{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T07:34:44Z","timestamp":1781076884668,"version":"3.54.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T00:00:00Z","timestamp":1652400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The hypermetabolic state of patients with \u226520% total body surface area (TBSA) causes loss of muscle mass and compromised immune function with delayed wound healing. Weight loss is most severe in patients with \u226520% TBSA with initial weight gain due to fluid resuscitation. The American Burn Association (ABA) proposed quality measures for burn injury admissions, including weight loss from admission to discharge. We assessed how our outcomes adhere to these measures and if they correlate with previously described results. We retrospectively reviewed adult admissions with \u226520% TBSA burn injuries from 2016 to 2021. Four groups were established based on %TBSA: 20% to 29% (Group 1), 30% to 39% (Group 2), 40% to 59% (Group 3), and \u226560% (Group 4). We assessed weight changes from admission to discharge and performed multivariate analyses to account for age, sex, total surgeries, and length of stay. Data from 123 patients revealed 40 with 20% to 29% TBSA, 29 with 30% to 39% TBSA, 33 with 40% to 59% TBSA, 21 with \u226560% TBSA. A significant difference in weight loss was observed when comparing Groups 1 and 2 and Groups 3 and 4 (Group 1: \u22123.63%, Group 2: \u22122%, Group 3: \u22129.28%, Group 4: \u221213.85%; P-value \u2264 .05). Groups 3 and 4 had significantly longer lengths of stay compared to Groups 1 and 2 (Group 1: 32.16, Group 2: 37.5, Group 3: 71.13, Group 4: 87.18; P-value \u2264 .01). Most patients that experienced weight loss during their admission had &amp;lt;15% weight loss. We found no significant difference in outcomes for patients receiving oxandrolone vs not. The mean weight change was \u221211% for patients with an overall weight loss and +5% for patients with an overall weight gain. The significant difference between the two groups was admission body mass index (BMI; loss: 30.4 kg\/m2, gain: 26.0 kg\/m2; P-value \u2264 .05). Patients with \u226520% TBSA suffer weight changes, likely due to metabolic disturbances. Increased length of stay and higher %TBSA may be associated with greater weight loss. Patients experiencing weight gain had lower admission BMI suggesting that patients with higher BMI are more prone to weight loss. Our findings support that patients with %TBSA \u226540 are unique, requiring specialized nutritional protocols and metabolic analysis.<\/jats:p>","DOI":"10.1093\/jbcr\/irac054","type":"journal-article","created":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T04:07:08Z","timestamp":1652414828000},"page":"781-786","source":"Crossref","is-referenced-by-count":5,"title":["Carry That Weight! The Challenge of Managing Weight Changes During Inpatient Admission for Patients With Burn Injuries \u226520% TBSA"],"prefix":"10.1093","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1794-9434","authenticated-orcid":false,"given":"Tomer","family":"Lagziel","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"},{"name":"Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arya A","family":"Akhavan","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua S","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"},{"name":"Department of General Surgery, George Washington University School of Medicine and Health Sciences , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie A","family":"Cox","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana F R","family":"Duraes","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"},{"name":"Department of Plastic Surgery, Cleveland Clinic , Cleveland, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles Scott","family":"Hultman","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Caffrey","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,13]]},"reference":[{"key":"2022082002572929900_CIT0001","doi-asserted-by":"crossref","first-page":"100709","DOI":"10.1016\/j.cpsurg.2019.100709","article-title":"Current problems in burn 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