Increased Risk of Adverse Events Following Burn Injury in Patients with Hypothyroidism
Author(s)
Thomas D1, Garate D1, Flores I2, Morgan B1, Fu S3, Golovko G4, El ayadi A4, Song J4, Wolf SE4
1University of Texas Medical Branch John Sealy School of Medicine, Galveston, TX, USA, 2Sam Houston State University College of Osteopathic Medicine, Conroe, TX, USA, 3Baylor College of Medicine, Houston, TX, USA, 4University of Texas Medical Branch, Galveston, TX, USA
Presentation Documents
OBJECTIVES:
Thyroid hormone is essential in the healing of soft tissue wounds, as it has shown to promote the proliferation of keratinocytes, dermal thickening, and deposition of mature type 1 collagen. Hypothyroidism has been associated with delayed wound healing and systemic manifestations that may worsen surgical outcomes. However, the impact of this condition following burn injury has not been described in the literature. This study evaluated the role of hypothyroidism on acute outcomes after burn injury.METHODS:
A retrospective cohort study using a multicentre research network, TriNetX, was used to stratify population cohorts to compare burn patients with and without a prior diagnosis of hypothyroidism. A 1:1 matched propensity score analysis (PSM) was conducted adjusting for demographics and percent total body surface area burned. Adjusted Risk Ratios (aRR) with 95% CI (p<0.05) were utilized to assess 30-day post-operative burn outcomes.RESULTS:
After PSM, we identified a set of balanced patient cohorts with 33,532 patients per cohort. Patients with a history of hypothyroidism were found to experience a significantly greater risk of infection of the skin and subcutaneous tissue 1.28 [1.22-1.34]), hyperglycemia (1.69 [1.50-1.89]), volume depletion (1.45 [1.33-1.59]), kidney failure (1.83 [1.70-1.97]), pulmonary edema (1.27 [1.11-1.45]), pneumonia (1.51 [1.40-1.64]), pulmonary collapse (1.27 [1.15-1.39]), respiratory failure (1.29 [1.18-1.40]), acute myocardial infarction (1.48 [1.35-1.63]), acute embolism and thrombosis of the lower extremity (1.51 [1.38-1.65]), and sepsis (1.76 [1.59-1.96]). There was a significantly lower risk of ICU admission (0.51 [0.355-0.739]). The following outcomes showed no significant differences: skin graft complications, ARDS, and mortality.CONCLUSIONS:
These results postulate that burned patients with a history of hypothyroidism are significantly more likely to experience severe acute adverse events. Additionally, they highlight the need for more research to elucidate the mechanism for this relationship and allow physicians to be more aware of the unique risks of this population.Conference/Value in Health Info
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
EPH15
Topic
Real World Data & Information Systems
Topic Subcategory
Distributed Data & Research Networks, Reproducibility & Replicability
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Injury & Trauma, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)