Increased admissions for diabetes mellitus after burn
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Background: Currently, limited long-term data on hyperglycaemia and insulin sensitivity in burn patients are available and the data that do exist are primarily related to paediatric severe burns. The aim of this study was to assess if burn is associated with increased post-burn admissions for diabetes mellitus. Methods: A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalized for a first burn (n = 30,997) in 1980–2012 and a frequency matched non-injury comparison cohort, randomly selected from Western Australia's birth registrations and electoral roll (n = 123,399). Crude admission rates and summed length of stay for diabetes mellitus were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. Results: After adjustment for socio-demographic factors and pre-existing health status, the burn cohort had 2.21 times (95% Confidence Interval (CI): 1.36–1.56) as many admissions and almost three times the number of days in hospital with a diabetes mellitus diagnosis (IRR, 95% CI: 2.94, 2.12–4.09) than the uninjured cohort. Admission rates were significantly elevated for those burned during childhood (<18 years, IRR, 95% CI: 2.65, 1.41–4.97) and adulthood (≥18 years, IRR, 95% CI: 2.12, 1.76–2.55). Incident admissions were significantly elevated in the burn cohort during the first 5 years post-burn when compared with the uninjured (HR, 95% CI: 1.96, 1.46–2.64); no significant difference was found beyond 5 years post-burn (HR, 95% CI: 1.08, 0.82–1.41).Conclusions: Findings of increased hospital admission rates and prolonged length of hospital stay for diabetes mellitus in the burn cohort provide evidence that burns have longer term effects on blood glucose and insulin regulation after wound healing. The first five years after burn discharge appears to be a critical period with significantly elevated incident admissions for diabetes mellitus during this time. Results would suggest prolonged clinical management after discharge and or wound healing to minimise post-burn admissions for diabetes mellitus is required.
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Diabetes mellitus after injury in burn and non-burned patients: A population based retrospective cohort studyDuke, J.; Randall, S.; Fear, M.; Boyd, James; Rea, S.; Wood, F. (2018)© 2017 Elsevier Ltd and ISBI. Objective: To compare hospitalisations for diabetes mellitus (DM) after injury experienced by burn patients, non-burn trauma patients and people with no record of injury admission, adjusting ...
Randall, Sean; Fear, M.; Wood, F.; Rea, S.; Boyd, James; Duke, Janine (2015)Objective - To investigate if adults who are hospitalised for a burn injury have increased long-term hospital use for musculoskeletal diseases. Design - A population-based retrospective cohort study using linked administrative ...
A population-based retrospective cohort study to assess the mental health of patients after a non-intentional burn compared with uninjured peopleDuke, J.; Randall, Sean; Boyd, James; Wood, F.; Fear, M.; Rea, S. (2018)© 2018 Elsevier Ltd and ISBI Background: The objective of this study was to describe and quantify mental health (MH) admissions experienced by patients with unintentional burns subsequent to their injury. Methods: A ...