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The purpose of this project was to evaluate the relationships between nutrition, physical activity levels, severity of illness, and survival in critically ill burn patients. We conducted a retrospective evaluation of consecutively admitted adult patients who had an intensive care unit stay ≥8 days after ≥20% total body surface area burns. Linear regression was used to assess the association between severity of illness (sequential organ failure assessment scores) and physical activity levels as well as between severity of illness and nutritional intake. After univariate analysis comparing survivors and non-survivors, factors with p<0.10 were analyzed with multiple logistic regression. Characteristics of the 45 included patients were: 42 ± 15 years old, 37 ± 17% total body surface area burns, 22% mortality. Factors independently associated with survival were burn size (negatively) (p=0.018), height (positively) (p=0.006), highest physical activity level during the first 8 intensive care unit days (positively) (p=0.016), and kcal balance during the fifth through the eighth intensive care unit days (positively) (p=0.012). Sequential organ failure assessment scores had a significant (p<0.001) but weak association with nutrition intake (R2=0.05) and physical activity levels (R2=0.25). Higher nutritional intake and activity were significantly associated with lower mortality in critically ill burn patients. Given the weak associations between both nutritional intake and physical activity levels with severity of illness, the primary barrier in achieving nutrition and activity goals was not severity of illness. We recommend that physical rehabilitation and nutritional intake be optimized in an effort to improve outcomes in critically ill burn patients.
This article was published in the following journal.
Name: Journal of burn care & research : official publication of the American Burn Association
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Levels of severity of illness within a diagnostic group which are established by various measurement criteria.
An acronym for Acute Physiology and Chronic Health Evaluation, a scoring system using routinely collected data and providing an accurate, objective description for a broad range of intensive care unit admissions, measuring severity of illness in critically ill patients.
An anatomic severity scale based on the Abbreviated Injury Scale (AIS) and developed specifically to score multiple traumatic injuries. It has been used as a predictor of mortality.
Simulation of symptoms of illness or injury with intent to deceive in order to obtain a goal, e.g., a claim of physical illness to avoid jury duty.
Evaluation and measurement of nutritional variables in order to assess the level of nutrition or the NUTRITIONAL STATUS of the individual. NUTRITION SURVEYS may be used in making the assessment.
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