Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
Impact of proton pump inhibitors on infectious and wound outcomes in burn patients.
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Wang Sarah, Dao Matthew Q, Won Paul, Stanton Eloise W, Gillenwater Justin T, Johnson Maxwell, Yenikomshian Haig A
Аннотация
INTRODUCTION: Proton pump inhibitors (PPIs) are commonly used for stress ulcer prophylaxis in critically ill patients, but they have adverse effects such as heightened infection risk. We evaluated the complex risk-benefit profile and impact of PPI use on long-term clinical and wound healing outcomes in burn patients.
METHODS: A retrospective analysis was conducted by using data extracted from the TriNetX database between 2015 and 2025. Adult patients receiving PPIs within one month of burn injury were identified (n= 52,100) and 1:1 propensity score matched to a control group of patients not receiving PPIs (n= 692,534). Outcomes were assessed using risk ratios (RR) at 90 days and 1-year post-burn; p-values < 0.05 were considered statistically significant.
RESULTS: After matching, each group included 42,239 patients. At 90 days post-burn, the PPI cohort showed significantly increased rates of pneumonia (RR=2.38), ventilator use (RR=2.13), sepsis (RR=2.91), mortality (RR=1.95), blood transfusion (RR=2.22), and hospital readmission (RR=1.40). Additionally, the PPI cohort showed elevated risk for wound dehiscence (RR=2.05), wound infection (RR=2.68), hematoma formation (RR=2.61), and seroma formation (RR=2.10). All outcomes remained significant at 1-year post-burn (p < 0.05).
CONCLUSION: Early PPI use after burn injury is associated with higher rates of infection, delayed wound healing, and increased mortality. It remains uncertain to what extent the observed complications reflect a direct effect of PPIs versus the severity of illness that prompted PPI use. Prospective studies are warranted to further compare the effects of different types of stress ulcer prophylaxis.
METHODS: A retrospective analysis was conducted by using data extracted from the TriNetX database between 2015 and 2025. Adult patients receiving PPIs within one month of burn injury were identified (n= 52,100) and 1:1 propensity score matched to a control group of patients not receiving PPIs (n= 692,534). Outcomes were assessed using risk ratios (RR) at 90 days and 1-year post-burn; p-values < 0.05 were considered statistically significant.
RESULTS: After matching, each group included 42,239 patients. At 90 days post-burn, the PPI cohort showed significantly increased rates of pneumonia (RR=2.38), ventilator use (RR=2.13), sepsis (RR=2.91), mortality (RR=1.95), blood transfusion (RR=2.22), and hospital readmission (RR=1.40). Additionally, the PPI cohort showed elevated risk for wound dehiscence (RR=2.05), wound infection (RR=2.68), hematoma formation (RR=2.61), and seroma formation (RR=2.10). All outcomes remained significant at 1-year post-burn (p < 0.05).
CONCLUSION: Early PPI use after burn injury is associated with higher rates of infection, delayed wound healing, and increased mortality. It remains uncertain to what extent the observed complications reflect a direct effect of PPIs versus the severity of illness that prompted PPI use. Prospective studies are warranted to further compare the effects of different types of stress ulcer prophylaxis.