Abstract
OBJECTIVE:: The purpose of this study is to develop a scoring system that stratifies burn patients at the time of hospital admission according to risk of developing heterotopic ossification (HO). SUMMARY OF BACKGROUND DATA:: HO in burns is an uncommon but severely debilitating problem with a poorly understood mechanism and no fully effective prophylactic measures. METHODS:: Data were obtained from the Burn Model System National Database from 1994 to 2010 (n = 3693). The primary outcome is diagnosis of HO at hospital discharge. Logistic regression analysis was used to determine significant demographic and medical predictors of HO. A risk scoring system was created in which point values were assigned to predictive factors and final risk score is correlated with the percent risk of developing HO. The model was internally and externally validated. RESULTS:: The mean age of the subjects is 42.5?±?16.0 years, the mean total body surface area (TBSA) burned is 18.5?±?16.4%, and the population is 74.9% male. TBSA and the need for grafting of the arm, head/neck, and trunk were significant predictors of HO development (P < 0.01). A 13-point risk scoring system was developed using these significant predictors. The model c-statistic is 0.92. The risk scoring system demonstrated evidence of internal and external validity. An online calculator was developed to facilitate translation of knowledge to practice and research. CONCLUSIONS:: This HO risk scoring system identifies high-risk burn patients suitable for diagnostic testing and interventional HO prophylaxis trials.
| Original language | English (US) |
|---|---|
| Journal | Annals of Surgery |
| DOIs | |
| State | Accepted/In press - Jun 24 2016 |
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ASJC Scopus subject areas
- Surgery
Cite this
Predicting Heterotopic Ossification Early After Burn Injuries : A Risk Scoring System. / Schneider, Jeffrey C.; Simko, Laura C.; Goldstein, Richard; Shie, Vivian L.; Chernack, Betty; Levi, Benjamin; Jayakumar, Prakash; Kowalske, Karen J.; Herndon, David; Gibran, Nicole S.; Ryan, Colleen M.
In: Annals of Surgery, 24.06.2016.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predicting Heterotopic Ossification Early After Burn Injuries
T2 - A Risk Scoring System
AU - Schneider, Jeffrey C.
AU - Simko, Laura C.
AU - Goldstein, Richard
AU - Shie, Vivian L.
AU - Chernack, Betty
AU - Levi, Benjamin
AU - Jayakumar, Prakash
AU - Kowalske, Karen J.
AU - Herndon, David
AU - Gibran, Nicole S.
AU - Ryan, Colleen M.
PY - 2016/6/24
Y1 - 2016/6/24
N2 - OBJECTIVE:: The purpose of this study is to develop a scoring system that stratifies burn patients at the time of hospital admission according to risk of developing heterotopic ossification (HO). SUMMARY OF BACKGROUND DATA:: HO in burns is an uncommon but severely debilitating problem with a poorly understood mechanism and no fully effective prophylactic measures. METHODS:: Data were obtained from the Burn Model System National Database from 1994 to 2010 (n = 3693). The primary outcome is diagnosis of HO at hospital discharge. Logistic regression analysis was used to determine significant demographic and medical predictors of HO. A risk scoring system was created in which point values were assigned to predictive factors and final risk score is correlated with the percent risk of developing HO. The model was internally and externally validated. RESULTS:: The mean age of the subjects is 42.5?±?16.0 years, the mean total body surface area (TBSA) burned is 18.5?±?16.4%, and the population is 74.9% male. TBSA and the need for grafting of the arm, head/neck, and trunk were significant predictors of HO development (P < 0.01). A 13-point risk scoring system was developed using these significant predictors. The model c-statistic is 0.92. The risk scoring system demonstrated evidence of internal and external validity. An online calculator was developed to facilitate translation of knowledge to practice and research. CONCLUSIONS:: This HO risk scoring system identifies high-risk burn patients suitable for diagnostic testing and interventional HO prophylaxis trials.
AB - OBJECTIVE:: The purpose of this study is to develop a scoring system that stratifies burn patients at the time of hospital admission according to risk of developing heterotopic ossification (HO). SUMMARY OF BACKGROUND DATA:: HO in burns is an uncommon but severely debilitating problem with a poorly understood mechanism and no fully effective prophylactic measures. METHODS:: Data were obtained from the Burn Model System National Database from 1994 to 2010 (n = 3693). The primary outcome is diagnosis of HO at hospital discharge. Logistic regression analysis was used to determine significant demographic and medical predictors of HO. A risk scoring system was created in which point values were assigned to predictive factors and final risk score is correlated with the percent risk of developing HO. The model was internally and externally validated. RESULTS:: The mean age of the subjects is 42.5?±?16.0 years, the mean total body surface area (TBSA) burned is 18.5?±?16.4%, and the population is 74.9% male. TBSA and the need for grafting of the arm, head/neck, and trunk were significant predictors of HO development (P < 0.01). A 13-point risk scoring system was developed using these significant predictors. The model c-statistic is 0.92. The risk scoring system demonstrated evidence of internal and external validity. An online calculator was developed to facilitate translation of knowledge to practice and research. CONCLUSIONS:: This HO risk scoring system identifies high-risk burn patients suitable for diagnostic testing and interventional HO prophylaxis trials.
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UR - http://www.scopus.com/inward/citedby.url?scp=84976320007&partnerID=8YFLogxK
U2 - 10.1097/SLA.0000000000001841
DO - 10.1097/SLA.0000000000001841
M3 - Article
C2 - 27348865
AN - SCOPUS:84976320007
JO - Annals of Surgery
JF - Annals of Surgery
SN - 0003-4932
ER -