Hypothyroidism in Severe Burn Patients Associated with Increased Risk of Musculoskeletal Complications and Decreased Risk of Mortality

Severe burn patients are prone to developing various musculoskeletal, dermatological, and cardiovascular complications, and hypothyroidism is associated with derangements of these same systems. This study aims to explore the association between hypothyroidism and the emergence of these complications in severe burn patients. Patients with severe burns, defined as those encompassing ≥20% total body surface area, were identified in the TriNetX US Collaborative Network and were categorized into 2 groups based on a history of hypothyroidism. Risk ratios (RRs) and differences of contractures, undergoing graft procedures, graft complications, amputations, and various infections and cardiovascular complications were generated using the database's measure of association analysis. The hypothyroidism cohort showed a greater risk of developing contractures (RR, 1.667; 95% confidence interval [CI], [1.207, 2.302]; P = .002), skin infections (RR, 1.885; CI, [1.192, 2.980]; P = .006), and urinary tract infections (RR, 1.950; CI, [1.155, 3.292]; P = .011) within 6 months of insult. The hypothyroidism cohort showed a decreased risk of mortality (RR, 0.688; CI, [0.516, 0.915]; P < .010), undergoing graft procedures (RR, 0.647; CI, [0.518, 0.807]; P < .001), and vasopressor use (RR, 0.806; CI, [0.667, 0.974]; P = .025) in this same time period. In conclusion, hypothyroidism in severe burn patients is associated with an increased risk of developing contractures and skin and urinary tract infections and a decreased risk of mortality, undergoing graft procedures, and vasopressor use.