Burn related mortality in Greater Manchester: 11-year review of Regional Coronial Department Data

• Epidemiology of burn injury related mortality is poorly described.
• Coroner's data holds useful data for burn related mortality.
• We present an 11-year review of Coronial Department data for Greater Manchester.
• There has been an overall reduction in mortality over the study period.
• Significant proportion of deaths occurs outside of burn service environment.

IntroductionThe Coroners Department (CD) records hold important demographic, injury and death details for victims of burn injuries derived from various sources yet this rich source of data has been infrequently utilised previously in describing the epidemiology of burn related mortality. The aim of this study was to use CD data to comprehensively investigate burn related mortality in the Greater Manchester region of United Kingdom.Materials and methodsA retrospective study design was used to collect data for deceased demographics, injury details, site of death and cause of death from four CD offices in GM over an 11-year period (2000–2010 inclusive). Office of National Statistics (ONS) population metrics were used to calculate age- and gender-specific population denominators and mortality rates. Index of Multiple Deprivation (IMD) was used to correlate mortality with deprivation. Linear regression and Pearson's/Spearman's rank correlation were used to calculate trends and correlations. Poisson regression was used to calculate relative risk (IRR) between age- and gender groups.ResultsThere were 314 recorded deaths in the region over the study period and thermal injury was 3-times less likely to result in death in 2010 compared to 2000. The largest proportion of these deaths (24.8%) was comprised of individuals ≥75 years in age. The relative risk of mortality in males was nearly 1.5-times higher and a significant majority of victims (77%) sustained their burn injury at their own home/residence. Inhalation injury without cutaneous burns was the most frequent type of injury (33%) and accidental house fires caused nearly half (49%) the injuries resulting in death. Sixty-five percent of deaths during this period were recorded to have occurred outside of regional burn service (RBS) hospitals and the commonest cause of immediate death on the death certificates was “inhalation of products of combustion” (32.1%). Within the >75 years age group the risk of death significantly increased with every quintile reduction in deprivation.ConclusionOur data shows that despite reducing overall mortality, certain age groups and causation patterns are associated with significantly higher risks of mortality in our region. Further reduction in burn mortality should focus on the use of prevention efforts with established effectiveness in these high-risk groups. In addition, as a significant proportion of deaths occur outside a burn service environment hence epidemiology data based solely on mortality statistics from burn services will underestimate true burn related mortality.