Comparison of military and civilian burn patients admitted to a single center during 12 years of war. Issue 1 (February 2019)

• Record Type: Journal Article
• Authors: Rizzo, Julie A.; Pruskowski, Kaitlin A.; Le, Tuan; Gurney, Jennifer; Rowan, Matthew P.; Chung, Kevin K.; Cancio, Leopoldo C.
• Is Part Of: Burns. Volume 45:Issue 1(2019)
• Page Start: 199
• Page End: 204
• Publication Date: 2019-02
• Subjects: Burns -- Military personnel -- Iraq war -- Afghanistan; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2018.08.026
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: Military patients had a higher mean % TBSA burned and lower mortality. Military patients had a higher incidence of blast trauma, resulting in larger burns, inhalation injury, and traumatic injury. Military patients had a higher rate of inhalation injury. Most military patients had a full functional recovery. Abstract: Objective: The current conflicts in Iraq and Afghanistan resulted in an increased incidence of burn injury in the military population. We sought to compare the characteristics and outcomes of this population to a civilian cohort cared for at the same burn center over the same time-period. Methods: A retrospective review was performed to examine differences in the demographics, etiology, mortality, and functional status over a 12-year period. Descriptive analyses were performed. Logistic regression was used to calculate the likelihood of mortality. Results: A total of 3814 patients were included in this analysis; 1069 were military casualties. When compared to civilians, military patients were younger, had a higher incidence of flame-induced burn injury, mean total body surface area burned (% TBSA), rate of inhalation injury, and lower mortality. Civilian patients presented with a higher Baux score. Although most military patients had a full functional recovery, they had a greater incidence of severe disability. In a univariate model, likelihood of mortality was higher in civilians. No difference in mortality between the two cohorts was found after adjusting for age, inhalation injury, gender, % TBSA and percent full-thickness burn. Conclusions: Military patients exhibited improved survival and functional recovery over their civilian counterparts. However, mortality did not differ between civilian and military patients after controlling for known covariates. Further studies are needed to improve functional outcomes in civilian patients, who may not have the inherent advantages of younger age and healthier physical status found in military patients.