scholarly journals Increased mortality in women: sex differences in burn outcomes

2017 ◽  
Vol 5 ◽  
Author(s):  
Karen Karimi ◽  
Iris Faraklas ◽  
Giavonni Lewis ◽  
Daniel Ha ◽  
Bridget Walker ◽  
...  
Keyword(s):  
Sex Differences ◽  
Body Size ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Thermal Injury ◽  
Inhalation Injury ◽  
Inpatient Mortality ◽  
Burn Centers ◽  
Significant Difference

Abstract Background There is increasing evidence that sex differences may influence responses after thermal injury and affect clinical outcomes. The objective of this study was to evaluate the relationships between sex, thermal injury, body size, and inpatient mortality in burn patients. Methods Medical records of adults with >20% total body surface area (TBSA) burn injury admitted to two American Burn Association (ABA)-verified burn centers between 2008 and 2014 were retrospectively reviewed. Injury details and baseline characteristics, including body size as estimated by body surface area (BSA) and body mass index (BMI) were recorded, along with details of the hospital course. The primary outcome of inpatient mortality was compared between sexes. Results Out of 334 subjects, 60 were women (18%). Median TBSA was 33% (IQR 25–49) in this cohort, with 19% full thickness burns and 30% inhalation injury. Despite no significant difference in age, presence of inhalation injury, TBSA, or depth of burn, women had significantly higher rates of inpatient mortality (45 vs. 29%, P = 0.01). BSA was significantly lower in women vs. men (P < 0.001), but this difference was not more pronounced among non-survivors. There was no difference in BMI between men and women non-survivors. Although not significant (P = 0.28), women succumbed to their injuries sooner than men (day 4 vs. 10 post-injury). Conclusions Women are less likely to survive burn injuries and die sooner than men with similar injuries. Body size does not appear to modulate this effect. Burn centers should be aware of the higher mortality risk in women with large burns.

scholarly journals Study of thyroid volume by ultrasonography in clinically euthyroid patients

1970 ◽  
Vol 32 (2) ◽  
pp. 36-43 ◽  
Author(s):  
P Kayastha ◽  
S Paudel ◽  
DM Shrestha ◽  
RJ Ghimire ◽  
S Pradhan
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Reference Values ◽  
Body Surface ◽  
Pearson Correlation ◽  
Thyroid Volume ◽  
Specific Reference ◽  
Reference Ranges ◽  
Hilly Region ◽  
Significant Difference

Introduction: The purpose of this study was to establish reference ranges of total thyroid volume among clinically euthyroid Nepalese population using Ultrasonography and correlate this volume with age, sex, individual’s built and geographic location. Methods: This was a prospective cross sectional study involving 485 clinically euthyroid individuals. B - mode Ultrasonography was used to measure the total thyroid volume by combining the volume of both the lobes obtained by using formula for prolate ellipsoid. Age specific reference values for thyroid volume were obtained and Pearson correlation test was used to see the relationship with various factors. Results: Among 485 individuals between 1 to 83 years of age, 221(45.57%) were males and 264(54.43%) were females. Maximum [354 individuals (72.99%)] were from hilly region and minimum [16 individual (3.30%)] were from Himalayan region. Mean thyroid volume was 6.629 ± 2.5025 ml. In general, thyroid volume was found to be more in older individuals than in young age group. There was no significant difference of thyroid volume between males and females. Thyroid volume best correlated with body surface area (r=0.444, p<0.0001). The volume had a positive correlation with weight (r=0.443, p<0.0001), body mass index (r=0.371, p<0.0001) and height (r=0.320, p<0.0001) of the individual. Conclusions: This study estimated the reference range of total thyroid volume for Nepalese population. These ranges are significantly lower than the WHO/ICCIDD thyroid volume references and reference values obtained in various other countries. Total thyroid volume best correlated with Body surface area. Keywords: Body surface area; clinically euthyroid; total thyroid volume; ultrasonography DOI: http://dx.doi.org/10.3126/joim.v32i2.4944 Journal of Institute of Medicine, August, 2010; 32: 36-43

Sex differences and higher upper normal limits for left atrial end-systolic volume in individuals in their mid-60s: data from the ACE 1950 Study

2020 ◽  
Vol 21 (5) ◽  
pp. 501-507 ◽  
Author(s):  
Peter Selmer Rønningen ◽  
Trygve Berge ◽  
Magnar Gangås Solberg ◽  
Steve Enger ◽  
Ståle Nygård ◽  
...  
Keyword(s):  
Sex Differences ◽  
General Population ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Left Atrial ◽  
Normal Range ◽  
Healthy Group ◽  
Systolic Volume ◽  
Normal Limits

