scholarly journals Inpatient and Postdischarge Outcomes Following Inhalation Injury Among Critically Injured Burn Patients

2021 ◽  
Author(s):  
Cordelie E Witt ◽  
Barclay T Stewart ◽  
Frederick P Rivara ◽  
Samuel P Mandell ◽  
Nicole S Gibran ◽  
...  
Keyword(s):  
Burn Injury ◽  
Hospital Readmissions ◽  
Vital Statistics ◽  
Inhalation Injury ◽  
Burn Patients ◽  
Increased Risk ◽  
Injury Grade ◽  
Initial Hospitalization ◽  
Fire Flame ◽  
The Impact

Abstract Inhalation injury is associated with high inpatient mortality, but the impact of inhalation injury after discharge and on non-mortality outcomes is poorly characterized. To address this gap, we evaluated the effect of inhalation injury on postdischarge morbidity, mortality, and hospital readmissions among patients who sustained burn injury, as well as on in-hospital outcomes for context. This was a retrospective cohort study of patients with cutaneous fire/flame burns admitted to a burn center intensive care unit from January 1, 2009 to December 31, 2015, with or without inhalation injury. Records were linked to statewide hospital admission and vital statistics databases to assess postdischarge outcomes. Mixed-effects Poisson regression was used to assess mortality, complications, and readmissions. The overall cohort included 830 patients with cutaneous burns; of these, 201 patients had inhalation injury. In-hospital mortality was 31% among inhalation injury patients vs 6% in patients without inhalation injury (adjusted OR 2.35; 95% CI 1.66–3.31). Inhalation injury was also associated with an increased risk of in-hospital pneumonia and tracheostomy (P < .05 for all). Inhalation injury was not associated with greater postdischarge mortality, all-cause readmission, readmission for pulmonary diagnosis, or readmission requiring intubation. Among the subset of patients with bronchoscopy-confirmed inhalation injury (n = 124; 62% of inhalation injuries), a higher injury grade was not associated with greater inpatient or postdischarge mortality. Inhalation injury was associated with increased early morbidity and mortality, but did not contribute to postdischarge mortality or readmission. These findings have implications for shared decision making with patients and families and for estimating healthcare utilization after initial hospitalization.

11 Vitamin D Deficiency on Admission and the Association with Length of Stay in Patients with Thermal Injury: A Multi-center Analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S13-S14
Author(s):  
Sarah Zavala ◽  
Kate Pape ◽  
Todd A Walroth ◽  
Melissa A Reger ◽  
Katelyn Garner ◽  
...  
Keyword(s):  
Vitamin D ◽  
Length Of Stay ◽  
Vitamin D Deficiency ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Inhalation Injury ◽  
Hospital Length Of Stay ◽  
Burn Patients ◽  
Comfort Care ◽  
The Impact

Abstract Introduction In burn patients, vitamin D deficiency has been associated with increased incidence of sepsis. The objective of this study was to assess the impact of vitamin D deficiency in adult burn patients on hospital length of stay (LOS). Methods This was a multi-center retrospective study of adult patients at 7 burn centers admitted between January 1, 2016 and July 25, 2019 who had a 25-hydroxyvitamin D (25OHD) concentration drawn within the first 7 days of injury. Patients were excluded if admitted for a non-burn injury, total body surface area (TBSA) burn less than 5%, pregnant, incarcerated, or made comfort care or expired within 48 hours of admission. The primary endpoint was to compare hospital LOS between burn patients with vitamin D deficiency (defined as 25OHD < 20 ng/mL) and sufficiency (25OHD ≥ 20 ng/mL). Secondary endpoints include in-hospital mortality, ventilator-free days of the first 28, renal replacement therapy (RRT), length of ICU stay, and days requiring vasopressors. Additional data collected included demographics, Charlson Comorbidity Index, injury characteristics, form of vitamin D received (ergocalciferol or cholecalciferol) and dosing during admission, timing of vitamin D initiation, and form of nutrition provided. Dichotomous variables were compared via Chi-square test. Continuous data were compared via student t-test or Mann-Whitney U test. Univariable linear regression was utilized to identify variables associated with LOS (p < 0.05) to analyze further. Cox Proportional Hazard Model was utilized to analyze association with LOS, while censoring for death, and controlling for TBSA, age, presence of inhalation injury, and potential for a center effect. Results Of 1,147 patients screened, 412 were included. Fifty-seven percent were vitamin D deficient. Patients with vitamin D deficiency had longer LOS (18.0 vs 12.0 days, p < 0.001), acute kidney injury (AKI) requiring RRT (7.3 vs 1.7%, p = 0.009), more days requiring vasopressors (mean 1.24 vs 0.58 days, p = 0.008), and fewer ventilator free days of the first 28 days (mean 22.9 vs 25.1, p < 0.001). Univariable analysis identified burn center, AKI, TBSA, inhalation injury, admission concentration, days until concentration drawn, days until initiating supplementation, and dose as significantly associated with LOS. After controlling for center, TBSA, age, and inhalation injury, the best fit model included only deficiency and days until vitamin D initiation. Conclusions Patients with thermal injuries and vitamin D deficiency on admission have increased length of stay and worsened clinical outcomes as compared to patients with sufficient vitamin D concentrations.

