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Understanding the long-term impacts of burn on the cardiovascular system
Janine M Duke1, Sean M Randall2, Mark W Fear1
1Burn Injury Research Unit, School of Surgery, University of Western Australia, Western Australia, Perth, Australia.
Insights
Burn survivors, especially older adults, face increased long-term risks of circulatory system diseases, including higher hospital admissions and mortality. This highlights the lasting systemic impact of burns on cardiovascular health.
Area of Science:
- Cardiology
- Burn Medicine
- Public Health
Background:
- Burns cause significant systemic effects beyond skin damage, impacting major organs like the heart.
- Long-term consequences of burn injuries on cardiovascular health in older adults remain understudied.
Purpose of the Study:
- To investigate the association between burn injury and long-term hospital admissions and mortality due to circulatory system diseases in adults aged 45 and older.
Main Methods:
- A population-based longitudinal study compared 6004 adults hospitalized for a first burn with 22,673 uninjured individuals.
- Linked hospital morbidity and death data from Western Australia (1980-2012) were analyzed.
- Statistical models (Negative Binomial, Cox Proportional Hazards) assessed admission rates and mortality ratios for circulatory diseases.
Main Results:
- The burn cohort experienced 1.46 times more admissions and nearly three times more hospital days for circulatory diseases compared to the uninjured cohort.
- Burn survivors showed elevated admission rates for ischemic heart disease, heart failure, and cerebrovascular disease.
- Long-term mortality due to circulatory system diseases was significantly increased in the burn cohort (MRR 1.11).
Conclusions:
- Burn injuries are associated with significant, long-lasting systemic impacts on the circulatory system.
- Increased hospital admissions, prolonged hospital stays, and higher mortality rates for circulatory diseases underscore the chronic nature of burn sequelae.
- Findings emphasize the need for ongoing cardiovascular monitoring and care for burn survivors.
Background:
Whilest the most obvious impact of burn is on the skin, systemic responses also occur after burn that lead to wide-spread changes to the body, including the heart. The aim of this study was to assess if burn in mid-aged and older adults is associated with increased long-term admissions and death due to diseases of the circulatory system.
Methods:
A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of adults aged at least 45 years when hospitalized for a first burn (n=6004) in 1980-2012 and a frequency matched non-injury comparison cohort, randomly selected from Western Australia's electoral roll (n=22,673). Crude admission rates and cumulative length of stay for circulatory diseases were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. HR was used as a measure of the mortality rate ratio (MRR).
Results:
After adjustment for demographic factors and pre-existing health status, the burn cohort had 1.46 times (95% confidence interval (CI): 1.36-1.56) as many admissions and almost three times the number of days in hospital with a circulatory system diagnosis (IRR, 95%CI: 2.90, 2.60-3.25) than the uninjured cohort for circulatory diseases. The burn cohort had higher admission rates for ischaemic heart disease (IRR, 95%CI: 1.21, 1.07-1.36), heart failure (IRR, 95%CI: 2.29, 1.85-2.82) and cerebrovascular disease (IRR, 95%CI: 1.57, 1.33-1.84). The burn cohort was found to have increased long-term mortality caused by circulatory system diseases (MRR, 95%CI: 1.11, 1.02-1.20).
Conclusions:
Findings of increased hospital admission rates, prolonged length of hospital stay and increased long-term mortality related to circulatory system diseases in the burn cohort provide evidence to support that burn has long-lasting systemic impacts on the heart and circulation.
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