Abstract Aims The current study aimed to describe normal values of left atrial (LA) volumes and LA emptying fraction (LAEF) in a large sample in their mid-60s from the general population and to explore sex differences. Methods and results In the Akershus Cardiac Examination (ACE) 1950 Study, body surface area-indexed LA maximum (LAVimax) and minimum (LAVimin) volumes and LAEF were measured in 3489 individuals aged 63.9 ± 0.6 years from the general population. A healthy group of 832 individuals was defined. Data are presented as mean ± standard deviation (SD) and a normal range of mean ± 2 SD. T-tests were used for comparisons. In the healthy group, mean LAVimax was 25.5 ± 6.2 mL/m2 and the normal range was 13.1–37.9 mL/m2. Men had significantly larger body surface area-indexed volumes than women, but there was no difference in LAEF. The mean LAVimax for healthy men was 26.4 ± 6.5 mL/m2, for healthy women 24.9 ± 5.8 mL/m2 (P &lt; 0.001) and the upper normal limits were 39.4 and 36.5 mL/m2, respectively. In the healthy group, 13.0% of all men and 5.4% of all women had LAVimax above the current upper normal limit of 34 mL/m2. Conclusion A large proportion of healthy individuals, in particular men, had LAVimax &gt;34 mL/m2. Our findings suggest that the recommended cut-off may be too low at the age of 65 years and above and that sex-specific cut-offs should be considered.

A Multicenter Evaluation of Outcomes Following the Use of Nebulized Heparin for Inhalation Injury (HIHI2 Study)

2020 ◽  
Vol 41 (5) ◽  
pp. 1004-1008
Author(s):  
Courtney L Cox ◽  
Allyson M McIntire ◽  
Kimberly J Bolton ◽  
David R Foster ◽  
Andrew C Fritschle ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Major Bleeding ◽  
Total Body Surface Area ◽  
Inhalation Injury ◽  
Control Group ◽  
Bleeding Events ◽  
Total Body

Abstract Inhalation injury causes significant morbidity and mortality secondary to compromise of the respiratory system as well as systemic effects limiting perfusion and oxygenation. Nebulized heparin reduces fibrin cast formation and duration of mechanical ventilation in patients with inhalation injury. To date, no study has compared both dosing strategies of 5000 and 10,000 units to a matched control group. This multicenter, retrospective, case-control study included adult patients with bronchoscopy-confirmed inhalation injury. Each control patient, matched according to age and percent of total body surface area, was matched to a patient who received 5000 units and a patient who received 10,000 units of nebulized heparin. The primary endpoint of the study was duration of mechanical ventilation. Secondary endpoints included 28-day mortality, ventilator-free days in the first 28 days, difference in lung injury scores, length of hospitalization, incidence of ventilator-associated pneumonia, and rate of major bleeding. Thirty-five matched patient trios met inclusion criteria. Groups were well-matched for age (P = .975) and total body surface area (P = .855). Patients who received nebulized heparin, either 5000 or 10,000 units, had 8 to 11 less days on the ventilator compared to controls (P = .001). Mortality ranged from 3 to 14% overall and was not statistically significant between groups. No major bleeding events related to nebulized heparin were reported. Mechanical ventilation days were significantly decreased in patients who received 5000 or 10,000 units of nebulized heparin. Nebulized heparin, either 5000 units or 10,000 units, is a safe and effective treatment for inhalation injury.

22 16-year State-wide Population-based Analysis of Burn and Inhalation Injury – Demographics, Injury Characteristics, Management, and One-year Outcomes

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S17-S18
Author(s):  
Philip D Hewes ◽  
Derek Bell
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Population Based ◽  
Inhalation Injury ◽  
Post Injury ◽  
Case Volume ◽  
Burn Care ◽  
Total Body

