title: Outcomes and predictors in burn rehabilitation.
abstract: Advances in burn care in recent decades have resulted in a growing population of burn survivors and an increased need for inpatient rehabilitation. Burn survivors who require inpatient rehabilitation typically experience severe and complicated injuries. The purpose of this study is to examine burn rehabilitation outcomes and their predictor variables. Data are obtained from the Uniform Data System for Medical Rehabilitation from 2002 to 2007. Inclusion criterion is primary diagnosis of burn injury. Predictor variables include demographic, medical, and facility data. Outcome measures are length of stay efficiency, FIM® gain, community discharge, and FIM® discharge of at least 78. Linear and logistic regression analyses are used to determine significant predictors of outcomes. There are 2920 patients who meet inclusion criteria. The mean age of the population is 51 years, 33% of the population is female, 73% is Caucasian, and 40% are married. The median TBSA decile is 20 to 29%. The population exhibits a mean FIM® gain of 28 and length of stay efficiency of 2.1. A majority of the population is discharged to the community (76%) and has a FIM® discharge of at least 78 (81%). Significant predictors of outcomes in burn rehabilitation include age, FIM® admission, onset days, employment status, and marital status. Inpatient rehabilitation is critical to community reintegration of burn survivors. Survivors who are young, married, employed, and higher functioning at the time of admission to rehabilitation demonstrate the best outcomes. This research will help assess the rehabilitation potential of burn survivors and inform resource allocation.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Wei-Han
authors.initials: WH
authors.lastname: Tan
authors.forename: Richard
authors.initials: R
authors.lastname: Goldstein
authors.forename: Paul
authors.initials: P
authors.lastname: Gerrard
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Ryan
authors.forename: Paulette
authors.initials: P
authors.lastname: Niewczyk
authors.forename: Karen
authors.initials: K
authors.lastname: Kowalske
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Schneider
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002056:Burns / Q000175:diagnosis* / Q000534:rehabilitation*; D015331:Cohort Studies; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology