIM: R=0.03, P = 0.215）。KL皮肤真菌组中马拉色菌（P <； 0.05）较多，枝孢菌、Alternaria、曲霉菌和Debaryomyces较少（P <； 0.05）。相关分析发现马拉色菌的相对丰度与疾病严重程度呈正相关（rs=0.56, P = 0.007）。本研究显示瘢痕疙瘩病变中真菌多样性减少，真菌组成结构改变。马拉色菌的过量及其与疾病严重程度的相关性突出了这些真菌在瘢痕疙瘩发病机制中的潜在作用，并为新的疾病管理方法提供了见解。
{"title":"Characterization and analysis of the skin mycobiome in keloid: A case-control study","authors":"Yuyan Yang , Mengyuan Zhang , Yixin Sun , Tianhao Li , Junxian Wen , Zhijin Li , Lin Jin , Yakun Bi , Wei Wei , Ang Zeng , Xiaojun Wang , Nanze Yu , Xiao Long","doi":"10.1016/j.burns.2025.107839","DOIUrl":"10.1016/j.burns.2025.107839","url":null,"abstract":"<div><div>Altered skin bacteriome has been associated with keloid, yet the relation of fungal community to this disease remains unclear. This study aimed to characterize the skin mycobiome in patients with keloid and its correlation to disease severity. A case-control study was designed to investigate the fungal landscape in participants with keloid and healthy controls. Disease severity was assessed using Vancouver Scar Scale. Swabs of the keloid lesion (KL) and non-lesional (KNL) skin of keloid patients and corresponding skin sites of healthy controls (C) were obtained for ITS rRNA sequencing. Our findings revealed decreased richness and evenness in the fungal community within the KL as well as KNL groups compared to C (P < 0.01). Notably, fungal composition was more similar between KNL and C compared to KL (KL-C, ANOSIM: R=0.12, P = 0.004; KL-KNL, ANOSIM: R=0.10, P = 0.021; KNL-C, ANOSIM: R=0.03, P = 0.215). Skin mycobiome in KL was more enriched with <em>Malassezia</em> (P < 0.05), and depleted in <em>Cladosporium</em>, <em>Alternaria</em>, <em>Aspergillus</em> and <em>Debaryomyces</em> (P < 0.05). Correlation analysis identified a positive association between the relative abundance of <em>Malassezia</em> and disease severity (r<sub>s</sub>=0.56, P = 0.007). The present study shows a decreased fungal diversity and altered fungal composition structure in keloid lesions. The overabundance of <em>Malassezia</em> and its correlation to disease severity highlight a potential role of these fungi in the pathogenesis of keloid and offer insights into novel disease-management approaches.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107839"},"PeriodicalIF":2.9,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-19DOI: 10.1016/j.burns.2025.107836
Ameen Mahmood , Ayushi Gianchandani , Cheuk Ying Kyleen Kiew , Anuska Shah , Hasan Zaidi , Abith Kamath , Rananjay Singh , Nikita Kartikapallil , Marya Abuarqoub , Daniel Markeson
Introduction
Burns education is underrepresented in UK undergraduate and early postgraduate medical training, despite being a core emergency presentation. This limits exposure to essential principles and skills. Porcine skin is anatomically similar to human tissue and cost-efficient, offering a valuable tool. This study evaluates the educational impact of a low-cost burns excision and skin-grafting porcine-based simulation model.
Methods
A prospective cohort study was conducted through a workshop comprising a lecture on burns followed by hands-on practice using porcine models. Participants completed pre- and post-workshop surveys, including multiple choice questions and evaluated self-rated confidence and perceptions using five-point Likert scales. Technical skills were assessed using supervisor-rated Objective Structured Assessment of Technical Skills (OSATS). Statistical analysis utilised Wilcoxon signed-rank and McNemar’s Tests.
Results
Thirty participants (28 medical students and two resident doctors) with no prior experience in burns management or grafting partook in the workshop. Theoretical knowledge significantly improved from 1.8 ± 0.7 to 3.9 ± 0.9 (p < 0.01), and surgical skills increased from 1.6 ± 0.7 to 3.6 ± 1.0 (p < 0.01). OSATS scoring showed significant improvements across all domains (p < 0.01). Knowledge-based assessments improved significantly in graft layers, total body surface area (TBSA), and viability assessment (p < 0.01). Participants rated the workshop's effectiveness score at 4.6 ± 0.7 and recommendation likelihood at 4.3 ± 0.5.
Conclusions
The model significantly improves knowledge, confidence, and technical skills in burns management and grafting.
{"title":"Educational impact of a cost-efficient burns excision and skin grafting porcine simulation model","authors":"Ameen Mahmood , Ayushi Gianchandani , Cheuk Ying Kyleen Kiew , Anuska Shah , Hasan Zaidi , Abith Kamath , Rananjay Singh , Nikita Kartikapallil , Marya Abuarqoub , Daniel Markeson","doi":"10.1016/j.burns.2025.107836","DOIUrl":"10.1016/j.burns.2025.107836","url":null,"abstract":"<div><h3>Introduction</h3><div>Burns education is underrepresented in UK undergraduate and early postgraduate medical training, despite being a core emergency presentation. This limits exposure to essential principles and skills. Porcine skin is anatomically similar to human tissue and cost-efficient, offering a valuable tool. This study evaluates the educational impact of a low-cost burns excision and skin-grafting porcine-based simulation model.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted through a workshop comprising a lecture on burns followed by hands-on practice using porcine models. Participants completed pre- and post-workshop surveys, including multiple choice questions and evaluated self-rated confidence and perceptions using five-point Likert scales. Technical skills were assessed using supervisor-rated Objective Structured Assessment of Technical Skills (OSATS). Statistical analysis utilised Wilcoxon signed-rank and McNemar’s Tests.</div></div><div><h3>Results</h3><div>Thirty participants (28 medical students and two resident doctors) with no prior experience in burns management or grafting partook in the workshop. Theoretical knowledge significantly improved from 1.8 ± 0.7 to 3.9 ± 0.9 (p < 0.01), and surgical skills increased from 1.6 ± 0.7 to 3.6 ± 1.0 (p < 0.01). OSATS scoring showed significant improvements across all domains (p < 0.01). Knowledge-based assessments improved significantly in graft layers, total body surface area (TBSA), and viability assessment (p < 0.01). Participants rated the workshop's effectiveness score at 4.6 ± 0.7 and recommendation likelihood at 4.3 ± 0.5.</div></div><div><h3>Conclusions</h3><div>The model significantly improves knowledge, confidence, and technical skills in burns management and grafting.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107836"},"PeriodicalIF":2.9,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号