Impact of pre-existing cancer diagnoses on burn injury survival and morbidity

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns Pub Date : 2025-02-03 DOI:10.1016/j.burns.2025.107414

Phillip Keys , Kassandra Corona , Sheldon McCown , Lyndon Huang , Elvia Villarreal , Jasmine Chaij , Giovanna De La Tejera , Douglas S. Tyler , George Golovko , Amina El Ayadi , Juquan Song , Steven E. Wolf

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Abstract

Objectives

Severe burns place patients in a compromised state, especially those with pre-existing chronic diseases such as malignancy. Due to improvements in detection and treatment, cancer mortality has declined significantly, leaving a growing population of cancer survivors. Therefore, we wondered whether pre-existing cancer diagnoses influence patient outcomes following burn injury.

Methods

46,275 patients with a neoplasm diagnosis prior to experiencing a burn injury were identified using the TriNetX research network. Two control groups were organized: 1) cancer patients without burns and 2) burn patients with no history of cancer. The test group included patients with a pre-existing cancer diagnosis who received a subsequent burn injury. Outcomes included death, sepsis, nutritional deficiency, eating disorder, immunodeficiency, and depression. Odds ratios were calculated with 95 % confidence intervals.

Results

Of the nearly 10 million cancer patients, 0.45 % experienced a burn injury after diagnosis. Compared to propensity-matched burned patients without cancer, burned patients with a previous cancer diagnosis had increased odds of developing sepsis (2.013, 1.895–2.138), nutritional deficiency (1.874, 1.58–2.221), immunodeficiency (5.584, 4.85–7.06), eating disorder (2.384, 1.947–2.918), and depression (1.772, 1.695–1.853). The odds ratios of sepsis (1.718, 1.612–1.83), nutritional deficiency (1.963, 1.593–2.418), immunodeficiency (1.265, 1.098–1.459), eating disorder (2.569, 2.077–3.177), and depression (1.538, 1.468–1.611) were increased when compared to cancer patients without burn injury. Burned patients with a previous neoplasm of hematologic origin fared worse in the odds of developing the mentioned outcomes compared to those with solid neoplasms. Lastly, burned patients with any previous neoplasm who later received chemotherapy and/or radiation suffered worse outcomes than those who never received such treatment.

Conclusion

Patients who developed neoplasms before receiving a burn injury demonstrated considerable increases in odds of poor outcomes. Increased odds of developing poor outcomes were greater in those with hematologic neoplasms and those who received chemotherapy or radiation treatment.

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既往癌症诊断对烧伤生存和发病率的影响

目的严重烧伤使患者处于受损状态，特别是那些已有慢性疾病（如恶性肿瘤）的患者。由于检测和治疗的改进，癌症死亡率显著下降，留下了越来越多的癌症幸存者。因此，我们想知道先前存在的癌症诊断是否会影响烧伤后患者的预后。方法使用TriNetX研究网络识别46,275例在经历烧伤之前被诊断为肿瘤的患者。对照组分为两组：1)无烧伤的癌症患者和2)无癌症病史的烧伤患者。试验组包括先前诊断为癌症并随后遭受烧伤的患者。结果包括死亡、败血症、营养缺乏、饮食失调、免疫缺陷和抑郁。比值比以95% %的置信区间计算。结果在近1000万癌症患者中，0.45 %的患者在诊断后出现了烧伤。与没有癌症的倾向匹配的烧伤患者相比，既往诊断为癌症的烧伤患者发生败血症（2.013,1.895-2.138）、营养缺乏（1.874,1.58-2.221）、免疫缺陷（5.584,4.85-7.06）、饮食失调（2.384,1.947-2.918）和抑郁症（1.772,1.695-1.853）的几率增加。败血症（1.718,1.612-1.83）、营养缺乏（1.963,1.593-2.418）、免疫缺陷（1.265,1.098-1.459）、饮食失调（2.569,2.077-3.177）、抑郁（1.538,1.468-1.611）的比值比均高于无烧伤的癌症患者。先前有血液学来源肿瘤的烧伤患者与实体肿瘤患者相比，发生上述结果的几率更低。最后，以前有任何肿瘤的烧伤患者后来接受化疗和/或放疗的结果比从未接受过这种治疗的患者更差。结论在烧伤前发生肿瘤的患者预后不良的几率显著增加。血液肿瘤患者和接受化疗或放疗的患者出现不良预后的几率更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.