The long-term impact of physical and emotional trauma: the station nightclub fire.
BACKGROUND
Survivors of physical and emotional trauma experience enduring occupational, psychological and quality of life impairments. Examining survivors from a large fire provides a unique opportunity to distinguish the impact of physical and emotional trauma on long-term outcomes. The objective is to detail the multi-dimensional long-term effects of a large fire on its survivor population and assess differences in outcomes between survivors with and without physical injury.


RESULTS
This is a survey-based cross-sectional study of survivors of The Station fire on February 20, 2003. The relationships between functional outcomes and physical injury were evaluated with multivariate regression models adjusted for pre-injury characteristics and post-injury outcomes. Outcome measures include quality of life (Burn Specific Health Scale-Brief), employment (time off work), post-traumatic stress symptoms (Impact of Event Scale-Revised) and depression symptoms (Beck Depression Inventory). 104 fire survivors completed the survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. Although depression and quality of life were associated with burn injury in univariate analyses (p<0.05), adjusted analyses showed no significant relationship between burn injury and these outcomes (p = 0.91; p = .51). Post-traumatic stress symptoms were not associated with burn injury in the univariate (p = 0.13) or adjusted analyses (p = 0.79). Time off work was the only outcome in which physical injury remained significant in the multivariate analysis (p = 0.03).


CONCLUSIONS
Survivors of this large fire experienced significant life disruption, including occupational, psychological and quality of life sequelae. The findings suggest that quality of life, depression and post-traumatic stress outcomes are related to emotional trauma, not physical injury. However, physical injury is correlated with employment outcomes. The long-term impact of this traumatic event underscores the importance of longitudinal and mental health care for trauma survivors, with attention to those with and without physical injuries.
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, United States of America. jcschneider@partners.org
Jeffrey C
JC
Schneider
Nhi-Ha T
NH
Trinh
Elizabeth
E
Selleck
Felipe
F
Fregni
Sara S
SS
Salles
Colleen M
CM
Ryan
Joel
J
Stein
D000328:Adult; D002056:Burns / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004644:Emotions; D005260:Female; D005390:Fires; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D014947:Wounds and Injuries / Q000503:physiopathology / Q000523:psychology*