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Citation
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Randall SM, Fear MW, Wood FM, Rea S, Boyd JH, Duke JM. BMJ Open 2015; 5(9): e009395. |
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Affiliation
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Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia. |
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Abstract
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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.
Language: en |