scholarly journals The Impact of Multidrug-Resistant Organisms Infection on Outcomes in Burn Injury Patients at Sanglah General Hospital, Bali

2021 ◽  
Vol 9 (A) ◽  
pp. 463-467
Author(s):  
Gede Wara Samsarga ◽  
I Made Suka Adnyana ◽  
Ni Nyoman Sri Budayanti ◽  
I Gusti Putu Hendra Sanjaya ◽  
Agus Roy Rusly Hariantana Hamid ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Length Of Stay ◽  
Antibiotic Therapy ◽  
General Hospital ◽  
Burn Injury ◽  
Multidrug Resistant ◽  
Burn Patients ◽  
Increased Risk ◽  
Multidrug Resistant Organisms ◽  
The Impact

BACKGROUND: Research related to the impact of multidrug resistant organisms (MDRO) infection on clinical outcomes in burns is still limited. AIM: This study evaluated the effect of MDRO infection on morbidity and mortality of burn patients. METHODS: A single-center retrospective cohort study was conducted on burn patients admitted to the burn unit of Sanglah General Hospital, Bali, between 2018 and 2020. MDRO patients were described as those who had at least one positive MDRO culture. All other patients were included in the non-MDRO group. Measurement and analysis included mortality and five indicators of morbidity: length of stay, duration of antibiotic therapy, sepsis, pneumonia, and acute kidney injury (AKI). RESULTS: Significant associations of MDRO infection were found for duration of antibiotic therapy (0 vs. 7 days), sepsis (odds ratio [OR] 13.90 [95% Confidence interval (CI) 95% 2.88–67.10]), pneumonia (OR 12,67 [95% CI 3.26–49.23]), and mortality (OR 9.75 [95% CI 2.00–47.50]). No significant association was found for the length of stay and the incidence of AKI. Multivariate analysis found that MDRO infection increased risk of sepsis (OR 36.53 [95% CI 2.05–652.45], pneumonia (OR 10.75 [95% CI 1.87–61.86]) and mortality (OR 57.09 [95% CI 1.41–2318.87]). Multivariate analysis of MDRO infection with duration of antibiotic therapy found no independent variables that were significantly related. CONCLUSION: These research findings suggest that MDRO infections are associated with increasing length of antibiotic treatment, sepsis, pneumonia, and mortality in burn patients.

scholarly journals A new nomogram to predict the need for tracheostomy in burned patients

2020 ◽  
Author(s):  
Stefan Janik ◽  
Stefan Grasl ◽  
Erdem Yildiz ◽  
Gerold Besser ◽  
Jonathan Kliman ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Burn Injury ◽  
Inhalation Injury ◽  
Burn Patients ◽  
Inpatient Mortality ◽  
Icu Stay ◽  
Neurocognitive Impairments ◽  
The Impact ◽  
Length Of Icu Stay

