{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:24:26Z","timestamp":1779297866207,"version":"3.51.4"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,1,12]],"date-time":"2020-01-12T00:00:00Z","timestamp":1578787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Taiwan Ministry of Health and Welfare Clinical Trial Center","award":["MOHW109-TDU-B-212-114004"],"award-info":[{"award-number":["MOHW109-TDU-B-212-114004"]}]},{"name":"MOST Clinical Trial Consortium for Stroke","award":["MOST 108-2321-B-039-003"],"award-info":[{"award-number":["MOST 108-2321-B-039-003"]}]},{"name":"Tseng-Lien Lin Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Narcolepsy is a rare brain disorder characterized by excessive daytime sleepiness (EDS), cataplexy, hypnagogic hallucinations, and sleep paralysis. Stimulants have been used to relieve the symptoms of EDS. Narcolepsy symptoms may pose a risk to burn injury. The study aimed to investigate the risk of burn injury in narcolepsy patients and to examine the relationship between the use of stimulants and the risk of burn injury. In all, 507 narcolepsy patients and 504 controls matched by gender, age, index year, and Charlson Comorbidity Index (CCI) score were enrolled between 1998 and 2012, then followed until the end of 2013 using Taiwan\u2019s National Health Insurance Research Database. During the follow-up period, participants who developed burn injury were identified. Cox regression analysis was used to calculate the hazard ratio (HR) with 95% confidence interval (CI) of the burn incidence rate between narcolepsy patients and unaffected controls. Narcolepsy patients had a significantly increased risk of burn injury compared to unaffected controls (5.37 versus 2.69 per 1,000 person-years, HR: 2.04, 95% CI: 1.13\u20133.67) after adjusting for gender, age, CCI score, urbanization degree, and duration of stimulants use. Also, the use of stimulants in narcolepsy patients was associated with a lower incidence rate of developing burn injury, but the risk estimate was not statistically significant after adjusting for the above-mentioned variables. This study shows narcolepsy patients have an increased risk of burn injury and the use of stimulants may reduce the burn incidence rate, providing a reference for developing prevention interventions.<\/jats:p>","DOI":"10.1093\/jbcr\/iraa004","type":"journal-article","created":{"date-parts":[[2020,1,12]],"date-time":"2020-01-12T08:26:21Z","timestamp":1578817581000},"page":"663-667","source":"Crossref","is-referenced-by-count":3,"title":["Risk of Burn Injury in Patients With Narcolepsy: A Nationwide Population-Based Cohort Study"],"prefix":"10.1093","volume":"41","author":[{"given":"En-Ting","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Chest Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Li","family":"Lin","sequence":"first","affiliation":[{"name":"Management Office for Health Data, China Medical University Hospital, and College of Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Fen","family":"Chen","sequence":"first","affiliation":[{"name":"Center of Medical Genetics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3503-5778","authenticated-orcid":false,"given":"Yu-Chih","family":"Shen","sequence":"first","affiliation":[{"name":"School of Medicine, Tzu Chi University, Hualien, Taiwan"},{"name":"Department of Psychiatry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,1,12]]},"reference":[{"key":"2020050201585478000_CIT0001","doi-asserted-by":"crossref","first-page":"16100","DOI":"10.1038\/nrdp.2016.100","article-title":"Narcolepsy","volume":"3","author":"Kornum","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"2020050201585478000_CIT0002","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1080\/03007995.2016.1208643","article-title":"The ICSD-3 and DSM-5 guidelines for diagnosing narcolepsy: clinical relevance and practicality","volume":"32","author":"Ruoff","year":"2016","journal-title":"Curr Med Res Opin"},{"key":"2020050201585478000_CIT0003","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1212\/WNL.57.11.2029","article-title":"Age at onset of narcolepsy in two large populations of patients in France and Quebec","volume":"57","author":"Dauvilliers","year":"2001","journal-title":"Neurology"},{"key":"2020050201585478000_CIT0004","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1093\/sleep\/25.2.197","article-title":"The epidemiology of narcolepsy in Olmsted County, Minnesota: a population-based study","volume":"25","author":"Silber","year":"2002","journal-title":"Sleep"},{"key":"2020050201585478000_CIT0005","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s40263-016-0337-4","article-title":"Treatment options for narcolepsy","volume":"30","author":"Barateau","year":"2016","journal-title":"CNS Drugs"},{"key":"2020050201585478000_CIT0006","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1017\/S0317167100043419","article-title":"Life effects of narcolepsy in 180 patients from North America, Asia and Europe compared to matched controls","volume":"8","author":"Broughton","year":"1981","journal-title":"Can J Neurol Sci"},{"issue":"8 Suppl","key":"2020050201585478000_CIT0007","doi-asserted-by":"crossref","first-page":"S45","DOI":"10.1093\/sleep\/17.suppl_8.S45","article-title":"Psychosocial impact of