Patterns of recovery over 12 months following a burn injury in Australia.
OBJECTIVE
To describe patients' generic health status and health-related quality of life (HRQoL) 12-months following admission to a state-wide burns service.


METHODS
A total of 114 injured adults with >10% total body surface area burned (TBSA) or burns less than 10% TBSA to smaller anatomical areas such as the hands and feet participated in this study. Retrospective assessment of pre-burn injury status and prospective assessment of generic health and HRQoL were followed up at 3, 6 and 12-months after injury using the 36-item Short Form Health Survey (SF-36 v.2) and Burns Specific Health Scale-Brief (BSHS-B). The SF-36 v.2 was administered retrospectively during the initial hospital stay to assess pre-injury HRQoL. Changes in instruments scores were assessed using multilevel mixed effects regression models. Mean scores were compared over time and between severity groups as defined by <10%, 10-30% and >30% TBSA.


RESULTS
For the overall sample, the SF-36 v.2 physical component scale (PCS) score between 3 and 12-months post-burn injury were significantly lower than pre-injury scores (p<0.01), with no significant change over time for the mental component scale (MCS) (p=0.36). Significant %TBSA-burden by time interactions highlighted changes from pre-burn injury in overall PCS (p=0.02), physical functioning (p<0.001) and role-physical (p=0.03), with subscales worse for the TBSA >30% group. With respect to the BSHS-B, significant improvement from 3 to 12-months post-burn injury was seen for the entire sample in simple abilities (p<0.001), hand function (p=0.001), work (p=0.01), and treatment regime (p=0.004) subscales. The TBSA >30% group showed a greater rate of improvement in simple abilities (p=0.01) and hand function (p=0.005) between 3 and 12 months post-burn injury.


CONCLUSIONS
Whilst certain HRQoL measures improve over the 12-months, in most cases they do not reach pre-morbid levels. Patients face ongoing challenges regarding their physical and psychosocial recovery 12-months post-burn injury with respect to generic health and burn-specific health. These challenges vary at different time periods over the 12-month post-burn period, and may provide windows of opportunity in which to address ongoing issues.
Victorian Adult Burns Service and School of Public Health and Preventive Medicine, Monash University, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia. Electronic address: J.Wasiak@alfred.org.au.
J
J
Wasiak
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Commercial Road, Melbourne, Australia.
E
E
Paul
Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Commercial Road, Melbourne, Australia.
S J
SJ
Lee
Victorian Adult Burns Service, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia.
P
P
Mahar
Victorian Adult Burns Service, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia.
B
B
Pfitzer
CSIRO Ecosystem Sciences, Queensland, Australia.
A
A
Spinks
Victorian Adult Burns Service, Department of Surgery, Monash University, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia.
H
H
Cleland
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Commercial Road, Melbourne, Australia.
B
B
Gabbe
D000328:Adult; D001315:Australia / Q000453:epidemiology; D002056:Burns / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*; D013997:Time Factors
Burns; Health related quality of life