Abstract Purpose To evaluate the impact of tracheostomy on complications, dysphagia and outcome in second and third degree burned patients. Methods Inpatient mortality, dysphagia, severity of burn injury (ABSI, TBSA) and complications in tracheotomized burn patients were compared to (I) non-tracheotomized burn patients and (II) matched tracheotomized non-burn patients. Results 134 (30.9%) out of 433 patients who underwent tracheostomy, had a significantly higher percentage of inhalation injury (26.1% vs. 7.0%; p < 0.001), higher ABSI (8.9 ± 2.1 vs. 6.0 ± 2.7; p < 0.001) and TBSA score (41.4 ± 19.7% vs. 18.6 ± 18.8%; p < 0.001) compared to 299 non-tracheotomized burn patients. However, complications occurred equally in tracheotomized burn patients and matched controls and tracheostomy was neither linked to dysphagia nor to inpatient mortality at multivariate analysis. In particular, dysphagia occurred in 6.2% of cases and was significantly linked to length of ICU stay (OR 6.2; p = 0.021), preexisting neurocognitive impairments (OR 5.2; p = 0.001) and patients’ age (OR 3.4; p = 0.046). A nomogram was calculated based on age, TBSA and inhalation injury predicting the need for a tracheostomy in severely burned patients. Conclusion Using the new nomogram we were able to predict with significantly higher accuracy the need for tracheostomy in severely burned patients. Moreover, tracheostomy is safe and is not associated with higher incidenc of complications, dysphagia or worse outcome.

scholarly journals Impact of COVID-19 on Patient Trends and Outcome: Results from a Tertiary Care Burn and Plastic Unit in Northern India

2021 ◽  
Author(s):  
Nupur Aggarwal ◽  
Rakesh Kumar Srivastava
Keyword(s):  
Burn Injury ◽  
Tertiary Care ◽  
Maxillofacial Surgery ◽  
Admission Rate ◽  
Trauma Patients ◽  
Care Hospital ◽  
Burn Patients ◽  
Time Period ◽  
Increased Risk ◽  
The Impact

Abstract Background Burn and trauma injuries need emergency care and resuscitation, which required uninterrupted delivery of inpatient care services during the coronavirus disease 2019 (COVID-19) pandemic. Burn patients are physiologically immunocompromised, increasing the risk of COVID-19 infection in them. This study analyzes the impact of COVID-19 pandemic on patient trends in a burn and plastic unit and assesses the effect of COVID-19 infection in burns. Methods This single-center, retrospective observational case–control study was conducted in the Department of Burns, Plastic and Maxillofacial Surgery of a tertiary care hospital in New Delhi, India. Patient data was collected from April 1, 2019 to August 10, 2019 and from April 1, 2020 to August 10, 2020. All data of burns and trauma patients collected was analyzed and compared. Results There were total 350 admissions during COVID time period and 562 admissions during non-COVID time period. The admission rate, type of burn injury, and death rate did not vary significantly during the two time periods. Thermal burn was the most common type of burn injury. There were total 18 cases diagnosed to be COVID-19 positive during the pandemic. There were two deaths among COVID-19 positive burn cases. Conclusion This study finds no difference in patient patterns during COVID and non-COVID time period. Amongst burn patients, no increased risk of COVID-19 infection is seen with larger body surface area of burns. No increase in mortality is seen in burn patients infected with COVID-19.

scholarly journals Once-Daily Amikacin Dosing in Burn Patients Treated with Continuous Venovenous Hemofiltration

2011 ◽  
Vol 55 (10) ◽  
pp. 4639-4642 ◽  
Author(s):  
Kevin S. Akers ◽  
Jason M. Cota ◽  
Christopher R. Frei ◽  
Kevin K. Chung ◽  
Katrin Mende ◽  
...  
Keyword(s):  
Burn Injury ◽  
Continuous Venovenous Hemofiltration ◽  
Burn Patients ◽  
Small Reduction ◽  
Target Attainment ◽  
Clinical Pharmacokinetics ◽  
Once Daily ◽  
Renal Replacement Therapies ◽  
Rapid Clearance ◽  
The Impact

