scholarly journals The Western Australia Population-based Burn Injury Project: Using record linkage to examine long-term effects of burn injury

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Janine Duke ◽  
James Boyd ◽  
Sean Randall ◽  
Mark Fear ◽  
Fiona Wood
Keyword(s):  
Western Australia ◽  
Record Linkage ◽  
Burn Injury ◽  
Population Based ◽  
Burn Patients ◽  
Long Term Effects ◽  
Admission Rates ◽  
Severe Burns ◽  
Disease Specific

ABSTRACTObjectivesWhile the most obvious impact of a burn is a visible scar, there are hidden impacts. The main contributors to adverse health outcomes after burns are the metabolic, inflammatory, immune and endocrine changes that occur in response to the initial injury. These responses have been shown to persist for at least three years after paediatric severe burns, with adverse effects to the circulatory and musculoskeletal systems. Recent evidence demonstrates that minor burns and severe burns can trigger these systemic responses. Currently, minimal data on the long-term effects of burns are available, and the data that do exist are primarily related to paediatric severe burns. We have used population-based record linkage to support a research program to shed light on the spectrum of long-term morbidity, expressed in terms of hospital admissions, experienced by burn patients to guide burn clinicians in the management of their patients. We report here our current findings of post-burn mortality and morbidity.ApproachA population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalised for a first burn injury (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 = 127,000). Crude admission rates and cumulative length of stay for disease-specific admissions were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively, adjusting for sociodemographic and health factors. ResultsFor both paediatric and adult burn patients we identified increased long-term all-cause mortality (IRR, 95%CI: <15 years: 1.6, 1.3-2.0; 15-44 years: 1.8, 1.7-2.0; ≥ 45 years: 1.4, 1.3-1.5). Increased post-burn discharge health service use for cardiovascular diseases (IRR, 95%CI: <15 years: 1.3, 1.1-1.6; 15-44 years: 1.6, 1.4-1.7; ≥ 45 years: 1.5, 1.4-1.6) and musculoskeletal conditions (IRR, 95%CI: <20 years: 1.9, 1.7-2.1; ≥ 20 years: 2.0, 1.9-2.1) were also found. Analyses found significantly elevated admission rates for minor and severe burns. Adjusted HRs identified time periods after discharge where burn patients experienced significantly elevated disease-specific incident admissions (results not provided).ConclusionsBoth minor and severe burns were associated with increased long-term cardiovascular and musculoskeletal morbidity and mortality. These results identify treatment needs for burn patients for a prolonged time after discharge. Further research that links primary care and pharmaceutical data is required to facilitate identification of at-risk patients and appropriate treatment pathways to reduce post-burn morbidity.

scholarly journals Epidemiology of injuries, treatment (costs) and outcome in burn patients admitted to a hospital with or without dedicated burn centre (Burn-Pro): protocol for a multicentre prospective observational study

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023709 ◽  
Author(s):  
Esther MM Van Lieshout ◽  
Daan T Van Yperen ◽  
Margriet E Van Baar ◽  
Suzanne Polinder ◽  
Doeke Boersma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Burn Injury ◽  
Treatment Costs ◽  
Burn Patients ◽  
Severe Burns ◽  
Referral Criteria ◽  
Age Limit

IntroductionThe Emergency Management of Severe Burns (EMSB) referral criteria have been implemented for optimal triaging of burn patients. Admission to a burn centre is indicated for patients with severe burns or with specific characteristics like older age or comorbidities. Patients not meeting these criteria can also be treated in a hospital without burn centre. Limited information is available about the organisation of care and referral of these patients. The aims of this study are to determine the burn injury characteristics, treatment (costs), quality of life and scar quality of burn patients admitted to a hospital without dedicated burn centre. These data will subsequently be compared with data from patients with<10% total bodysurface area (TBSA) burned who are admitted (or secondarily referred) to a burn centre. If admissions were in agreement with the EMSB, referral criteria will also be determined.Methods and analysisIn this multicentre, prospective, observational study (cohort study), the following two groups of patients will be followed: 1) all patients (no age limit) admitted with burn-related injuries to a hospital without a dedicated burn centre in the Southwest Netherlands or Brabant Trauma Region and 2) all patients (no age limit) with<10% TBSA burned who are primarily admitted (or secondarily referred) to the burn centre of Maasstad Hospital. Data on the burn injury characteristics (primary outcome), EMSB compliance, treatment, treatment costs and outcome will be collected from the patients’ medical files. At 3 weeks and at 3, 6 and 12 months after trauma, patients will be asked to complete the quality of life questionnaire (EuroQoL-5D), and the patient-reported part of the Patient and Observer Scar Assessment Scale (POSAS). At those time visits, the coordinating investigator or research assistant will complete the observer-reported part of the POSAS.Ethics and disseminationThis study has been exempted by the medical research ethics committee Erasmus MC (Rotterdam, The Netherlands). Each participant will provide written consent to participate and remain encoded during the study. The results of the study are planned to be published in an international, peer-reviewed journal.Trial registration numberNTR6565.

