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J Transl Med. 2018 Dec 5;16(1):342. doi: 10.1186/s12967-018-1713-2.

Increased risk of chronic fatigue syndrome following burn injuries.

Tsai SY1,2,3, Lin CL4,5, Shih SC6,7, Hsu CW8,9, Leong KH8,9, Kuo CF10, Lio CF9,11, Chen YT8,9, Hung YJ8,9, Shi L12.

Author information

1
Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei, Taiwan. stsai22@jhu.edu.
2
Department of Medicine; Graduate Institute of Long-Term Care, Mackay Medical College, Taipei, Taiwan. stsai22@jhu.edu.
3
Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States. stsai22@jhu.edu.
4
College of Medicine, China Medical University, Taichung City, Taiwan.
5
Management Office for Health Data, China Medical University Hospital, Taichung City, Taiwan.
6
Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan.
7
Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
8
Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
9
Department of Medicine; Graduate Institute of Long-Term Care, Mackay Medical College, Taipei, Taiwan.
10
Institute of Infectious Disease, Mackay Memorial Hospital, Taipei, Taiwan.
11
Centro Hospitalar Conde de Sao Januario, Macao, China.
12
Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States. lshi2@jhu.com.

Abstract

BACKGROUND:

The overlapping symptoms and pathophysiological similarities between burn injury and chronic fatigue syndrome (CFS) are noteworthy. Thus, this study explores the possible association between burn injury and the subsequent risk of CFS.

METHOD:

We used data from the Taiwan National Health Insurance system to address the research topic. The exposure cohort comprised of 17,204 patients with new diagnoses of burn injury. Each patient was frequency matched according to age, sex, index year, and comorbidities with four participants from the general population who did not have a history of CFS (control cohort). Cox proportional hazards regression analysis was conducted to estimate the relationship between burn injury and the risk of subsequent CFS.

RESULT:

The incidence of CFS in the exposure and control cohorts was 1.61 and 0.86 per 1000 person-years, respectively. The exposure cohort had a significantly higher overall risk of subsequent CFS than did the control cohort (adjusted hazard ratio [HR] = 1.48, 95% confidence interval [CI] = 1.41-1.56). The risk of CFS in patients with burn injury in whichever stratification (including sex, age, and comorbidity) was also higher than that of the control cohort.

CONCLUSION:

The findings from this population-based retrospective cohort study suggest that thermal injury is associated with an increased risk of subsequent CFS and provided a point of view suggesting burn injuries in sun- exposed areas such as the face and limbs had greater impact on subsequent development of CFS compared with trunk areas. In addition, extensively burned areas and visible scars were predictors of greater physiological and psychosocial that are needed to follow-up in the long run.

KEYWORDS:

Burn; Chronic fatigue syndrome; Immune system diseases; National health programs; Thermal injury

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