Changes in body composition of burn patients during the phases of response to trauma

Arruda, Andressa Maranhão de; Gadelha, Patrícia Calado Ferreira Pinheiro; Soares, Bruna Lúcia de Mendonça; Dowsley, Catiana Coelho Cabral; Lemos, Maria da Conceição Chaves de; Santos, Ana Célia Oliveira dos

doi:10.1590/0034-7167-2023-0039

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 76 (6) • 2023 • https://doi.org/10.1590/0034-7167-2023-0039 copy

Changes in body composition of burn patients during the phases of response to trauma

Alterações na composição corporal de pacientes queimados durante as fases de resposta ao trauma

Cambios en la composición corporal de pacientes quemados durante las fases de respuesta al trauma

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To assess the changes in body composition of burn patients through electrical bioimpedance in the phases of response to trauma.

Methods:

a longitudinal observational study, carried out from October 2019 to March 2020. Sociodemographic, clinical, epidemiological, anthropometric and body composition data were collected. Statistical analysis was performed with SPSS, considering a significance of 5%. The comparison between variables was performed using the paired Student’s t test.

Results:

the sample consisted of 58 adult burn patients, with a mean age of 38.2±12.5 years. The mean body surface area (BSA) with burns was 10.8±7.3%. Nutritional assessment demonstrated a depletion of body weight, Body Mass Index, fat-free mass and muscle mass in the phases of response to trauma (p<0.005).

Conclusion:

metabolic alterations in the different phases of the metabolic response to trauma led to a depletion of the nutritional status of burn patients of both sexes during hospitalization.

Descriptors:
Burns; Nutritional Assessment; Nutritional Status; Body Composition; Bioelectrical Impedance

Variables	n (%)
Sex
Male	28 (48.3)
Female	30 (51.7)
Race
White	12 (20.7)
Black	31 (53.4)
Others	15 (25.9)
Originating from
Urban area	38 (65.5)
Rural area	20 (34.5)
Education
Elementary school	39 (67.2)
High school	17 (29.3)
Higher education	2 (3.4)
Comorbidities
Diabetes mellitus	1 (1.7)
Hypertension	9 (15.5)
Etiological agent
Overheated liquids	23 (39.7)
Flammable liquids	14 (24.1)
Electricity	9 (15.5)
Flames	3 (5.2)
Chemicals	5 (8.6)
Others	4 (6.9)
Severity of injury
1^st degree	1 (1.7)
2^nd degree	52 (89.7)
3^rd degree	5 (8.6)
Nature of injury
Accidental	52 (89.7)
Violence	2 (3.4)
Self-harm	4 (6.9)
Where it took place
Home	41 (70.7)
Work	11 (19.0)
Outside	6 (10.3)
Area of body affected
Head/neck	22 (37.9)
Trunk	21 (36.2)
Upper limbs	35 (60.3)
Lower limbs	26 (44.8)

Variables	Admission (ebb phase)	7^th day (flow phase)	p value
Glycemia^ Wilcoxon t test for non-normally distributed variables for variables with non-normal distribution. p<0.05. , mg/dL	88.0 (81.7 - 97.5)	88.0 (82.0 - 92.7)	0.317
HB^* * Paired Student’s t test for normally distributed variables; , g/dL	13.9±1.5	13.2±1.4	<0.001
HT^* * Paired Student’s t test for normally distributed variables; , %	40.6±4.2	39.2±4.3	0.010
MCV^* * Paired Student’s t test for normally distributed variables; , fL	87.9±5.8	88.2±5.4	0.235
MCHC^ Wilcoxon t test for non-normally distributed variables for variables with non-normal distribution. p<0.05. , g/dL	34.1 (33.2 - 35.1)	34.0 (33.0 - 34.6)	0.023
MCH^* * Paired Student’s t test for normally distributed variables; , pg	30.7±2.0	30.7±2.3	0.791
Urea^ Wilcoxon t test for non-normally distributed variables for variables with non-normal distribution. p<0.05. , mg/dL	28.0 (23.0 - 32.0)	29.0 (27.0 - 35.2)	0.003
Creatinine^ Wilcoxon t test for non-normally distributed variables for variables with non-normal distribution. p<0.05. , mg/dL	0.6 (0.5 -0.7)	0.7 (0.6 -0.8)	0.021
Sodium^ Wilcoxon t test for non-normally distributed variables for variables with non-normal distribution. p<0.05. , mg/dL	139.0 (136.0 - 140.0)	137.0 (136.0 - 140.0)	0.284
Potassium^ Wilcoxon t test for non-normally distributed variables for variables with non-normal distribution. p<0.05. , mg/dL	4.2 (3.9 - 4.5)	4.2 (4.0 - 4.5)	0.167
Albumin^ Wilcoxon t test for non-normally distributed variables for variables with non-normal distribution. p<0.05. , mg/dL	3.6 (3.4 - 4.0)	3.5 (3.5 - 3.9)	0.269
Total proteins^ Wilcoxon t test for non-normally distributed variables for variables with non-normal distribution. p<0.05. , mg/dL	6.9 (6.7 - 7.0)	6.9 (6.7 - 7.0)	0.977
CRP^ Wilcoxon t test for non-normally distributed variables for variables with non-normal distribution. p<0.05. , mg/L	6.3 (1.5 - 9.0)	1.2 (1.2 - 5.4)	<0.001
WBC^* * Paired Student’s t test for normally distributed variables; , x10³	10.9±3.4	10.1±2.3	0.062
Platelets^* * Paired Student’s t test for normally distributed variables; , x10³	267.9±93.6	231.2±65.0	0.006

Variables	Female (n=30)			Male (n=28)
Variables	Admission (ebb phase)	7^th day (flow phase)	P value	Admission (ebb phase)	7^th day (flow phase)	P value
Weight	73.5±15.9	72.2±15.6	<0.001^* * p<0.05.	69.2±11.3	67.3±10.1	<0.001^* * p<0.05.
BMI	28.9±5.4	28.4±5.3	<0.001^* * p<0.05.	24.2±3.8	23.6±3.5	<0.001^* * p<0.05.
BMR	1400.0±224.7	1332.7±218.9	<0.001^* * p<0.05.	1626.9±223.4	1552.4±203.9	<0.001^* * p<0.05.
TBF	37.3±3.1	36.8±6.2	<0.001^* * p<0.05.	18.5±5.9	17.7±6.0	<0.001^* * p<0.05.
FFM	46.2±7.3	43.9±7.0	<0.001^* * p<0.05.	53.8±7.5	51.1±7.1	0.001^* * p<0.05.
FM	26.4±11.1	28.1±10.2	0.017^* * p<0.05.	15.2±7.3	16.0±7.9	0.362
SMM	19.6±3.2	18.4±2.7	0.001^* * p<0.05.	28.2±3.9	27.0±4.0	0.021^* * p<0.05.
SMMI	28.0±5.7	26.4±5.6	0.003^* * p<0.05.	42.4±6.7	40.7±7.6	0.031^* * p<0.05.
SMMI	7.7±1.1	7.2±0.8	0.001^* * p<0.05.	9.9±1.2	9.4±1.2	0.020^* * p<0.05.
TBW	70.8±2.9	70.9±3.0	0.850	71.5±2.5	72.2±3.9	0.166

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[1] Corresponding author: Andressa Maranhão de Arruda, E-mail: andressa.maranhao@upe.br