The Role of Previous History of Muscle Wasting in Burn Outcomes-A Burn Care Quality Platform Study.

BACKGROUND: Burn patients can suffer prolonged hospital stays, infections, and wound breakdown. Given the complexity of burns, it is often difficult to determine which underlying factors contribute to complications. The Burn Care Quality Platform (BCQP) is the largest database of burn patients globally available, and it accounts for underlying or coinciding disease conditions present in burn patients. Muscle wasting conditions, such as sarcopenia, cachexia, and protein malnutrition, are suspected of causing worse outcomes. Prior analysis of BCQP data (2000-2017) demonstrated that patients with muscle wasting had prolonged hospitalization and adverse outcomes. METHODS: Building on our previous work, we extended logistic regression analysis to BCPQ data through 2022 to assess whether reporting and outcomes had changed. RESULTS: Updated BCQP data demonstrated a statistically significant increase in mortality in cachexia vs. non-muscle wasting patients (Odds Ratio [OR]: 2.2 [95% Confidence Interval (CI): 1.3-3.7], p = 0.004), but no increase in mortality was seen with protein malnutrition (OR: 1.1 [95% CI: 0.93-1.35], p = 0.239). However, the diagnosis rate of muscle wasting conditions decreased by 53% since the previous analysis, suggesting a potential under-reporting of these diagnoses in BCQP patients. CONCLUSIONS: Burn care could be augmented by better diagnosis of underlying conditions that predispose to muscle wasting.