Gender differences in pediatric burn patients

Does it make a difference?

Marc G. Jeschke, Ronald P. Mlcak, Celeste Finnerty, William Norbury, Rene Przkora, Gabriela A. Kulp, Gerd G. Gauglitz, Xiao Jun Zhang, David Herndon

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

OBJECTIVE:: There is evidence that females have a better outcome in intensive care units (ICUs) when compared with males. The aim of the present study was to compare hospital course and physiologic markers between severely burned pediatric females and males. SUMMARY BACKGROUND DATA:: One-hundred eighty-nine children sustaining a 40% total body surface area burn were divided into females (n = 76) and males (n = 113). METHODS:: Patient emographics, clinical parameters, and mortality were noted. Muscle protein synthesis was determined by stable isotope technique. Resting energy expenditure (REE) was measured by indirect calorimetry and body composition by dual x-ray absorptiometry. Serum hormones, proteins, and cytokines were determined. Cardiac function and liver size were determined by repeated ultrasound measurements. RESULTS:: There were no significant differences between females and males for mortality, demographics, burn size, nutritional intake, or concomitant injuries. ICU stay was in females: 29±3 days whereas the stay in males was 38±3 days, P < 0.05. Females had a significant attenuated loss in muscle protein net balance (females: -0.028±0.001% vs. males: -0.05±0.007%) and an increase in lean body mass (Δ females: 5±4% vs. Δ males: -1±3%), P < 0.05. Percent-predicted REE was significantly decreased in females compared with males, P < 0.05. Systemic inflammatory markers and stress hormone levels were significantly decreased in females, P < 0.05. Cardiac and liver dysfunction were significantly attenuated in females compared with males, P < 0.05. CONCLUSIONS:: Female burned patients exert an attenuated inflammatory and hypermetabolic response compared with males. This decrease is reflected in improved muscle protein net balance and preservation of lean body mass, which are associated with shortened hospital stay.

Original languageEnglish (US)
Pages (from-to)126-136
Number of pages11
JournalAnnals of Surgery
Volume248
Issue number1
DOIs
StatePublished - Jul 2008

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Pediatrics
Muscle Proteins
Energy Metabolism
Intensive Care Units
Hormones
Indirect Calorimetry
Mortality
Body Surface Area
Body Composition
Isotopes
Liver Diseases
Blood Proteins
Length of Stay
X-Rays
Demography
Cytokines
Liver
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Gender differences in pediatric burn patients : Does it make a difference? / Jeschke, Marc G.; Mlcak, Ronald P.; Finnerty, Celeste; Norbury, William; Przkora, Rene; Kulp, Gabriela A.; Gauglitz, Gerd G.; Zhang, Xiao Jun; Herndon, David.

In: Annals of Surgery, Vol. 248, No. 1, 07.2008, p. 126-136.

Research output: Contribution to journalArticle

Jeschke, MG, Mlcak, RP, Finnerty, C, Norbury, W, Przkora, R, Kulp, GA, Gauglitz, GG, Zhang, XJ & Herndon, D 2008, 'Gender differences in pediatric burn patients: Does it make a difference?', Annals of Surgery, vol. 248, no. 1, pp. 126-136. https://doi.org/10.1097/SLA.0b013e318176c4b3
Jeschke, Marc G. ; Mlcak, Ronald P. ; Finnerty, Celeste ; Norbury, William ; Przkora, Rene ; Kulp, Gabriela A. ; Gauglitz, Gerd G. ; Zhang, Xiao Jun ; Herndon, David. / Gender differences in pediatric burn patients : Does it make a difference?. In: Annals of Surgery. 2008 ; Vol. 248, No. 1. pp. 126-136.
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abstract = "OBJECTIVE:: There is evidence that females have a better outcome in intensive care units (ICUs) when compared with males. The aim of the present study was to compare hospital course and physiologic markers between severely burned pediatric females and males. SUMMARY BACKGROUND DATA:: One-hundred eighty-nine children sustaining a 40{\%} total body surface area burn were divided into females (n = 76) and males (n = 113). METHODS:: Patient emographics, clinical parameters, and mortality were noted. Muscle protein synthesis was determined by stable isotope technique. Resting energy expenditure (REE) was measured by indirect calorimetry and body composition by dual x-ray absorptiometry. Serum hormones, proteins, and cytokines were determined. Cardiac function and liver size were determined by repeated ultrasound measurements. RESULTS:: There were no significant differences between females and males for mortality, demographics, burn size, nutritional intake, or concomitant injuries. ICU stay was in females: 29±3 days whereas the stay in males was 38±3 days, P < 0.05. Females had a significant attenuated loss in muscle protein net balance (females: -0.028±0.001{\%} vs. males: -0.05±0.007{\%}) and an increase in lean body mass (Δ females: 5±4{\%} vs. Δ males: -1±3{\%}), P < 0.05. Percent-predicted REE was significantly decreased in females compared with males, P < 0.05. Systemic inflammatory markers and stress hormone levels were significantly decreased in females, P < 0.05. Cardiac and liver dysfunction were significantly attenuated in females compared with males, P < 0.05. CONCLUSIONS:: Female burned patients exert an attenuated inflammatory and hypermetabolic response compared with males. This decrease is reflected in improved muscle protein net balance and preservation of lean body mass, which are associated with shortened hospital stay.",
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AU - Jeschke, Marc G.

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AU - Finnerty, Celeste

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AU - Przkora, Rene

AU - Kulp, Gabriela A.

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N2 - OBJECTIVE:: There is evidence that females have a better outcome in intensive care units (ICUs) when compared with males. The aim of the present study was to compare hospital course and physiologic markers between severely burned pediatric females and males. SUMMARY BACKGROUND DATA:: One-hundred eighty-nine children sustaining a 40% total body surface area burn were divided into females (n = 76) and males (n = 113). METHODS:: Patient emographics, clinical parameters, and mortality were noted. Muscle protein synthesis was determined by stable isotope technique. Resting energy expenditure (REE) was measured by indirect calorimetry and body composition by dual x-ray absorptiometry. Serum hormones, proteins, and cytokines were determined. Cardiac function and liver size were determined by repeated ultrasound measurements. RESULTS:: There were no significant differences between females and males for mortality, demographics, burn size, nutritional intake, or concomitant injuries. ICU stay was in females: 29±3 days whereas the stay in males was 38±3 days, P < 0.05. Females had a significant attenuated loss in muscle protein net balance (females: -0.028±0.001% vs. males: -0.05±0.007%) and an increase in lean body mass (Δ females: 5±4% vs. Δ males: -1±3%), P < 0.05. Percent-predicted REE was significantly decreased in females compared with males, P < 0.05. Systemic inflammatory markers and stress hormone levels were significantly decreased in females, P < 0.05. Cardiac and liver dysfunction were significantly attenuated in females compared with males, P < 0.05. CONCLUSIONS:: Female burned patients exert an attenuated inflammatory and hypermetabolic response compared with males. This decrease is reflected in improved muscle protein net balance and preservation of lean body mass, which are associated with shortened hospital stay.

AB - OBJECTIVE:: There is evidence that females have a better outcome in intensive care units (ICUs) when compared with males. The aim of the present study was to compare hospital course and physiologic markers between severely burned pediatric females and males. SUMMARY BACKGROUND DATA:: One-hundred eighty-nine children sustaining a 40% total body surface area burn were divided into females (n = 76) and males (n = 113). METHODS:: Patient emographics, clinical parameters, and mortality were noted. Muscle protein synthesis was determined by stable isotope technique. Resting energy expenditure (REE) was measured by indirect calorimetry and body composition by dual x-ray absorptiometry. Serum hormones, proteins, and cytokines were determined. Cardiac function and liver size were determined by repeated ultrasound measurements. RESULTS:: There were no significant differences between females and males for mortality, demographics, burn size, nutritional intake, or concomitant injuries. ICU stay was in females: 29±3 days whereas the stay in males was 38±3 days, P < 0.05. Females had a significant attenuated loss in muscle protein net balance (females: -0.028±0.001% vs. males: -0.05±0.007%) and an increase in lean body mass (Δ females: 5±4% vs. Δ males: -1±3%), P < 0.05. Percent-predicted REE was significantly decreased in females compared with males, P < 0.05. Systemic inflammatory markers and stress hormone levels were significantly decreased in females, P < 0.05. Cardiac and liver dysfunction were significantly attenuated in females compared with males, P < 0.05. CONCLUSIONS:: Female burned patients exert an attenuated inflammatory and hypermetabolic response compared with males. This decrease is reflected in improved muscle protein net balance and preservation of lean body mass, which are associated with shortened hospital stay.

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