Long-term mortality among older adults with burn injury: a population-based study in Australia

Abstract

ObjectiveTo assess if burn injury in older adults is associated with changes in long-term all-cause mortality and to estimate the increased risk of death attributable to burn injury.MethodsWe conducted a population-based matched longitudinal study – based on administrative data from Western Australia’s hospital morbidity data system and death register. A cohort of 6014 individuals who were aged at least 45 years when hospitalized for a first burn injury in 1980–2012 was identified. A non-injury comparison cohort, randomly selected from Western Australia’s electoral roll (n = 25 759), was matched to the patients. We used Kaplan–Meier plots and Cox proportional hazards regression to analyse the data and generated mortality rate ratios and attributable risk percentages.FindingsFor those hospitalized with burns, 180 (3%) died in hospital and 2498 (42%) died after discharge. Individuals with burn injury had a 1.4-fold greater mortality rate than those with no injury (95% confidence interval, CI: 1.3–1.5). In this cohort, the long-term mortality attributable to burn injury was 29%. Mortality risk was increased by both severe and minor burns, with adjusted mortality rate ratios of 1.3 (95% CI: 1.1–1.9) and 2.1 (95% CI: 1.9–2.3), respectively.ConclusionBurn injury is associated with increased long-term mortality. In our study population, sole reliance on data on in-hospital deaths would lead to an underestimate of the true mortality burden associated with burn injury.

Respiratory Morbidity After Childhood Burns: A 10-Year Follow-up Study

“…The project methodology has been reported previously. 22,30 WADLS staff provided a de-identified extraction of hospital records for individuals <5 years of age when admitted to a hospital in Western Australia with a first burn between January 1, 1980 and June 30, 2012 by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 940-949 or International Classification of Diseases, Tenth Revision, Australian Modification (ICD-10-AM) codes T20-T31. A first (index) burn injury was defined as the first hospital admission with a burn identified as the principal or additional diagnosis.…”

Burn Injury Leads to Increased Long-Term Susceptibility to Respiratory Infection in both Mouse Models and Population Studies

“…Advances in medical management in recent years have resulted in significant declines in hospital mortality,[5, 6]. However, population-based research has shown burn survivors experience decreased long-term survival [7, 8], whilst increased long-term morbidity has been shown both in population studies and other models of burn injury [9–11]. …”

Understanding the long-term impacts of burn on the cardiovascular system

“…[16] Recent analysis of population-based health administrative data identified increased long-term mortality after both severe and minor burn injury. [17,18] Given the potential for longer-term impacts of burns on the heart, the aim of this study was to use population-based linked health administrative data to assess if adults 45 years and older surviving a burn injury have increased longer-term hospital service use for circulatory diseases and mortality caused by circulatory diseases, controlling for demographic factors and pre-existing comorbidities.…”