title: Long-term mortality among older adults with burn injury: a population-based study in Australia.
abstract: OBJECTIVE
  To assess if burn injury in older adults is associated with changes in long-term all-cause mortality and to estimate the increased risk of death attributable to burn injury.
  
  
  METHODS
  We conducted a population-based matched longitudinal study - based on administrative data from Western Australia's hospital morbidity data system and death register. A cohort of 6014 individuals who were aged at least 45 years when hospitalized for a first burn injury in 1980-2012 was identified. A non-injury comparison cohort, randomly selected from Western Australia's electoral roll (n = 25 759), was matched to the patients. We used Kaplan-Meier plots and Cox proportional hazards regression to analyse the data and generated mortality rate ratios and attributable risk percentages.
  
  
  RESULTS
  For those hospitalized with burns, 180 (3%) died in hospital and 2498 (42%) died after discharge. Individuals with burn injury had a 1.4-fold greater mortality rate than those with no injury (95% confidence interval, CI: 1.3-1.5). In this cohort, the long-term mortality attributable to burn injury was 29%. Mortality risk was increased by both severe and minor burns, with adjusted mortality rate ratios of 1.3 (95% CI: 1.1-1.9) and 2.1 (95% CI: 1.9-2.3), respectively.
  
  
  CONCLUSIONS
  Burn injury is associated with increased long-term mortality. In our study population, sole reliance on data on in-hospital deaths would lead to an underestimate of the true mortality burden associated with burn injury.
authors.affiliation: Burn Injury Research Unit, School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, M318 35 Stirling Highway, Crawley, 6009, Perth, Western Australia, Australia .
authors.forename: Janine M
authors.initials: JM
authors.lastname: Duke
authors.affiliation: Centre for Data Linkage, Curtin University, Perth, Australia .
authors.forename: James H
authors.initials: JH
authors.lastname: Boyd
authors.affiliation: Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Australia .
authors.forename: Suzanne
authors.initials: S
authors.lastname: Rea
authors.affiliation: Centre for Data Linkage, Curtin University, Perth, Australia .
authors.forename: Sean M
authors.initials: SM
authors.lastname: Randall
authors.affiliation: Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Australia .
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Wood
mesh_terms: D000368:Aged; D002056:Burns / Q000401:mortality* / Q000473:pathology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014904:Western Australia / Q000453:epidemiology