TY - JOUR PY - 2015// TI - Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study JO - BMJ open A1 - Randall, Sean M. A1 - Fear, Mark W. A1 - Wood, Fiona M. A1 - Rea, Suzanne A1 - Boyd, James H. A1 - Duke, Janine M. SP - e009395 EP - e009395 VL - 5 IS - 9 N2 - 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

LA - en SN - 2044-6055 UR - http://dx.doi.org/10.1136/bmjopen-2015-009395 ID - ref1 ER -