ABSTRACTAmikacin clearance can be increased in burn injury, which is often complicated by renal insufficiency. Little is known about the impact of renal replacement therapies, such as continuous venovenous hemofiltration (CVVH), on amikacin pharmacokinetics. We retrospectively examined the clinical pharmacokinetics, bacteriology, and clinical outcomes of 60 burn patients given 15 mg/kg of body weight of amikacin in single daily doses. Twelve were treated with concurrent CVVH therapy, and 48 were not. The pharmacodynamic target of ≥10 for the maximum concentration of drug in serum divided by the MIC (Cmax/MIC) was achieved in only 8.5% of patients, with a small reduction ofCmaxin patients receiving CVVH and no difference in amikacin clearance. Mortality and burn size were greater in patients who received CVVH. Overall, 172 Gram-negative isolates were recovered from the blood cultures of 39 patients, with amikacin MIC data available for 82 isolates from 24 patients. A 10,000-patient Monte Carlo simulation was conducted incorporating pharmacokinetic and MIC data from these patients. The cumulative fraction of response (CFR) was similar in CVVH and non-CVVH patients. The CFR rates were not significantly improved by a theoretical 20 mg/kg amikacin dose. Overall, CVVH did not appear to have a major impact on amikacin serum concentrations. The low pharmacodynamic target attainment appears to be primarily due to higher amikacin MICs rather than more rapid clearance of amikacin related to CVVH therapy.

Trisomy 18 Pregnancies: Is there an Increased Maternal Risk?

2017 ◽  
Vol 34 (11) ◽  
pp. 1054-1057
Author(s):  
Kayli Senz ◽  
Whitney Humphrey ◽  
Vanessa Lee ◽  
Aaron Caughey ◽  
Sarah Dotters-Katz
Keyword(s):  
International Classification Of Diseases ◽  
Vital Statistics ◽  
Trisomy 18 ◽  
Trisomy 13 ◽  
Obstetric Outcomes ◽  
Maternal Risk ◽  
Increased Risk ◽  
Multiparous Women ◽  
Classification Of Diseases ◽  
The Impact

Objective Characterize the impact of a trisomy 18 (T18) fetus on maternal and obstetric outcomes in a cohort including T18-affected deliveries. Study Design Retrospective cohort study of singleton deliveries in California from 2005 to 2008 using linked vital statistics and the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) data to compare deliveries affected by T18 to those without known aneuploidy. Outcomes of interest included gestational diabetes mellitus (GDM), preterm delivery (PTD), preeclampsia, cesarean delivery (CD), and intrauterine fetal demise (IUFD). The χ2 and paired t-tests were used to compare the outcomes. Multiple logistic regression was used to further characterize these risks and control potential confounders. Results Of 2,029,000 deliveries, 298 involved T18. Compared with unaffected deliveries, T18 was associated with GDM (10.7 vs. 6.5%, p = 0.003), PTD < 37 (40.6 vs. 9.9%, p < 0.001) and < 32 weeks (14.8 vs. 1.4%, p < 0.001), and cesarean section (56 vs. 30.2%, p < 0.001), but not preeclampsia. In adjusted analyses, T18 pregnancies were associated with an increased risk of PTD < 37 and < 32 weeks (adjusted odds ratio [AOR]: 5.48, 95% confidence interval [CI]: 4.29, 6.99; AOR: 10.4, 95% CI: 7.26, 14.8), and an increased odd of CD for primiparous and multiparous women (AOR: 2.41, 95% CI: 1.48, 3.91; AOR: 5.42, 95% CI: 3.90, 7.53). Risk of GDM did not persist. Conclusion Unlike trisomy 13 (T13), pregnancies complicated by fetal T18 did not appear to result in an increased risk of preeclampsia. However, there is an increased risk of a range of other obstetric complications.

Impact of cancer on the risk of unplanned 30-day readmissions.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6581-6581
Author(s):  
Alexander Qian ◽  
Edmund Qiao ◽  
Vinit Nalawade ◽  
Nikhil V. Kotha ◽  
Rohith S. Voora ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Hospital Admissions ◽  
Reference Group ◽  
Cancer Site ◽  
Cancer Type ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Initial Hospitalization ◽  
The Impact

