title: Mortality after burn injury in children: a 33-year population-based study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Australia; janine.duke@uwa.edu.au.
authors: Janine M
authors: JM
authors: Duke
authors: Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Australia; Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Australia; and.
authors: Suzanne
authors: S
authors: Rea
authors: Population Health Research Network Centre for Data Linkage, Curtin University, Perth, Australia.
authors: James H
authors: JH
authors: Boyd
authors: Population Health Research Network Centre for Data Linkage, Curtin University, Perth, Australia.
authors: Sean M
authors: SM
authors: Randall
authors: Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Australia; Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Australia; and.
authors: Fiona M
authors: FM
authors: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000401:mortality*; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D014904:Western Australia; D055815:Young Adult
keywords: Outcomes; burden of disease; burns; epidemiology; mortality; record linkage