25 Baseline Copper Levels are Associated with Worse Outcome in Burn Patients with Overweight and Obesity

Abstract

Abstract Introduction While copper (Cu) has been shown to be beneficial in wound healing, high levels of circulating Cu are also associated with increased oxidative stress. Interestingly, elevated baseline Cu levels have been seen in obese patients, and theoretically, this is associated with higher baseline oxidative stress. Overweight (OW) and Obesity (OB) are common conditions in the US; therefore, a significant proportion of burn patients will be potentially affected. We examined the interactive effects of Cu and obesity on outcomes of burn patients; specifically, we hypothesized that higher baseline Cu levels in OW and OB burn patients are associated with worse clinical outcomes. Methods A retrospective review of patients with burns ≥20% TBSA between 2015–2019. Patients were grouped according to body mass index (BMI) (i.e., NW:18–24.9; OW:25–29.9; and OB: ≥ 30 kg/m2). Baseline characteristics were compared using ANOVA and χ 2 tests. The interactions between baseline Cu and BMI groups on 1) lengths of ICU stay (ICUS), 2) overall hospital stay (LOS), and 3) the number of operative procedures, were examined in a series of multiple regression models in R. Results Data of 160 patients met eligibility (NW: OW: OB = 53: 38: 69). BMI groups did not differ significantly on demographics, TBSA, degree of burn, inhalational injury, or mortality. Regression models revealed that NW patients with high baseline Cu levels had shorter ICUS (p< 0.001) and LOS (p=0.003) and also had fewer operations (p = 0.001). While OW and OB were protective at low Cu levels, patients with OW or OB who had high baseline Cu levels had longer ICUS (p< 0.001 and p=0.033), LOS (p=0.001 and p=0.063), and a greater number of operations (p< 0.001 and p=0.066) (Table 1). Conclusions High baseline Cu seems to be beneficial for NW burn patients, yet associated with adverse outcomes in burn patients with OW and OB. While further evidence is needed to confirm this notion, caution is advised when supplementing Cu for burn patients with OW and OB.