B54-33 Perioperative Predictors of Early Infection and Prolonged Hospitalization in Burn Patients: A Retrospective Observational Study

Abstract Rationale Burn surgery represents a unique anesthetic and metabolic challenge, where systemic inflammation and tissue stress may predispose to postoperative complications. Identifying clinical and demographic predictors of infection or prolonged hospitalization remains crucial to refine perioperative strategies. Despite advances in multidisciplinary management, evidence on intraoperative risk modifiers in burn patients remains limited. This study aimed to analyze demographic, clinical, and intraoperative variables associated with early infection and extended hospital stay in a high-complexity burn population. Methods A retrospective analytical study was conducted in 152 adult burn patients admitted between 2023 and 2024 to a tertiary burn center. Variables included demographics, comorbidities, burn type, degree, total body surface area (TBSA), anatomical zone, anesthesia type and duration, analgesia regimen, time to mobilization, and diet initiation. Outcomes were early postoperative infection (≤48 hours) and prolonged hospitalization (13 days, median-based). Comparative analyses employed chi-square, Mann-Whitney U, and Kruskal-Wallis tests. Variables with p 0.05 were further explored as potential independent predictors. Results Of 152 patients, 68% were male, with second-degree burns in 61% and a median TBSA of 10% (IQR: 5-19). Ninety percent involved special anatomical zones. Median hospital stay was 13 days (IQR: 8-23). Early mobilization occurred in 42% and early diet initiation (24h) in 72%. No significant associations were observed between prolonged hospitalization and demographic or baseline clinical variables, including sex (p = 0.92), age (p = 0.36), BMI (p = 0.51), hypertension (p = 0.161), diabetes (p = 0.081), COPD (p = 0.303), burn degree (p = 0.350), or TBSA (p = 0.092). Notably, anesthesia duration 100 minutes was the only independent predictor significantly associated with early infection (p = 0.042). Early infection, in turn, correlated with prolonged hospital stay (p = 0.013). Delayed diet initiation (24h) also predicted longer hospitalization (p = 0.003). No differences were found regarding anesthesia type (p = 0.820), use of regional blocks (p = 0.795), or intraoperative analgesic technique (p = 0.953). Conclusion Demographic and baseline clinical factors showed no significant influence on early infection or hospital stay in surgical burn patients. However, prolonged anesthesia duration (100 minutes) emerged as an independent risk factor for early infection, which itself predicted extended hospitalization. These findings suggest that optimizing surgical timing, minimizing anesthesia exposure, and promoting early postoperative nutrition may reduce complications and improve recovery trajectories in burn surgery. This abstract is funded by: None