Fungal Wound Infection (Not Colonization) Is Independently Associated With Mortality in Burn Patients

Abstract

Objective: To analyze the occurrence of fungal wound infection (FWI) after thermal injury and its relationship to mortality. Background: FWI is an uncommon but potentially lethal complication of severe thermal injury. Methods: The records of patients with thermal burns admitted to a single burn center (1991 2002) were reviewed. Analyses accounted for total burn size (TBS, percentage body surface area), full-thickness burn size (FTBS, percentage body surface area), age, inhalation injury, sex, and fungal-status category. Fungal colonization and infection were determined histopathologically. Results: Criteria for inclusion were met by 2651 patients. Each patient s fungal-status category was defined according to the deepest level of fungal involvement observed during the hospital course: no fungus (2476 patients), fungal wound colonization (FWC, 121 patients), or fungal wound infection (FWI, 54 patients). Median TBS (9%, 47%, 64%, respectively) and mortality (5%, 27%, 76%, respectively) varied significantly among fungal-status groups. Logistic regression was used to detect significant independent associations. FWI was associated with higher TBS. Mortality was associated with TBS, FTBS, inhalation injury, FWI, and age. Unlike FWI, FWC was not independently related to mortality, the greater observed mortality in FWC being explained by other variables such as TBS. The odds ratio for FWI (8.16) suggested about the same mortality impact as augmenting TBS by 33%. A midrange TBS of 30% to 60% was required for most of the detectable association of FWI with mortality. Conclusions: FWI accompanies larger burns and is associated with mortality in burn patients, particularly in those with TBS 30% to 60%. This association is independent of burn size, inhalation injury, and age.

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Document Details

Document Type
Technical Report
Publication Date
Jun 01, 2007
Accession Number
ADA627894

Entities

People

  • Arthur D. Mason Jr.
  • Charles E Wade
  • Clinton K. Murray
  • Duane R. Hospenthal
  • Edward E. Horvath
  • George M. Vaughan
  • John B Holcomb
  • Kevin K Chung
  • Leopoldo C. Cancio
  • Steven Wolf

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Anti-Infective Agents
  • Antifungal Agents
  • Burns
  • Dermatologic Agents
  • Diseases And Disorders
  • Fungi
  • Health Services
  • Infection
  • Infection Control
  • Information Science
  • Institutional Review Board
  • Regression Analysis
  • Statistical Analysis
  • Therapy
  • Wound Infections
  • Wounds And Injuries

Fields of Study

  • Medicine

Readers

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