Acute burn injuries associated with long-term mortality: a systematic review and meta-analysis |
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| Affiliation: | 1. Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK;2. Scar Free Foundation Centre for Conflict Wound Research, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK;3. Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK;4. Institute of Applied Health Research, University of Birmingham, Birmingham, UK;5. National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK;1. Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China;2. Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu 212001, China;3. School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212001, China;4. Inner Mongolia Medical University, Hohhot, Inner Mongolia 010050, China;1. Department of Orthopedics, Orthopedic Research Center, Poorsina Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran;2. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran;3. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran;1. WFBMC Burn Center; Wake Forest Baptist Health System, USA;2. Burn Center; University Medical Center New Orleans, USA;3. Louisiana State University School of Medicine, USA;4. Wake Forest University School of Medicine, USA;1. Division of Plastic Surgery, Department of Surgery, Cipto Mangunkusumo Hospital/ Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia;2. ICTEC (Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital/ Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia;3. Medical Technology Cluster, IMERI (Indonesian Medical Education and Research Institute), Faculty of Medicine Universitas Indonesia, Education Tower, 2nd Floor, Jl. Salemba Raya No. 6, Jakarta, Indonesia;1. Department of Physiology, School of Medicine, Cellular and the Molecular Research Center, Guilan University of Medical Science, Rasht, Iran;2. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;3. Department of Parasitology, School of Medicine, Guilan University of Medical Science, Rasht, Iran;4. Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran;5. Department of Orthopedics, Poorsina Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran;6. Mazandaran University of Medical Sciences, Sari, Iran;7. Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran;8. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran |
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| Abstract: | BackgroundEmerging evidence suggests that the pathophysiological impact of acute burn injuries may have chronic health consequences. We conducted a systematic review and meta-analysis to investigate the association between burn injuries and long-term mortality in patients surviving to initial discharge from hospital.MethodsMedline and Embase databases were searched on 22 October 2021. Studies were eligible for inclusion if they compared long-term mortality amongst burn survivors to non-injured controls from the general population. When the same output metrics related to mortality were reported, meta-analyses were undertaken using a random effects model. Risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool.ResultsFollowing an extensive literature search, six studies (seven articles) were identified for inclusion. They were predominantly based in high-income countries, with each comparing burns’ survivors to matched non-injured controls from the general population. The four studies included in the meta-analysis had a combined unadjusted odds ratio of 2.65 (1.84 – 3.81; 95 % confidence interval) and adjusted mortality rate ratio of 1.59 (1.31 – 1.93; 95 % confidence interval). Thus, burn survivors demonstrated greater mortality rates when compared to their non-injured counterparts. Similar findings were illustrated in the remaining studies not included in the meta-analysis, with the exception of one study which found no significant difference between the two groups.ConclusionsOur review suggests that acute burn injuries may be associated with greater long-term mortality rates (unadjusted and adjusted). The underlying mechanism is unclear and further work is required to establish the role of certain factors such as biological ageing processes, to improve outcomes for burn patients. |
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| Keywords: | Burns Mortality Life expectancy Long-term Survival Chronic |
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