6581 Background: Hospital readmission are associated with unfavorable patient outcomes and increased costs to the healthcare system. Devising interventions to reduce risks of readmission requires understanding patients at highest risk. Cancer patients represent a unique population with distinct risk factors. The purpose of this study was to define the impact of a cancer diagnosis on the risks of unplanned 30-day readmissions. Methods: We identified non-procedural hospital admissions between January through November 2017 from the National Readmission Database (NRD). We included patients with and without a cancer diagnosis who were admitted for non-procedural causes. We evaluated the impact of cancer on the risk of 30-day unplanned readmissions using multivariable mixed-effects logistic regression models. Results: Out of 18,996,625 weighted admissions, 1,685,099 (8.9%) had record of a cancer diagnosis. A cancer diagnosis was associated with an increased risk of readmission compared to non-cancer patients (23.5% vs. 13.6%, p < 0.001). However, among readmissions, cancer patients were less likely to have a preventable readmission (6.5% vs. 12.1%, p < 0.001). When considering the 10 most common causes of initial hospitalization, cancer was associated with an increased risk of readmission for each of these 10 causes (OR range 1.1-2.7, all p < 0.05) compared to non-cancer patients admitted for the same causes. Compared to patients aged 45-64, a younger age was associated with increased risk for cancer patients (OR 1.29, 95%CI [1.24-1.34]) but decreased risk for non-cancer patients (OR 0.65, 95%CI [0.64-0.66]). Among cancer patients, cancer site was the most robust individual predictor for readmission with liver (OR 1.47, 95%CI [1.39-1.55]), pancreas (OR 1.36, 95%CI [1.29-1.44]), and non-Hodgkin’s lymphoma (OR 1.35, 95%CI [1.29-1.42]) having the highest risk compared to the reference group of prostate cancer patients. Conclusions: Cancer patients have a higher risk of 30-day readmission, with increased risks among younger cancer patients, and with individual risks varying by cancer type. Future risk stratification approaches should consider cancer patients as an independent group with unique risks of readmission.

scholarly journals COPD, Depression and COVID-19 Pandemic: A Harrowing, Demoralizing and Deleterious Triad

2021 ◽  
Vol 3 (8) ◽  
pp. 01-06
Author(s):  
Iqbal Akhtar Khan ◽  
Hamza Iltaf Malik
Keyword(s):  
Hospital Admissions ◽  
Hospital Readmissions ◽  
Public Health Problem ◽  
Well Being ◽  
Care Utilization ◽  
Global Public Health ◽  
Increased Risk ◽  
Co Morbidity ◽  
Pulmonary Manifestations ◽  
The Impact

COPD is a highly incapacitating global public health problem, with pulmonary and extra-pulmonary manifestations and usually associated with significant concomitant chronic diseases. With enhanced understanding, it has extensively been reported as a complex, heterogeneous and dynamic disease affecting patients’ health beyond pulmones. Depression, with prevalence of 322 million people, is a major contributor to the overall global burden of disease. In various epidemiological and clinical studies, its prevalence among patients with COPD varies from 18% to 80%. This deadly duo leads to excessive health care utilization rates and costs including increased rates of exacerbation, sub-optimal adherence to prescribed medications, increased hospital admissions, longer hospital stays and increased hospital readmissions. Moreover, there is increased risk of suicidal ideation, suicidal attempts, and suicidal drug overdose. It is a pity that, in significant cases, the co-morbidity remains under-recognized and under-treated. The impact of prevailing COVID 19 pandemic, on the dual burden of COPD and depression, and possible remedial measures including “The 6 ways to boost one’s well-being-by Mental Heath UK, “The Living with the Times” toolkit--by WHO” and innovative add-ons like Dance Movement Therapy and Musical Engagement Therapy have been discussed.

scholarly journals Positive Signs on Physical Examination Are Not Always Indications for Endotracheal Tube Intubation in Patients with Facial Burn

2020 ◽  
Author(s):  
Ruo-Yi Huang ◽  
Szu-Jen Chen ◽  
Yen-Chang Hsiao ◽  
Ling-Wei Kuo ◽  
Chien-Hung Liao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endotracheal Tube ◽  
Odds Ratio ◽  
Inhalation Injury ◽  
Burn Patients ◽  
Shortness Of Breath ◽  
Airway Protection ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Facial Burn

