Predicting Heterotopic Ossification Early After Burn Injuries: A Risk Scoring System

Jeffrey C. Schneider, Laura C. Simko, Richard Goldstein, Vivian L. Shie, Betty Chernack, Benjamin Levi, Prakash Jayakumar, Karen J. Kowalske, David Herndon, Nicole S. Gibran, Colleen M. Ryan

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 languageEnglish (US)
JournalAnnals of Surgery
DOIs
StateAccepted/In press - Jun 24 2016

Fingerprint

Heterotopic Ossification
Wounds and Injuries
Body Surface Area
Translational Medical Research
Burns
Arm
Neck
Logistic Models
Head
Regression Analysis
Demography
Databases

ASJC Scopus subject areas

  • Surgery

Cite this

Schneider, J. C., Simko, L. C., Goldstein, R., Shie, V. L., Chernack, B., Levi, B., ... Ryan, C. M. (Accepted/In press). Predicting Heterotopic Ossification Early After Burn Injuries: A Risk Scoring System. Annals of Surgery. https://doi.org/10.1097/SLA.0000000000001841

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 journalArticle

Schneider, JC, Simko, LC, Goldstein, R, Shie, VL, Chernack, B, Levi, B, Jayakumar, P, Kowalske, KJ, Herndon, D, Gibran, NS & Ryan, CM 2016, 'Predicting Heterotopic Ossification Early After Burn Injuries: A Risk Scoring System', Annals of Surgery. https://doi.org/10.1097/SLA.0000000000001841
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. / Predicting Heterotopic Ossification Early After Burn Injuries : A Risk Scoring System. In: Annals of Surgery. 2016.
@article{1308c44216924c389d99085542a1f3fe,
title = "Predicting Heterotopic Ossification Early After Burn Injuries: A Risk Scoring System",
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.",
author = "Schneider, {Jeffrey C.} and Simko, {Laura C.} and Richard Goldstein and Shie, {Vivian L.} and Betty Chernack and Benjamin Levi and Prakash Jayakumar and Kowalske, {Karen J.} and David Herndon and Gibran, {Nicole S.} and Ryan, {Colleen M.}",
year = "2016",
month = "6",
day = "24",
doi = "10.1097/SLA.0000000000001841",
language = "English (US)",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",

}

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.

UR - http://www.scopus.com/inward/record.url?scp=84976320007&partnerID=8YFLogxK

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 -