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    Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study

    228611_163135_Long-term_musculoskeletal_.pdf (1.084Mb)
    Access Status
    Open access
    Authors
    Randall, Sean
    Fear, M.
    Wood, F.
    Rea, S.
    Boyd, James
    Duke, Janine
    Date
    2015
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Randall, S. and Fear, M. and Wood, F. and Rea, S. and Boyd, J. and Duke, J. 2015. Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study. BMJ Open. 5: e009395.
    Source Title
    BMJ Open
    DOI
    10.1136/bmjopen-2015-009395
    ISSN
    20446055
    School
    Centre for Population Health Research
    Remarks

    This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by-nc/4.0/

    URI
    http://hdl.handle.net/20.500.11937/18303
    Collection
    • Curtin Research Publications
    Abstract

    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 health data from the Western Australian Data Linkage System. Subjects - Records of 17,753 persons aged at least 20 years when hospitalised for a first burn injury in Western Australia during the period 1980–2012, and 70,758 persons who were age and gender-frequency matched with no injury admissions randomly selected from Western Australia's electoral roll. Main outcome measures - Admission rates and cumulative length of stay for musculoskeletal diseases. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and HRs with 95% CIs, respectively. Results - After adjustment for pre-existing health status and demographic characteristics, the burn cohort had almost twice the hospitalisation rate for a musculoskeletal condition (IRR, 95% CI 1.98, 1.86 to 2.10), and spent 3.70 times as long in hospital with a musculoskeletal diagnosis (95% CI 3.10 to 4.42) over the 33-year period, than the uninjured comparison cohort. Adjusted survival analyses of incident post-burn musculoskeletal disease admissions found significant increases for the 15-year post burn discharge period (0–6 months: HR, 95% CI 2.51, 2.04 to 3.11; 6 months–2 years: HR, 95% CI 1.77, 1.53 to 2.05; 2–15 years: HR, 95% CI 1.32, 1.23 to 1.42). Incident admission rates were significantly elevated for 20 years post-burn for minor and severe burn injury for a range of musculoskeletal diseases that included arthropathies, dorsopathies, osteopathies and soft tissue disorders. Conclusions - Minor and severe burn injuries were associated with significantly increased post-burn incident admission rates, long-term hospital use and prolonged length of stay for a range of musculoskeletal diseases. Further research is required that facilitates identification of at-risk patients and appropriate treatment pathways, to reduce the long-term morbidity associated with burns.

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    • Increased admissions for musculoskeletal diseases after burns sustained during childhood and adolescence
      Duke, J.; Randall, S.; Fear, M.; Boyd, James; Rea, S.; Wood, F. (2015)
      © 2015 Elsevier Ltd and ISBI. Background: Severe burn triggers systemic responses that result in reduced muscle mass and bone formation, with recent evidence also suggesting systemic effects on bone after minor burn. The ...
    • Burns and long-term infectious disease morbidity: A population-based study
      Duke, J.; Randall, Sean; Wood, F.; Boyd, James H.; Fear, M. (2016)
      Background: There is a growing volume of data that indicates that serious injury suppresses immune function, predisposing individuals to infectious complications. With recent evidence showing long-term immune dysfunction ...
    • A retrospective cohort study to compare post-injury admissions for infectious diseases in burn patients, non-burn trauma patients and uninjured people
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      Background: Injury triggers a range of systemic effects including inflammation and immune responses. This study aimed to compare infectious disease admissions after burn and other types of injury using linked hospital ...
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