Abstract BackgroundAfter clinical evaluation in the emergency department (ED), facial burn patients are usually intubated to protect their airways. However, the possibility of unnecessary intubation or delayed intubation after admission exists. Objective criteria for the evaluation of inhalation injury and the need for airway protection in facial burn patients are needed.MethodsFacial burn patients between January 2013 and May 2016 were reviewed. Patients who were and were not intubated in the ED were compared. All intubated patients received routine bronchoscopy to evaluate whether they had inhalation injuries. Patients with and without confirmed inhalation injuries were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for inhalation injuries in facial burn patients. The reasons for intubation in patients without inhalation injuries were also investigated.ResultsDuring the study period, 121 patients were intubated in the ED among a total of 335 facial burn patients. Only 73 (60.3%) patients were later confirmed to have inhalation injuries on bronchoscopy. The comparison between patients with and without inhalation injuries showed that shortness of breath (odds ratio=3.376, p=0.027) and high total body surface area (TBSA) (odds ratio=1.038, p=0.001) were independent risk factors for inhalation injury. Other physical signs (e.g., hoarseness, burned nostril hair, etc.), laboratory examinations and chest X-ray findings were not predictive of inhalation injury in facial burn patients. All patients with a TBSA over 60% were intubated in the ED even if they did not have inhalation injuries.ConclusionIn the management of facial burn patients, positive signs on conventional physical examinations may not always be predictive of inhalation injury and the need for endotracheal tube intubation in the ED. More attention should be paid to facial burn patients with shortness of breath and a high TBSA because they have an increased risk of inhalation injuries. Airway protection is needed in facial burn patients without inhalation injuries because of their associated injuries and treatment.

87 Evaluating Endothelial Dysfunction in Thermally-injured Patients with syndecan-1, Tissue Factor Pathway Inhibitor, and Thrombomodulin as Predictors of Mortality

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S57-S58
Author(s):  
John W Keyloun ◽  
Saira Nisar ◽  
Kathleen Brummel-Ziedins ◽  
Maria Bravo ◽  
Matthew Gissell ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Tissue Factor Pathway Inhibitor ◽  
Burn Injury ◽  
Endothelial Damage ◽  
Inhalation Injury ◽  
Burn Patients ◽  
Mixed Effect ◽  
Significant Difference ◽  
Tissue Factor Pathway ◽  
Injured Patients

Abstract Introduction Endotheliopathy in burn patients is largely uncharacterized. Syndecan-1 (SDC-1), thrombomodulin (TM), and tissue factor pathway inhibitor (TFPI) are components of the vascular endothelial glycocalyx. Proteolytic cleavage of these moieties may yield biomarkers for endothelial damage. The aim of this study is to evaluate endotheliopathy after burn injury by monitoring plasma levels of these biomarkers over time to investigate potential relationship to mortality. Methods Burn injured patients presenting to a regional burn center from 2012 to 2017 were prospectively enrolled. Blood samples were collected at 0, 2, 4, 8, 12, 24, 36, 48, 60, and 72 hours from admission. Plasma SDC-1, TM, and TFPI levels were quantified by ELISA. Demographic data and injury characteristics were obtained from the medical chart. Patients with concomitant inhalation injury, trauma, or &lt; 10% total body surface area (TBSA) burns were excluded. Statistical analysis was performed using mixed-effect models with Sidak’s correction for multiple comparisons. Significance was set at p =0.05. Data are presented as mean ± standard deviation. Results A cohort of 22 patients was identified with an average age of 45±14 years, TBSA of 30±15%, with 6 patients who died from their injuries. The deceased group was older (59±13 vs. 40±10 years, p = 0.01), and there was no significant difference in burn size. Mean SDC-1 levels were higher in the deceased group at all time points (p=0.0004) and this difference was significant at hour 12 (106±11 vs. 41±31 ng/mL, p = 0.0002), hour 24 (160±39 vs. 35±20 ng/mL, p = 0.04) and hour 72 (100±3 vs. 35±38 ng/mL, p = 0.01). Mean soluble TM levels were higher in the deceased group after hour 12 (p = 0.04) and there was a trend towards higher TFPI levels after hour 12 in the deceased group. Conclusions Biomarkers are elevated in patients following burn injury who die, when inhalation injury and trauma are excluded. Given equivalent TBSA, older patients appear more sensitive to thermally induced glycocalyx degradation. SDC-1 shows the greatest promise as a prognostic indicator as levels tend to be higher among deceased patients on admission and are significantly higher as early as hour 12. Applicability of Research to Practice Reliable assessment of the patient’s endothelial damage may hold predictive value for clinicians and could assist in clinical decision making. Further research must investigate endotheliopathy in burn patients.

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