Stevenson Andrew W, Randall Sean M, Boyd James H, Wood Fiona M, Fear Mark W, Duke Janine M
Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia.
Centre for Data Linkage, Curtin University, Perth, Western Australia, Australia.
Burns. 2017 May;43(3):665-673. doi: 10.1016/j.burns.2016.09.009. Epub 2016 Oct 5.
While the most obvious impact of burn is on the skin, systemic responses also occur after burn, including intestinal inflammation. The objective of this study was to assess if burns are associated with increased long-term admissions for gastrointestinal diseases.
A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of adults aged at least 15 years when hospitalized for a first burn (n=20,561) in 1980-2012. A frequency matched non-injury comparison cohort was randomly selected from Western Australia's birth registrations and electoral roll (n=80,960). Crude admission rates and summed days in hospital for digestive diseases were calculated. Negative binomial and Cox proportional hazards regression modeling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively.
After adjustment for demographic factors and pre-existing health status, the burn cohort had 1.54 times (95% confidence interval (CI): 1.47-1.62) as many admissions and almost three times the number of days in hospital with a digestive system diagnosis (IRR, 95% CI: 2.90, 2.60-3.25) than the uninjured cohort. Significantly elevated adjusted post-burn incident rates were identified, with the risk decreasing with increasing time: in the first month (HR, 95% CI: 3.02, 1.89-4.82), from one month to five years (HR, 95% CI: 1.42, 1.31-1.54), and from five to twenty years after burn (HR, 95% CI: 1.13, 1.06-1.20).
Findings of increased hospital admission rates and prolonged length of hospital stay for gastrointestinal diseases in the burn cohort provide evidence to support that burns have effects that persist long after the initial injury.
虽然烧伤最明显的影响是在皮肤上，但烧伤后也会出现全身反应，包括肠道炎症。本研究的目的是评估烧伤是否与胃肠道疾病的长期住院率增加有关。
利用西澳大利亚州1980 - 2012年首次烧伤住院的至少15岁成年人（n = 20,561）的医院发病率和死亡数据进行了一项基于人群的纵向研究。从西澳大利亚州的出生登记和选民名册中随机选取频率匹配的非受伤对照队列（n = 80,960）。计算消化系统疾病的粗住院率和累计住院天数。分别使用负二项回归和Cox比例风险回归模型生成发病率比（IRR）和风险比（HR）。
在调整人口统计学因素和既往健康状况后，烧伤队列的住院次数是未受伤队列的1.54倍（95%置信区间（CI）：1.47 - 1.62），消化系统疾病诊断的住院天数几乎是未受伤队列的三倍（IRR，95% CI：2.90，2.60 - 3.25）。确定了烧伤后调整后的发病率显著升高，风险随时间增加而降低：烧伤后第一个月（HR，95% CI：3.02，1.89 - 4.82），烧伤后1个月至5年（HR，95% CI：1.42，1.31 - 1.54），以及烧伤后5至20年（HR，95% CI：1.13，1.06 - 1.20）。
烧伤队列中胃肠道疾病住院率增加和住院时间延长的研究结果提供了证据，支持烧伤的影响在初始损伤后会长期持续。
