G. Hundeshagen1,4, R. P. Clayton1,4, V. N. Collins3, D. N. Herndon1,4, L. K. Branski1,4, M. P. Kinsky2 1University Of Texas Medical Branch,Surgery,Galveston, TX, USA 2University Of Texas Medical Branch,Anesthesiology,Galveston, TX, USA 3University Of Texas Medical Branch,School Of Medicine,Galveston, TX, USA 4Shriners Hospitals For Children,Galveston,Galveston, TX, USA
Introduction: There is little data describing long-term sequelae of pediatric burn injury on cardiovascular disease (CVD). A recent retrospective cohort analysis of more than 10.000 pediatric burn patients over 30 years showed increased admission rates and prolonged hospitalization times for cardiovascular and circulatory disease in this patient population1. In an ongoing prospective trial we are assessing cardiovascular risk factors of long-term pediatric burn survivors. The following data collection focuses on specific and potentially modifiable risk factors of CVD.
Methods: Former pediatric burn patients greater than 3 years post injury were prospectively enrolled and screened for established CVD risk factors: elevated blood pressure is defined as >140mmg systolic or >90mmg diastolic, smoking is defined as smoking status at the time of survey, overweight is defined as BMI>25 and obesity is defined as BMI>30, total body fat percentage is measured using whole body bone densitometry (DEXA). All results are presented as mean ± SD or count and percentage.
Results: We included 64 patients (39male, 29 female) in this study. Age was 21±5 years, age at burn was 9±6 years, elapsed time between burn injury and assessment was 12±5 years, burn size was 62±19% total body surface area (TBSA). Four patients (6.25%) had evidence of hypertension (average prevalence in this age group, 5.4%), mean systolic blood pressure was 118±5mmg, mean diastolic blood pressure was 72±10mmg. Twenty-six patients (41%) were overweight (average prevalence in this age group 35%), 7 patients (11%) were obese (average prevalence in this age group 20%). While mean BMI was 24±5, mean total body fat percentage was 31±8% which is above the threshold for obesity in adolescents and adults. Six patients (9%) were actively smoking at the time of survey (average prevalence in this age group 27%).
Conclusion: Our results to date suggest a similar incidence of hypertension. Interestingly, smoking risk was lower in this cohort. On the other-hand, despite only a moderate increase in BMI, total body fat percentage was higher than age match controls. The considerable prevalence of overweight and obesity in this patient collective raises questions about the long-term persistence of the burn-induced hyperdynamic state. Our results have limitations, other CVD risk factors e.g., hyperlipidemia was not measured and indices of systolic and diastolic dysfunction, which could impact hospitalization1, are not reported to date.
Reference: 1 Duke, Janine M., et al. "Long-term Effects of Pediatric Burns on the Circulatory System." Pediatrics 136.5 (2015): e1323-e1330.