narcolepsy","volume":"17","author":"Broughton","year":"1994","journal-title":"Sleep"},{"key":"2020050201585478000_CIT0008","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.sleep.2010.05.010","article-title":"The clinical features of cataplexy: a questionnaire study in narcolepsy patients with and without hypocretin-1 deficiency","volume":"12","author":"Overeem","year":"2011","journal-title":"Sleep Med"},{"key":"2020050201585478000_CIT0009","doi-asserted-by":"crossref","first-page":"e0129386","DOI":"10.1371\/journal.pone.0129386","article-title":"Car crashes and central disorders of hypersomnolence: a French study","volume":"10","author":"Pizza","year":"2015","journal-title":"PLoS One"},{"key":"2020050201585478000_CIT0010","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.sleep.2017.11.1125","article-title":"Comorbidities in a community sample of narcolepsy","volume":"43","author":"Cohen","year":"2018","journal-title":"Sleep Med"},{"key":"2020050201585478000_CIT0011","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.jsmc.2017.03.018","article-title":"Hypersomnolence and traffic safety","volume":"12","author":"Gupta","year":"2017","journal-title":"Sleep Med Clin"},{"key":"2020050201585478000_CIT0012","doi-asserted-by":"crossref","first-page":"483","DOI":"10.5665\/sleep.3480","article-title":"Modafinil improves real driving performance in patients with hypersomnia: a randomized double-blind placebo-controlled crossover clinical trial","volume":"37","author":"Philip","year":"2014","journal-title":"Sleep"},{"issue":"3 Suppl","key":"2020050201585478000_CIT0013","first-page":"199","article-title":"[Guidelines for the fitness to drive assessment in people with obstructive sleep apnoea syndrome (OSAS) and narcolepsy]","volume":"33","author":"Garbarino","year":"2011","journal-title":"G Ital Med Lav Ergon"},{"key":"2020050201585478000_CIT0014","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.sleep.2016.04.004","article-title":"Medical comorbidity in narcolepsy: findings from the Burden of Narcolepsy Disease (BOND) study","volume":"33","author":"Black","year":"2017","journal-title":"Sleep Med"},{"key":"2020050201585478000_CIT0015","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.sleep.2016.09.013","article-title":"Morbidity of childhood onset narcolepsy: a controlled national study","volume":"29","author":"Jennum","year":"2017","journal-title":"Sleep Med"},{"issue":"6","key":"2020050201585478000_CIT0016","doi-asserted-by":"crossref","first-page":"835","DOI":"10.5665\/sleep.2706","article-title":"Comorbidity and mortality of narcolepsy: a controlled retro- and prospective national study","volume":"36","author":"Jennum","year":"2013","journal-title":"Sleep"},{"key":"2020050201585478000_CIT0017","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1016\/j.burns.2015.02.020","article-title":"Psychosocial adjustment following burns: an integrative literature review","volume":"41","author":"Attoe","year":"2015","journal-title":"Burns"},{"key":"2020050201585478000_CIT0018","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1179\/2046905514Y.0000000157","article-title":"Socio-demographic factors and the prevalence of burns in children: an overview of the literature","volume":"36","author":"Alnababtah","year":"2016","journal-title":"Paediatr Int Child Health"},{"key":"2020050201585478000_CIT0019","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.burns.2006.04.002","article-title":"Burns in low- and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention","volume":"32","author":"Forjuoh","year":"2006","journal-title":"Burns"},{"key":"2020050201585478000_CIT0020","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"2020050201585478000_CIT0021","first-page":"70","article-title":"Narcolepsy-cataplexy and psychosis: a case study","volume":"65","author":"Canellas-Dols","year":"2017","journal-title":"Rev Neurol"},{"key":"2020050201585478000_CIT0022","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.sleep.2017.07.022","article-title":"Comorbidity of narcolepsy and depressive disorders: a nationwide population-based study in Taiwan","volume":"39","author":"Lee","year":"2017","journal-title":"Sleep Med"},{"key":"2020050201585478000_CIT0023","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1007\/s11325-016-1365-5","article-title":"Misdiagnosis of narcolepsy","volume":"20","author":"Dunne","year":"2016","journal-title":"Sleep Breath"}],"container-title":["Journal of Burn Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jbcr\/advance-article-pdf\/doi\/10.1093\/jbcr\/iraa004\/32442446\/iraa004.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jbcr\/article-pdf\/41\/3\/663\/33154672\/iraa004.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jbcr\/article-pdf\/41\/3\/663\/33154672\/iraa004.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,5,2]],"date-time":"2020-05-02T05:59:07Z","timestamp":1588399147000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbcr\/article\/41\/3\/663\/5700801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,12]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,1,12]]},"published-print":{"date-parts":[[2020,5,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jbcr\/iraa004","relation":{},"ISSN":["1559-047X","1559-0488"],"issn-type":[{"value":"1559-047X","type":"print"},{"value":"1559-0488","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,5]]},"published":{"date-parts":[[2020,1,12]]}}}