Evidence map›Paper›PMID 42028952›Full record

ArticleJournal of burn care & research : official publication of the American Burn Association2026

Persistent Inflammation, Immunosuppression, and Catabolism Syndrome and Serious Infections in Burn-Injured Adults: A Retrospective Single-Center Study from 1997 to 2023.

Hannah Kieffer, Michael D Santarelli, Anne L Wagner, Alvin D Jeffery, Ryan J Stark

Abstract read
In one paragraph

Article in Journal of burn care & research : official publication of the American Burn Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Hannah KiefferDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, United States.ORCID 0000-0003-1044-3465
Michael D SantarelliDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, United States.
Anne L WagnerDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States.
Alvin D JefferyDepartment of Biomedical Informatics, Vanderbilt School of Medicine, Nashville, TN 37232, United States.
Ryan J StarkDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, United States.

Funding

Vanderbilt Integrated Center of Excellence in Maternal and Pediatric Precision Therapeutics (VICE-MPRINT)P50HD106446 · NICHD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PRINCE Joseph KANNANKERIL, Digna R Velez Edwards · 2021 to 2026
$9.7M
Mechanisms of vascular dysfunction in acute systemic inflammationR35GM138191 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI STARK, RYAN J · 2020 to 2024
$2.2M
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentGordon and Betty Moore Foundation GBMF9048National Institute of General Medical Sciences of the National Institutes of Health R35GM138191National Institutes of Health or the Gordon and Betty Moore FoundationNIGMS NIH HHS R35 GM138191NIH HHS P50HD106446
6 · The paper itself

Abstract

Alterations in both the innate and adaptive immune systems can induce a significant immunocompromised state among those hospitalized after burn injury. These changes can devolve into the clinical entity known as persistent inflammation, immunosuppression, and catabolism syndrome (PIICS), characterized by profound and chronic immune dysregulation. Persistent inflammation, immunosuppression, and catabolism syndrome is defined by the presence of lymphopenia, elevated C-reactive protein levels, and evidence of catabolism through weight loss or hypoalbuminemia in the context of a prolonged hospitalization. Though PIICS has previously been described in patients with burn injuries, this immunophenotype in the setting of serious bacterial and fungal infections is poorly characterized. We performed a detailed retrospective analysis of burn-injured adults (aged 19-64 years) in a de-identified institutional database of patient medical records from 1997 to 2023. Of the 960 patients admitted for a primary burn injury, the overall prevalences of serious infections and PIICS was 38% and 25%, respectively. Both the presence of an inhalation injury and the total body surface area (TBSA) burn size correlated with the development of serious infections and PIICS. Patients with PIICS had more pathogens isolated and a higher prevalence of Acinetobacter and Stenotrophomonas infections. The immunophenotype of PIICS was strongly associated with recurrent infections during hospitalization. Detailed assessments of PIICS criteria, including trends in lymphocyte counts, may help identify the development of serious bacterial and fungal infections in burn-injured adults.

Indexed as

BurnsInflammationAdultFemaleHumansMaleMiddle AgedRetrospective StudiesSyndromeYoung Adultburn injurypersistent inflammation, immunosuppression, and catabolism syndromeserious bacterial infection

Identifiers

PMID42028952
PMCPMC13338637

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.