Hepatic Functional Pathophysiology and Morphological Damage Following Severe Burns: A Systematic Review and Meta-analysis.

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Title: Hepatic Functional Pathophysiology and Morphological Damage Following Severe Burns: A Systematic Review and Meta-analysis.
Authors: Tapking, Christian, Kilian, Katja, Hundeshagen, Gabriel, Haug, Valentin, Teufel, Andreas, Houschyar, Khosrow S, Kneser, Ulrich, Hirche, Christoph
Source: Journal of Burn Care & Research; Sep/Oct2022, Vol. 43 Issue 5, p1074-1080, 7p
Subject Terms: BURNS & scalds complications, RESEARCH, META-analysis, LIVER, RESEARCH methodology, SYSTEMATIC reviews, EVALUATION research, COMPARATIVE studies, AMINOTRANSFERASES, NECROSIS
Abstract: Severe burns are devastating injuries affecting multiple organ systems. Little is known about the influence on the hepatic system and its physiology. This systematic review aimed to assess the current state of research on morphologic liver damage following severe burns. A search was conducted in PubMed, Web of Science, and Cochrane databases using PRISMA guidelines. Outcomes included serum levels of transaminases, fatty infiltration, and necrosis. Weighted individual study estimates were used to calculate pooled transaminase levels and necrosis/fatty infiltration rates using a random-effects approach. Risk ratios or odds ratios and 95% confidence intervals (CIs) were used to describe pooled estimates for risk factors. The literature search retrieved 2548 hits, of which 59 studies were included in qualitative synthesis, and finally 10 studies were included in the meta-analysis. Studies were divided into those reporting autopsies and those reporting changes of serum transaminase levels. The majority of liver autopsies showed fatty infiltration, 82% (95% CI 39-97%) or necrosis of the liver, 18% (95% CI 13-24%). Heterogeneity in studies on hepatic functional damage following severe burns was high. Only a few were well-designed and published in recent years. Many studies could not be included because of insufficient numerical data. There is a high number of patients dying from burns that present with fatty infiltration or necrosis of hepatic tissue. Transaminases were elevated during the initial days postburn. Further research on how severe burns affect the hepatic function and outcome, especially long-term, is necessary. Systematic review registration: PROSPERO:CRD42020206061. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Burn Care & Research is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Hepatic Functional Pathophysiology and Morphological Damage Following Severe Burns: A Systematic Review and Meta-analysis.
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  Data: <searchLink fieldCode="AR" term="%22Tapking%2C+Christian%22">Tapking, Christian</searchLink><br /><searchLink fieldCode="AR" term="%22Kilian%2C+Katja%22">Kilian, Katja</searchLink><br /><searchLink fieldCode="AR" term="%22Hundeshagen%2C+Gabriel%22">Hundeshagen, Gabriel</searchLink><br /><searchLink fieldCode="AR" term="%22Haug%2C+Valentin%22">Haug, Valentin</searchLink><br /><searchLink fieldCode="AR" term="%22Teufel%2C+Andreas%22">Teufel, Andreas</searchLink><br /><searchLink fieldCode="AR" term="%22Houschyar%2C+Khosrow+S%22">Houschyar, Khosrow S</searchLink><br /><searchLink fieldCode="AR" term="%22Kneser%2C+Ulrich%22">Kneser, Ulrich</searchLink><br /><searchLink fieldCode="AR" term="%22Hirche%2C+Christoph%22">Hirche, Christoph</searchLink>
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  Data: Journal of Burn Care & Research; Sep/Oct2022, Vol. 43 Issue 5, p1074-1080, 7p
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  Data: <searchLink fieldCode="DE" term="%22BURNS+%26+scalds+complications%22">BURNS & scalds complications</searchLink><br /><searchLink fieldCode="DE" term="%22RESEARCH%22">RESEARCH</searchLink><br /><searchLink fieldCode="DE" term="%22META-analysis%22">META-analysis</searchLink><br /><searchLink fieldCode="DE" term="%22LIVER%22">LIVER</searchLink><br /><searchLink fieldCode="DE" term="%22RESEARCH+methodology%22">RESEARCH methodology</searchLink><br /><searchLink fieldCode="DE" term="%22SYSTEMATIC+reviews%22">SYSTEMATIC reviews</searchLink><br /><searchLink fieldCode="DE" term="%22EVALUATION+research%22">EVALUATION research</searchLink><br /><searchLink fieldCode="DE" term="%22COMPARATIVE+studies%22">COMPARATIVE studies</searchLink><br /><searchLink fieldCode="DE" term="%22AMINOTRANSFERASES%22">AMINOTRANSFERASES</searchLink><br /><searchLink fieldCode="DE" term="%22NECROSIS%22">NECROSIS</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Severe burns are devastating injuries affecting multiple organ systems. Little is known about the influence on the hepatic system and its physiology. This systematic review aimed to assess the current state of research on morphologic liver damage following severe burns. A search was conducted in PubMed, Web of Science, and Cochrane databases using PRISMA guidelines. Outcomes included serum levels of transaminases, fatty infiltration, and necrosis. Weighted individual study estimates were used to calculate pooled transaminase levels and necrosis/fatty infiltration rates using a random-effects approach. Risk ratios or odds ratios and 95% confidence intervals (CIs) were used to describe pooled estimates for risk factors. The literature search retrieved 2548 hits, of which 59 studies were included in qualitative synthesis, and finally 10 studies were included in the meta-analysis. Studies were divided into those reporting autopsies and those reporting changes of serum transaminase levels. The majority of liver autopsies showed fatty infiltration, 82% (95% CI 39-97%) or necrosis of the liver, 18% (95% CI 13-24%). Heterogeneity in studies on hepatic functional damage following severe burns was high. Only a few were well-designed and published in recent years. Many studies could not be included because of insufficient numerical data. There is a high number of patients dying from burns that present with fatty infiltration or necrosis of hepatic tissue. Transaminases were elevated during the initial days postburn. Further research on how severe burns affect the hepatic function and outcome, especially long-term, is necessary. Systematic review registration: PROSPERO:CRD42020206061. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of Journal of Burn Care & Research is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1093/jbcr/irab239
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      – Code: eng
        Text: English
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        PageCount: 7
        StartPage: 1074
    Subjects:
      – SubjectFull: BURNS & scalds complications
        Type: general
      – SubjectFull: RESEARCH
        Type: general
      – SubjectFull: META-analysis
        Type: general
      – SubjectFull: LIVER
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      – SubjectFull: RESEARCH methodology
        Type: general
      – SubjectFull: SYSTEMATIC reviews
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      – SubjectFull: EVALUATION research
        Type: general
      – SubjectFull: COMPARATIVE studies
        Type: general
      – SubjectFull: AMINOTRANSFERASES
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      – SubjectFull: NECROSIS
        Type: general
    Titles:
      – TitleFull: Hepatic Functional Pathophysiology and Morphological Damage Following Severe Burns: A Systematic Review and Meta-analysis.
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            NameFull: Tapking, Christian
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            NameFull: Kilian, Katja
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            NameFull: Hundeshagen, Gabriel
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            NameFull: Houschyar, Khosrow S
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            – D: 01
              M: 09
              Text: Sep/Oct2022
              Type: published
              Y: 2022
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