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Hypertension after injury among burned combat veterans: A retrospective cohort study.

Stewart IJ, Sosnov JA, Snow BD, Batou A, Howard JT, Janak JC, Bollinger M, Chung KK. Hypertension after injury among burned combat veterans: A retrospective cohort study. Burns : journal of the International Society for Burn Injuries. 2017 Mar 1; 43(2):290-296.

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BACKGROUND: The long-term health effects of burn are poorly understood. We sought to evaluate the relationship between burn and the subsequent development of hypertension. METHODS: Retrospective cohort study of patients admitted to our burn center from 2003 to 2010. Data collected included demographic variables, burn size, injury severity score, presence of inhalation injury, serum creatinine, need for renal replacement therapy, as well as days spent in the hospital, in the intensive care unit and on mechanical ventilation. Data for the subsequent diagnosis of hypertension was obtained from medical records. Cox proportional hazard regression models were performed to determine what factors were associated with hypertension. RESULTS: Of the 711 patients identified, 670 were included for analysis after exclusions. After adjustment, only age (HR 1.06 per one year increase, 95% confidence interval 1.03-1.08; p < 0.001), percentage of total body surface area burned (HR 1.11 per 5% increase, 95% confidence interval 1.04-1.19; p = 0.002) and acute kidney injury (HR 1.68, 95% confidence interval 1.05-2.69; p = 0.03) were associated with hypertension. CONCLUSION: Burn size is independently associated with the subsequent risk of hypertension in combat casualties. Clinical support for primary prevention techniques to reduce the incidence of hypertension specific to burn patients may be warranted.

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