Baseline glucose levels moderate the association between burn-related mortality inpatients with obesity

Background: Differing findings concerning outcomes for burn patients with obesity indicate additional factors at play. One possible explanation could lie in determining metabolically healthy versus unhealthy obesity, which necessitates further study.

Methods: A retrospective study was conducted using the Cerner Health Facts® Database. Deidentified patient data from 2014 to 2018 with second or third-degree burn injuries were retrieved. A moderator analysis was conducted to determine if the association between increased body mass index (BMI) and mortality is moderated by baseline glucose level, a surrogate marker associated with metabolically unhealthy obesity.

Results: The study included 4682 adult burn patients. BMI alone was not associated with higher mortality (β = 0.106, p = 0.331). Moderation analysis revealed that baseline glucose level significantly modulated the impact of BMI on burn-related obesity; patients with higher BMI and higher baseline blood glucose levels had higher mortality than those with lower baseline blood glucose levels (β = 0.277, p = 0.009). These results remained unchanged after adjusting for additional covariates (β = 0.285, p = 0.025) and inthe sensitivity analysis.

Conclusions: Increased baseline glucose levels indicate increased mortality in obese patients with burn injuries, emphasizing the differentiation between metabolically unhealthy versus healthy obesity.