Increased admissions for diabetes mellitus after burn

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 diabet...

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Main Authors: Duke, J., Randall, Sean, Fear, M., Boyd, J., O'Halloran, E., Rea, S., Wood, F.
Format: Journal Article
Published: Pergamon Press 2016
Online Access:http://hdl.handle.net/20.500.11937/12320
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author Duke, J.
Randall, Sean
Fear, M.
Boyd, J.
O'Halloran, E.
Rea, S.
Wood, F.
author_facet Duke, J.
Randall, Sean
Fear, M.
Boyd, J.
O'Halloran, E.
Rea, S.
Wood, F.
author_sort Duke, J.
building Curtin Institutional Repository
collection Online Access
description 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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spelling curtin-20.500.11937-123202017-09-13T14:59:51Z Increased admissions for diabetes mellitus after burn Duke, J. Randall, Sean Fear, M. Boyd, J. O'Halloran, E. Rea, S. Wood, F. 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. 2016 Journal Article http://hdl.handle.net/20.500.11937/12320 10.1016/j.burns.2016.06.005 Pergamon Press restricted
spellingShingle Duke, J.
Randall, Sean
Fear, M.
Boyd, J.
O'Halloran, E.
Rea, S.
Wood, F.
Increased admissions for diabetes mellitus after burn
title Increased admissions for diabetes mellitus after burn
title_full Increased admissions for diabetes mellitus after burn
title_fullStr Increased admissions for diabetes mellitus after burn
title_full_unstemmed Increased admissions for diabetes mellitus after burn
title_short Increased admissions for diabetes mellitus after burn
title_sort increased admissions for diabetes mellitus after burn
url http://hdl.handle.net/20.500.11937/12320