Abstracts Health Sciences

Extreme Band Engineering of III-Nitride NanowireHeterostructures for Electronic and Photonic Application

by Rebecca A Coffey

Diabetes is an increasing chronic health problem in the United States with projections that by 2050, 15 out of every 1,000 people will have diabetes. Costs are high with an estimated 1 in every 5 health care dollars spent on care. Diabetes complications including peripheral neuropathy, retinopathy, and gait instability put this population at higher risk for burn injury. It’s estimated that 10% of all burn patients have diabetes and incidence increases with age. The presence of diabetes in burn patients has profound effects on treatment, resource utilization, and outcomes. Treatment is complicated by the micro-vascular complications associated with diabetes and the hypermetabolic response associated with burn injuries. The relationship between glycemic control and the stress response on wound healing, predisposes burn patients with diabetes to more infections, more surgeries, and longer lengths of hospital stay, thus more resource utilization. Conceptual frameworks, such as the Andersen and Aday Behavioral Model of Health Services Utilization contribute to a greater understanding of throughput in relation to health outcomes and resource utilization. The purpose of this study was to gain an understanding of the impact the cormorbidity of diabetes patients in the United States adult burn patients. Greater knowledge about the trends, burn type, severity, and outcomes in this population is needed to develop care strategies to improve outcomes and reduce or control resource utilization. This descriptive cross sectional design used the National Burn Repository 2012 data to identify the trend, describe the differences in burn patients with and without diabetes, and to compare resource utilization between the groups. This sample of 58,707 adult burn patients included patients from 91 of the 127 burn centers in the United States over a 9.5 year period. Findings included a significant increasing trend for burn patients to experience a comorbidity of diabetes so that in 2002, 4.8% of burn patients also had diabetes increasing to 16.68% in 2011. In all age groups, patients with diabetes were significantly older (p < .0001), had higher percent of full thickness burns (p < .0001), and had higher rates of inhalation injury (p < .0001). Patients with diabetes had significantly higher mortality rates in all age groups when compared to their counterparts without diabetes (p < 0.0001). Burn patients with diabetes had significantly longer hospital days [12.99 vs. 10.52 days (p < .0001)], more intensive care unit days [7.30 vs. 5.59 days (p < .0001)], more ventilator days [3.49 vs. 3.04 days (p = 0.0475)], and higher adjusted charges [136,849 vs. 101,318 (p < 0.0001)]. There were no significant differences in total body surface areas burned (p = 0.1395) or percent partial thickness area between the two groups (p = 0.8980). This study provides evidence that the incidence of diabetes in burn patients is on the rise and overall these patients are older, have more severe burns, have poorer outcomes, and use more health care resources. There… Advisors/Committee Members: Salsberry, Pamela (Advisor).