title: Health-related quality of life after burns: a prospective multicenter cohort study with 18 months follow-up.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) is an important parameter after medical treatments. Knowledge of (predictors of) diminished quality of life can help improve medical outcome. The aim of this study was to quantify health loss in patients with burns and to assess the contribution of injury extent, age, gender, and psychologic factors to HRQOL and speed of recovery. A multicenter prospective cohort design was used to address these aims.
  
  
  METHODS
  Data were obtained from 260 adults with burns. Patients completed the EQ-5D at 3 weeks, 3, 6, 9, and 18 months after burn and psychologic questionnaires during hospitalization. Patients' scores were compared with an age- and gender-weighted normpopulation.
  
  
  RESULTS
  Patients suffered from substantial health losses at short term, but after 18 months the majority reached a HRQOL comparable with the norm population with the exception of patients requiring two or more surgeries. The best predictor of long-term HRQOL and the speed of recovery was the number of surgeries, followed by psychologic problems. Both predicted baseline and trajectories of improvement. Symptoms of traumatic stress were most debilitating over time.
  
  
  CONCLUSIONS
  Both injury severity and psychologic problems play a pivotal role in reduced HRQOL and the speed of recovery. The number of surgeries seems to give a practically useful indication of the expected recovery speed that could aid in decision making and provides adequate information for patients in the aftermath of their initial surgical treatment. Screening for traumatic stress is recommended.
authors.affiliation: Department of Psychosocial and Behavioural Research, Association of Dutch Burns Centres, Beverwijk, The Netherlands. nvanloey@burns.nl
authors.forename: Nancy E
authors.initials: NE
authors.lastname: van Loey
authors.forename: Ed F
authors.initials: EF
authors.lastname: van Beeck
authors.forename: Bertus W
authors.initials: BW
authors.lastname: Faber
authors.forename: Rens
authors.initials: R
authors.lastname: van de Schoot
authors.forename: Marco
authors.initials: M
authors.lastname: Bremer
mesh_terms: D000328:Adult; D001530:Belgium; D002056:Burns / Q000503:physiopathology* / Q000523:psychology* / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*