A/Prof. Jennifer Paratz¹, Professor Cate Cameron², Ms Jaycelle Warren², Dr Elizabeth Paratz³, Mr Vidal Corte-Real¹, Professor Michael Muller⁴, Dr Kerianne Watt⁵

¹Griffith University, Nathan/Brisbane, Australia, ²Jamieson Trauma Institute, Herston/Brisbane, Australia, ³St Vincent’s Hospital, Fitzroy/Melbourne, Australia, ⁴Royal Brisbane & Women’s Hospital, Herston/Brisbane, Australia, ⁵James Cook University, Townsville, Australia

Abstact:

BACKGROUND: Burn injury results in acute and chronic inflammation impacting multiple systems, with minimal investigation into long term outcomes. This study aimed to investigate mortality due to cardiovascular causes.

METHODS: In a retrospective cohort study, adult cases (1997–2013) in a clinical burns registry were linked with mortality outcomes from a Death Registry, and compared with national cardiovascular deaths data. Mortality Rate Ratios (MRR) and 95% CI were calculated to compare the burns cohort mortality age-standardised incidence with the national mortality incidence rates; age- and gender-specific incidence rates were also compared (15-44, 45-64 and 65+ yrs) .  Logistic regression identified demographic and clinical factors associated with cardiovascular mortality.

RESULTS: 4134 individuals in the database were analysed; the 20-year age-standardised cardiovascular mortality rate for the burns cohort was significantly higher than the Australian population (250.6 per 100,000 person-years (PYs) v 207.9 per 100,000 PYs; MRR=1.21, 95%CI 1.001-1.45). Cardiovascular mortality was significantly higher in males aged 15-44 and 45-64 years in the burns cohort than in age-matched Australian population (MRR=8.48, 95% CI 3.47-13.49 and MRR=1.75, 95% CI 1.07-2.44 respectively). Those who died of cardiovascular disease were more frequently intubated post-burn injury (p=0.01), admitted to ICU (p<0.0001), and had pre-existing physical conditions (60.9% v 15.0%, p<0.0001).

CONCLUSION: Survivors from burn injury, especially young males are at increased risk of death from cardiovascular disease.  Screening and counselling should be standard management post burn injury. We recommend longitudinal observation of physiological changes, investigation of mechanistic factors and interventional strategies.

Biography:

A/Professor Jennifer Paratz is a specialist ICU physiotherapist with extensive experience in research and teaching. She has an MPhil, PhD and a Master of  Medical and Health Law. She is frequently invited to speak at national and international conferences. Research interests include haemodynamics in intensive care, fluid resuscitation and sepsis.