Dr Alexandria Turner1, Dr Megan Grigg1, Dr Jason Brown1
1Royal Brisbane and Women’s Hospital, Herston, Australia
In patients with burns >30% Total Body Surface Area (TBSA), Oxandrolone is routinely prescribed after resuscitative and damage control surgery, ideally between day 3-7 of admission, to attenuate the hypermetabolic response and ceased when 80% of lost body weight had been regained and the patient had returned to a level of function allowing for independent daily activities.
The aim of the audit was to evaluate the characteristics of burns patients admitted to Royal Brisbane and Women’s Hospital Burns Unit between January 2017 and December 2018 who received oxandrolone and whether the indication, length of treatment/cessation was appropriate.
A total of 16 patients were identified with a mean TBSA of 63% and an average length of stay of 119 days. The average time to start Oxandrolone was day 18 post injury. Treatment length ranged from 4 – 165days. Patients lost on average 13.5% of Total Body Weight (TBW) and only 20% of patients regained 80% of TBW prior to discharge. Patients weight was recorded 93.75% on admission with weight recorded anywhere from 3days to 8weeks later. Reason for cessation of Oxandrolone was unclear in half of patients. 68.75% of patients had mild liver dysfunction during treatment but did not necessitate cessation of Oxandrolone.
In conclusion, patients are commenced on Oxandrolone on average at least 7 days later than studies recommend. It is unclear whether Oxandrolone is being ceased appropriately as reason for cessation are poorly documented, as are recording of patient weights. LFTs should be monitored at least weekly for the duration of Oxandrolone treatment and post cessation to ensure resolution of liver dysfunction.
Dr Alexandria Turner is a General Surgery PHO at Toowoomba Hospital. She has previously worked at the Royal Brisbane and Womens Stuart Pegg Burns Centre.