Abstract Introduction Estimates on frequency and outcomes of burn or inhalation injury in the United States are limited since reported databases are confined to specific phases of care, included facilities, length of follow-up, facility/provider/patient identification and/or lack of longitudinal tracking. A population-based database addresses these issues. Methods We queried a statewide mandated-reporting database for the years from 2000 through 2015 at the time of injury using a set of ICD9-CM codes for second degree or deeper burns, inhalation injury, and chemical and electrical burns. Burn total body surface area percentage by anatomical region was assigned as appropriate using modified and age-stratified Lund and Browder charts. Records for each patient were extracted out to one year pre- and post-injury, as available. Provider and facility burn volume and survival was stratified into quartiles. We applied the Committee on Trauma/American Burn Association referral criteria to the index presentation. Kaplan-Meier curves were generated to 1-year post injury for testing combinations of burn percent total body surface area of 20% and inhalation injury for age ranges &lt; 15, 15 - 60, and &gt;60 years. Regression models were developed to model the probabilities of in-patient, 90-day, and 365-day mortality and readmission. Results 56,712 patients were included. Overall, 22% of patients meeting referral criteria were never seen at a burn center within 1-year post-injury. The greatest positive predictors of in-patient mortality were facility case volume and burn percent total body surface area. The greatest negative predictors were high provider burn case volume (for highest quartile, adjusted odds ratio 0.08, 95% confidence intervals 0.06 – 0.12). The highest risk of unscheduled 30-day readmission was associated with index presentation to a non-burn care facility (p &lt; 0.001). For all groups, the first 100 days had the greatest mortality rate, the most severe being among patients of age greater than 60 with &gt;20% burn percent total body surface area and inhalation injury, with a 40% survival rate. Conclusions This study is the first to be able to simultaneously evaluate in-patient, post-discharge, and facility-based parameters for outcomes. A significant number of patients are not accounted with current databases. Applicability of Research to Practice A population-based approach with longitudinal tracking allows for greater realization of the outcomes of all patients following burn injury. Existing association-supported or government databases fail to account for a significant portion of burn victims, motivating further evaluation of burn care efforts.

Hand sanitiser–fuelled fire performance and thermal injury: case report

2021 ◽  
Vol 14 (6) ◽  
pp. e235106
Author(s):  
Samantha T Murphy ◽  
Leopoldo C Cancio
Keyword(s):  
Case Report ◽  
Surface Area ◽  
Body Surface Area ◽  
Performance Art ◽  
Body Surface ◽  
Thermal Injury ◽  
Total Body Surface Area ◽  
Fire Performance ◽  
Burn Center ◽  
Total Body

A 23-year-old man presented to our burn center after sustaining a 62.5% total body surface area burn during a fire performance, in which he applied alcohol-based hand sanitiser to his body and ignited it. The patient underwent 6 operations at this facility and was discharged after 41 days. Fire-performance art is a growing pastime and profession. This case demonstrates the hazards of using hand sanitiser during such activities.

Allometric Scaling Factors for Oxygen Uptake during Exercise in Children

1995 ◽  
Vol 7 (1) ◽  
pp. 12-25 ◽  
Author(s):  
Danette M. Rogers ◽  
Kenneth R. Turley ◽  
Kathleen I. Kujawa ◽  
Kevin M. Harper ◽  
Jack H. Wilmore
Keyword(s):  
Oxygen Consumption ◽  
Body Size ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Allometric Scaling ◽  
Scaling Factors ◽  
Treadmill Testing ◽  
The Relationship

This study was designed to examine the relationship between oxygen consumption and both body surface area and body mass in children to determine what allometric scaling factors from these variables provide appropriate means of expressing data for this population. These scaling factors were then compared to exponents based on theoretical and animal models to determine if the same relationships were present. Forty-two children (21 boys and 21 girls) 7 to 9 years of age participated in maximal and submaximal treadmill testing. The submaximal V̇O2 to body size relationship proved to be a more appropriate factor to use when scaling V̇O2 than the relationship seen between body size and V̇O2max. Therefore, in this population of children, V̇O2 relative to body surface area or body mass to the power 0.67, demonstrated submaximally, provided a more appropriate means of data expression both statistically and physiologically than the traditional expression of V̇O2 relative to body mass (ml·kg−1·min−1).

Determination of body surface area in Indian Hindu children

1961 ◽  
Vol 16 (6) ◽  
pp. 969-970 ◽  
Author(s):  
Sachchidananda Banerjee ◽  
Ashim Kumar Bhattacharya
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Indian Children ◽  
Du Bois ◽  
Significant Difference ◽  
New Equation ◽  
New Formula

Body surface area (BSA) was actually measured in 13 Indian Hindu children, of ages varying between 3 and 12 yr, with tape and surface integrator. In 9 out of 13 children the results obtained were lower than the BSA calculated with the weight-height formula of Du Bois and Du Bois. Based on the actual measurements, a new constant for the weight-height formula was obtained and a new equation: surface area, cm2 = weight 0.425 kg x height 0.725 cm x 70, has been suggested for the BSA of Indian children. A nomogram for reading off surface area in metric units based on the above formula was prepared. A significant difference existed between the BSA calculated with the new formula and that of Du Bois and Du Bois. Submitted on December 30, 1960

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