scholarly journals Cross-Sectional, Short-, Medium- and Long-Term Effects of Dietary Pattern on Frailty in Taiwan

2021 ◽  
Vol 18 (18) ◽  
pp. 9717
Author(s):  
Mei-Huey Shiau ◽  
Meng-Chih Lee ◽  
Fang-Ling Lin ◽  
Baai-Shyun Hurng ◽  
Chih-Jung Yeh
Keyword(s):  
Dietary Patterns ◽  
Dietary Pattern ◽  
Multinomial Logistic Regression ◽  
Population Based ◽  
Long Term Effects ◽  
Reduced Rank Regression ◽  
Cross Sectional ◽  
Protein Rich ◽  
Healthy Dietary Pattern

This study examined the association between dietary patterns and the development of frailty during 4-, 8-, 12-year follow-up periods in the population-based Taiwan Study. We used the data of an elderly population aged 53 years and over (n = 3486) from four waves of the Taiwan Longitudinal Study on Aging. Frailty was identified by using the modified Fried criteria and the values were summed to derive a frailty score. We applied reduced rank regression to determine dietary patterns, which were divided into tertiles (healthy, general, and unhealthy dietary pattern). We used multinomial logistic regression models to assess the association between dietary patterns and the risk of frailty. The healthy dietary pattern was characterized by a higher intake of antioxidant drinks (tea), energy-rich foods (carbohydrates, e.g., rice, noodles), protein-rich foods (fish, meat, seafood, and eggs), and phytonutrient-rich foods (fruit and dark green vegetables). Compared with the healthy pattern, the unhealthy dietary pattern showed significant cross-sectional, short-term, medium-term, and long-term associations with a higher prevalence of frailty (odds ratios (OR) 2.74; 95% confidence interval (CI) 1.94–3.87, OR 2.55; 95% CI 1.67–3.88, OR 1.66; 95% CI 1.07–2.57, and OR 2.35; 95% CI 1.27–4.34, respectively). Our findings support recommendations to increase the intake of antioxidant drinks, energy-rich foods, protein-rich foods, and phytonutrient-rich foods, which were associated with a non-frail status. This healthy dietary pattern can help prevent frailty over time in elderly people.

scholarly journals Validation of Predictive Ability of Bobi Score in Burn Patients

2021 ◽  
Vol 6 (4) ◽  
Keyword(s):  
Burn Injury ◽  
Prognostic Score ◽  
Area Under The Curve ◽  
Predictive Ability ◽  
Scoring Systems ◽  
Good Prediction ◽  
Burn Patients ◽  
Severe Burns ◽  
Inhalation Burn ◽  
Outstanding Result

Introduction: Scoring systems have been used successfully in burn centers to predict the prognosis and take measures for careful monitoring of the burned patient. Belgium Outcome Burn Injury score is one of them which takes into consideration age, burn surface area, and presence of inhalation burn. Objectives: This presentation aims to validate the use of the BOBI prognostic score in our patients. Patients and Methods: The study is a retrospective analytical study that utilized the investigation of the medical charts of 1515 patients hospitalized with severe burns within the ICU of the Service of Burns in Tirana, Albania during 2010-2019. Results: The overall mortality of our patients was 7.06% (107 deaths in 1515 patients). Up to BOBI score 6, we have noticed better mortality than prediction while there is a very good prediction up to score 10. Area Under the Curve was 0.978 (p<0.0001) which is an outstanding result in being a classifier between deaths and survivors. Conclusions: BOBI score is a very good prediction score for mortality in burn patients.

