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

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 - R...

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Main Authors: Randall, Sean, Fear, M., Wood, F., Rea, S., Boyd, James, Duke, Janine
Format: Journal Article
Published: BM J Group 2015
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/18303
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author Randall, Sean
Fear, M.
Wood, F.
Rea, S.
Boyd, James
Duke, Janine
author_facet Randall, Sean
Fear, M.
Wood, F.
Rea, S.
Boyd, James
Duke, Janine
author_sort Randall, Sean
building Curtin Institutional Repository
collection Online Access
description 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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spelling curtin-20.500.11937-183032017-09-13T16:05:29Z Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study Randall, Sean Fear, M. Wood, F. Rea, S. Boyd, James Duke, Janine musculoskeletal diseases linked administrative health data burns hospitalisation rate long-term morbidity 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. 2015 Journal Article http://hdl.handle.net/20.500.11937/18303 10.1136/bmjopen-2015-009395 BM J Group fulltext
spellingShingle musculoskeletal diseases
linked administrative health data
burns
hospitalisation rate
long-term morbidity
Randall, Sean
Fear, M.
Wood, F.
Rea, S.
Boyd, James
Duke, Janine
Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study
title Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study
title_full Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study
title_fullStr Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study
title_full_unstemmed Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study
title_short Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study
title_sort long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study
topic musculoskeletal diseases
linked administrative health data
burns
hospitalisation rate
long-term morbidity
url http://hdl.handle.net/20.500.11937/18303