Dr Michaela Pollock¹, Dr Cheng Lo¹

¹The Alfred Hospital, Melbourne, Australia

Abstract:

INTRODUCTION / AIM: The “obesity paradox” demonstrates a survival advantage in patients who are obese with acute critical illness as well as chronic disease¹. There is minimal research of this paradox in severely burned patients worldwide. We aimed to determine if this paradox exists in the Australian population.

METHODS: A retrospective cohort study involving severely burned patients (>20% TBSA) admitted to the Victorian Adult Burns Service between 2016 to 2021 (5-year period). Patients were stratified into six groups according to their BMI². Demographics, burn characteristics, presence of inhalational injury and incidence of bacteraemia were obtained. The primary outcome was in-hospital mortality. The secondary outcomes assessed were time spent in ICU, time spent on a ventilator, and whether a patient developed a bacteraemia.

RESULTS: Of the 165 patients included in this study, 31 patients died. In hospital mortality was 2.5 times more likely in obese patients compared to those with a normal BMI. The median length of stay in hospital was lower in obese patients (19 days, IQR 6-37) due to the higher mortality rate in this category. Median ICU length of stay was also lowest obese patients (133, IQR 32-278). Age increased the risk of death by 7% each year (OR 1.07).

The trend from our data concluded that younger patients with a normal BMI had the lowest mortality rate, but spent the most amount of time in ICU on ventilation. Our results will be comprehensively discussed and compared with the existing literature at the conference presentation.

¹Lester, ELW, Dvorak, JE, Maluso, PJ, Bendjemil, S, Messer, T, Poulakidas, S, Bokhari, F 2020, ‘Obesity Paradox in the Burn Patient’, Journal of Burn Care & Research, vol. 41, no. 1, pp. 30-32.

²World Health Organisation 2022, WHO Body mass index – BMI, World Health Organisation, viewed 15/03/2022, < https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi#>

Biography:

Dr Michaela Pollock is a surgical resident at the Alfred Hospital. Michaela is supervised by Mr Cheng Lo, Burns Consultant at the Alfred Hospital. Michaela developed a keen interest in burns surgery after completing a rotation in 2021. Michaela would like to pursue a career in the field.