16: INCREASED CARBOHYDRATE INTAKE IS ASSOCIATED WITH SURVIVAL IN PATIENTS WITH SEVERE BURNS
Bibliographic record
Abstract
Introduction: There is some limited data from randomized controlled trials (RCT) that indicate higher carbohydrate, lower fat intake may reduce the incidence of pneumonia for patients with severe burns. Our study is a post-hoc analysis of a large RCT which evaluated glutamine for adults with severe burns. We sought to evaluate the association between macronutrient intake and mortality and long-term outcomes in these subjects. Methods: This is a post-hoc analysis of RE-ENERGIZE, which was a multicenter, international, randomized trial that enrolled 1200 subjects, evaluating glutamine versus an isocaloric control (maltodextrin). Adults with ≥10-20% total body surface area (TBSA) burns requiring skin grafting were included and both short and long-term outcomes were collected. The research protocol for the post-hoc analysis was approved by our Research Regulatory Compliance Division. The resting energy expenditure (REE) was estimated for this analysis using the Milner equation. We included subjects who had 12 full days of nutrition information for this analysis. The average daily macronutrient intake was divided by the REE to determine the %REE achieved. Results: There were 252 subjects from 45 burn centers who met the inclusion criteria as follows: median of 46 years of age (IQR: 31-59) with 35% TBSA burn (IQR: 26-46). The Milner equation REE was 2618 kcal/day (IQR: 2301-2930), and overall subjects achieved a median of 88% REE (IQR: 75-107) during the first 12 hospital days. There was a significant difference in the carbohydrate % REE between those who lived versus those who died [35% (IQR: 28-45) versus 31% (IQR: 25-38), respectively, p=0.045], but no difference in the fat or protein intake. Multiple logistic regression (which adjusted for age and burn size) found for every 1% increase in carbohydrate % REE over the first 12 hospital days, the odds ratio for survival increased by 3.8%. Higher carbohydrate (% REE) was also found to be associated with improved general health perceptions (p=0.005, R2=0.07) and improved vitality (p=0.040, R2=0.04) at 6 months. Conclusions: In summary, higher carbohydrate intake during the first 12 days of hospitalization was associated with survival and may also be associated with improved long-term outcomes for patients with severe burns.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".