The influence of plant diversity on the resilience of harvester termites to fire

1995 ◽  
Vol 2 (3) ◽  
pp. 279 ◽  
Author(s):  
Max Abensperg-Traun ◽  
Dion Steven ◽  
Lyn Atkins
Keyword(s):  
Western Australia ◽  
High Intensity ◽  
Experimental Studies ◽  
Grazing Pressure ◽  
Livestock Grazing ◽  
Floristic Diversity ◽  
Long Term Effects ◽  
Burnt Area ◽  
Food Species

The harvester termites in floristically rich mallee-heath of southern Western Australia appear resilient to high-intensity fire. This contrasts with the temporary extinction of harvesters occupying a narrow food niche in floristically simple, intensely burnt spinifex Triodia angusta grassland in tropical Western Australia. The present study examines the effects of high-intensity fire on harvester termites Drepanotermes tamminensis in vegetation of intermediate floristic diversity and compares its findings with these earlier studies. We sampled 20 mounds (termitaria) in both an unburnt and (adjacent) burnt stand of Allocasuarina campestris shrubland. Although partially regenerated three years after the fire, 40% of mounds in the burnt area were abandoned, contrasting with 10% in the unburnt stand. No harvested chaff was found in any of the abandoned mounds. The extent of mound occupation by D. tamminensis was considerably lower, and ant invasion higher, in the burnt stand. These findings are consistent with the hypothesis that high floristic diversity enhances the resilience of harvester termites to fire. The most likely mechanism is the availability of a range of plant (food) species with different regenerative responses to high-intensity fire. The death of spinifex and the associated harvester termites after fire may be atypical. We argue, however, that temporary extinction of harvester populations in arid Australia may not be exceptional, particularly where fire coincides with drought and high livestock grazing pressure. Rigorous experimental studies are necessary to enhance our understanding of the long-term effects of fire on harvester termite populations in different vegetation types and climatic zones.

scholarly journals Burn injury, gender and cancer risk: population-based cohort study using data from Scotland and Western Australia

BMJ Open ◽  
2014 ◽  
Vol 4 (1) ◽  
pp. e003845 ◽  
Author(s):  
Janine M Duke ◽  
Jacqui Bauer ◽  
Mark W Fear ◽  
Suzanne Rea ◽  
Fiona M Wood ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Risk ◽  
Western Australia ◽  
Burn Injury ◽  
Population Based ◽  
Risk Population ◽  
Using Data

scholarly journals Neuronal Plasticity Associated with Burn Injury and Its Relevance for Perception and Management of Pain in Burn Patients

2000 ◽  
Vol 5 (3) ◽  
pp. 205-213
Author(s):  
Terence J Coderre ◽  
Manon Choinière
Keyword(s):  
Neuronal Plasticity ◽  
Pain Perception ◽  
Burn Injury ◽  
Clinical Care ◽  
Strong Support ◽  
Burn Injuries ◽  
Burn Patients ◽  
Pain Mechanisms ◽  
Gate Control Theory

Through the introduction of the gate control theory and various subsequent works, Ronald Melzack has inspired many investigators worldwide to realize two important facts about pain. First, incoming pain messages are subject to both negative and positive modulation, which significantly affect its perception. Second, the progression of knowledge about the basic mechanisms underlying persistent and chronic pain is critically dependent on the increased understanding of the complexity of the symptoms experienced by pain patients. The present paper examines these two very important issues in an effort to understand better the mechanisms that underlie the pain suffered by burn patients. The physiological responses to burn injury involve many different mediators and mechanisms, all of which contribute to pain perception and development of neuronal plasticity underlying short and long term changes in pain sensitivity. While experimental burn injuries in humans and animals are typically well controlled and mild, in burn victims, the severity is much more variable, and clinical care involves repeated traumas and manipulations of the injured sites. Recurrent inputs from damaged and redamaged tissue impinge on a nervous system that becomes an active participant in the initiation of changes in sensory perception and maintenance of long term sensory disturbances. Recently acquired experimental evidence on postburn hyperalgesia, central hyperexcitability and changes in opioid sensitivity provides strong support that burn patients need an analgesic approach aimed at preventing or reducing the 'neural' memory of pain, including the use of more than one treatment modality. Burn injuries offer a unique opportunity to combine experimental and clinical research to understand pain mechanisms better. Over the years, Ronald Melzack has insisted that one of the most laudable enterprises in research is to span the gap between these two often separate worlds.

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