Mortality after burn injury in children: a 33-year population-based study

• Published in: Pediatrics (Evanston) 2015-04, Vol.135 (4), p.e903-e910
• Main Authors: Duke, Janine M, Rea, Suzanne, Boyd, James H, Randall, Sean M, Wood, Fiona M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analysis; Burns; Burns - mortality; Burns and scalds; Case-Control Studies; Cause of Death; Child; Child, Preschool; Children; Children & youth; Cohort analysis; Cohort Studies; Female; Follow-Up Studies; Health aspects; Health Surveys; Humans; Infant; Infant, Newborn; Kaplan-Meier Estimate; Male; Middle Aged; Mortality; Pediatrics; Population Surveillance; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Western Australia; Young Adult
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2014-3140

To assess the impact of burn injury sustained during childhood on long-term mortality and to quantify any increased risk of death attributable to burn injury. A population-based cohort study of children younger than 15 years hospitalized for burn injury in Western Australia (1980-2012) and a matched noninjured comparison group. Deidentified extraction of linked hospital morbidity and death records for the period 1980-2012 were provided by the Western Australian Data Linkage System. An inception cohort (1980-2012) of burn cases younger than 15 years of age when hospitalized for a first burn injury (n = 10,426) and a frequency matched noninjured comparison cohort (n = 40,818) were identified. Survival analysis was conducted by using the Kaplan-Meier method and Cox proportional hazards regression. Mortality rate ratios and attributable risk percent adjusted for sociodemographic and preexisting heath factors were generated. The median follow-up time for the pediatric burn cohort was 18.1 years after discharge. The adjusted all-cause mortality rate ratios for burn injury was 1.6 (95% confidence interval: 1.3-2.0); children with burn injury had a 1.6 times greater rate of mortality than those with no injury. The index burn injury was estimated to account for 38% (attributable risk percent) of all recorded deaths in the burn injury cohort during the study period. Burn injury sustained by children is associated with an increased risk of long-term all-cause mortality. Estimates of the total mortality burden based on in-hospital deaths alone underestimates the true burden from burn injury.