title: Predictors of health status and health-related quality of life 12 months after severe burn.
abstract: BACKGROUND
  Sustaining a moderate to severe burn injury is associated with the potential for substantial impairments to long-term physical and psychosocial health, including health related quality of life (HRQoL). The objective of this study was to identify clinical and patient characteristics which predict HRQoL 12-months after injury.
  
  
  METHODS
  A total of 125 patients were recruited over the study period, although only 99 were included in the final analysis representing all those who completed both the pre-burn and 12-months after burn injury Short Form 36 Medical Outcomes Survey (SF-36v2). These patients also completed the Burn Specific Health Scale-Brief (BSHS-B). Patient demographics and burn injury characteristics and treatment factors were collected to identify which factors predict 12-month health status outcomes. Multiple linear regression analyses were conducted to identify important predictors of outcomes. The SF36v2 models were adjusted for pre-injury measurements.
  
  
  RESULTS
  Older age (regression coefficient -0.26, 95% confidence interval (95% CI) -0.38, -0.13), female gender (-8.08, 95% CI -12.8, -3.34) and increased percentage of full-thickness burns per body surface area (-0.51; 95% CI -0.88, -0.13) were important predictors of poorer physical health status at 12 months. Older age (-0.15, 95% CI -0.26, -0.04) and increased percentage of full-thickness burns per body surface area (-0.36, 95% CI -0.69, -0.03) were important predictors of poorer mental health status at 12 months. Older age (-0.38; 95%CI -0.66, -0.11) and female gender (-12.17; 95% CI -22.76, -1.57) were important predictors of poorer BSHS-B total score at 12 months after injury.
  
  
  CONCLUSIONS
  Given the complexity of burn care rehabilitation, physical and psychosocial screening and assessment within the first weeks after a burn injury along with adequate monitoring after discharge should be undertaken in burn injured patients. In this context, patients of specific demographics, such as female patients and older patients, and patients with a higher percentage of full thickness surface area burns are of greater risk for poorer physical and psychological outcomes and may benefit from additional monitoring and rehabilitation.
authors.affiliation: Victorian Adult Burns Service and School of Public Health and Preventive Medicine, Monash University, The Alfred Hospital, Commercial Rd, Melbourne, Victoria, Australia. Electronic address: J.Wasiak@alfred.org.au.
authors.forename: J
authors.initials: J
authors.lastname: Wasiak
authors.affiliation: Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School Monash University, Melbourne, Victoria, Australia.
authors.forename: S J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Paul
authors.affiliation: Victorian Adult Burns Service, The Alfred Hospital, Commercial Rd, Melbourne, Victoria, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Mahar
authors.affiliation: Victorian Adult Burns Service, The Alfred Hospital, Commercial Rd, Melbourne, Victoria, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Pfitzer
authors.affiliation: CSIRO Ecosystem Sciences, Queensland, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Spinks
authors.affiliation: Victorian Adult Burns Service and Department of Surgery, Monash University, The Alfred Hospital, Commercial Rd, Melbourne, Victoria, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Cleland
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Gabbe
mesh_terms: D000328:Adult; D000367:Age Factors; D002056:Burns / Q000523:psychology / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D008297:Male; D008603:Mental Health; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D011795:Surveys and Questionnaires; D017741:Survivors
keywords: Burns; Health-related quality of life