Comparison Between Civilian Burns and Combat Burns From Operation Iraqi Freedom and Operation Enduring Freedom

Wolf, Steven E.; Kauvar, David S.; Wade, Charles E.; Cancio, Leopoldo C.; Renz, Evan; Horvath, Edward E.; White, Christopher E.; Park, Myung S.; Wanek, Sandra M.; Albrecht, Michael; Blackbourne, Lorne H.; Barillo, David J.; Holcomb, John B.

doi:10.1097/01.sla.0000219645.88867.b7

Cited by 110 publications

(59 citation statements)

References 19 publications

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“…In the literature, 5-10% of all combat injuries are isolated or combined burn injuries [1,2]. In September of 2008 in Iraqi and Afghanistan, 366 patients with combat injuries were treated in one of the coalition hospitals.…”

Section: Incidencementioning

confidence: 99%

Incidence, Cause and Treatment of Burn Casualties Under War Circumstances

Breederveld

Tuinebreijer

2009

Eur J Trauma Emerg Surg

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Five to ten percent of all combat injuries in the last decade of armed conflicts have been burns. Here, the incidence, demographics, and treatment are different compared to civilian practice. The percentage of hand and facial burns is higher, the population of patients is healthier, there are more associated injuries, and the transportation time is longer. Due to the prolonged transportation time, emergency treatment and also intermediate treatment are important for a good outcome in patients with burns suffered in a military environment. Treatment guidelines and education of the involved medical personnel according to the findings described herein are important for better results in future combat casualties.

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Section: Incidencementioning

confidence: 99%

Incidence, Cause and Treatment of Burn Casualties Under War Circumstances

Breederveld

Tuinebreijer

2009

Eur J Trauma Emerg Surg

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“…Given the often limited antibiotic choices for treating Acinetobacterassociated infection and the potentially significant side effects of colistin therapy, especially nephrotoxicity, it is incumbent on clinicians to differentiate between Acinetobacter colonization and infection and thereby avoid unnecessary treatments. Burns are an important cause of morbidity in OIF/ OEF patients, comprising about 5 percent of all casualties [15]. Burn patients are susceptible to bacteremia because of skin breakdown and infections associated with critical care.…”

Section: Trauma-related and Acinetobacter Infectionsmentioning

confidence: 99%

Infectious complications in OIF/OEF veterans with traumatic brain injury

Dau

Oda²,

Holodniy³

2009

JRRD

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Abstract-Of veterans from the U.S. Global War on Terrorism who have sought care in the Department of Veterans Affairs, approximately 12% have an infectious disease diagnosis. Infections in those veterans with traumatic brain injury (TBI) include infections associated with blast injuries and burns, such as skin and soft tissue infections; infections as a result of retained bullet or shrapnel fragments; pulmonary infections resulting from lung injury, intubation, or resultant tracheostomy; hospital-acquired infections, such as those associated with methicillin-resistant Staphylococcus aureus and other antimicrobial resistant organisms such as Acinetobacter baumannii; and infections from implanted prosthetic devices, such as metal hardware or skull flaps. Longer-term cognitive impairment may result in behaviors that place veterans with TBI at risk for human immunodeficiency virus or hepatitis C virus infections. Finally, chronic infections acquired abroad, such as cutaneous leishmaniasis or Q-fever, may be diagnosed after veterans return to the United States. These infections present challenges in terms of added morbidity and costs associated with complex antimicrobial management; isolation requirements; and surgical procedures, such as those to remove infected retained fragments or prosthetic devices. In this review, providers will become more familiar with the scope and complexity of infectious disease management in veterans with TBI.

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“…The U.S. Army Institute of Surgical Research burn center provides care to a mixed population of civilian and military patients who have similar outcomes after adjustments for age and injury severity. 15 The study database included arterial blood glucose (BG) measurements for the first 8 days of hospitalization. Since three is the minimum number of measurements for computation of ADRR, 14 we used only subjects who had at least 1 day in the ICU with three BG measurements ( Figure 1A).…”

Section: Study Databasementioning

confidence: 99%

Average Daily Risk Range as a Measure of Glycemic Risk is Associated with Mortality in the Intensive Care Unit: A Retrospective Study in a Burn Intensive Care Unit

Farhy

Ortiz

Kovatchev

et al. 2011

J Diabetes Sci Technol

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Background: Although tight glycemic control has been associated with improved outcomes in the intensive care unit (ICU), glycemic variability may be the influential factor in mortality. The main goal of the study was to relate blood glucose (BG) variability of burn ICU patients to outcomes using a sensitive measure of glycemic variability, the average daily risk range (ADRR). Method: Data from patients admitted to a burn ICU were used. Patients were matched by total body surface area (TBSA) and injury severity score (ISS) to test whether increased BG variability measured by ADRR was associated with higher mortality risk and whether we could identify ADRR-based classifications associated with the degree of risk. Results: Four ADRR classifications were identified: Low risk, medium-low, medium-high, and high. Mortality progressively increased from 25% in the low-risk group to over 60% in the high-risk group ( p < .001). In a post hoc analysis, age also contributed to outcome. Younger (age < 43 years) survivors and nonsurvivors matched by TBSA and ISS had no significant difference in age, mean BG or standard deviation of BG; however, nonsurvivors had higher ADRR ( p < .01). Conclusions: Independent of injury severity, glycemic variability measured by the ADRR was significantly associated with mortality in the ICU. When age was considered, ADRR was the only measure of glycemia significantly associated with mortality in younger patients with burns.

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Comparison Between Civilian Burns and Combat Burns From Operation Iraqi Freedom and Operation Enduring Freedom

Abstract: Mortality does not differ between civilians evacuated locally and military personnel injured in distant austere environments treated at the same center.

Cited by 110 publications

References 19 publications

Incidence, Cause and Treatment of Burn Casualties Under War Circumstances

Incidence, Cause and Treatment of Burn Casualties Under War Circumstances

Infectious complications in OIF/OEF veterans with traumatic brain injury

Average Daily Risk Range as a Measure of Glycemic Risk is Associated with Mortality in the Intensive Care Unit: A Retrospective Study in a Burn Intensive Care Unit

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