Factors predicting health status and recovery of hand function after hand burns in the second year after hospital discharge.
BACKGROUND
Hands are the most commonly burnt body part given humans' innate response to guard their face from injury, and are known to have detrimental functional and psychological consequences. Conflicting evidence exists regarding the impact of hand burns on long-term health status and global functioning. The objective of this study was to identify patient and clinical characteristics that predict health status and hand function of people at 12-24 months after hand burn.


METHODS
The Burns Specific Health Scale-Brief (BSHS-B) and the Brief Michigan Hand Outcome Questionnaire (Brief MHQ) were administered to community-dwelling adults who were between one and two years after admission to a statewide burns service for burns including one or both hands. Demographic, injury, and treatment data were collected to identify which factors predict health status and hand function in the second year after admission. Linear regression analyses adjusted for total burn surface area and burn depth were conducted to identify important predictors or outcomes.


RESULTS
The sample (n=41) was 80.5% male, with a mean age of 44.5 years and total body surface area (TBSA) of 8.4%. Psychiatric illness (regression coefficient -56.6, confidence interval (95% CI) -76.70, -36.49) and female gender (-20.3; 95% CI -0.77, -40.29) were key predictors of poorer global health status on the BSHS-B. Females also scored worse on body image (-5.35; 95% CI -1.83, -8.87) and work (-4.13; 95% CI -0.64, -7.62) domains of BSHS-B. The need for reconstructive or secondary surgery (-38.84; 95% CI -58.04, -19.65) and female gender (-16.30; 95% CI -4.03, -28.57) were important predictors of poorer hand function.


CONCLUSIONS
Women and those with a history of psychiatric illness are particularly vulnerable to poorer outcomes in health status and/or hand function after burns, and may benefit from more intensive rehabilitation support and long-term follow-up.
Monash University, Peninsula Campus, McMahons Rd, Frankston, Victoria 3199, Australia. Electronic address: amber.m.knight11@gmail.com.
Amber
A
Knight
Epworth Radiation Oncology, Epworth HealthCare, Melbourne, Australia; The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: jason.wasiak@epworth.org.au.
Jason
J
Wasiak
Victorian Adult Burns Service, Alfred Health, 55 Commercial Rd, Prahran, Victoria 3181, Australia. Electronic address: j.salway@alfred.org.au.
Jacqueline
J
Salway
Monash University, Peninsula Campus, McMahons Rd, Frankston, Victoria 3199, Australia. Electronic address: lisa.obrien@monash.edu.
Lisa
L
O'Brien
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image / Q000523:psychology; D002056:Burns / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006230:Hand Injuries / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D011379:Prognosis; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D020127:Recovery of Function; D012307:Risk Factors; D012737:Sex Factors; D016038:Skin Transplantation; D014739:Victoria; D055815:Young Adult
Burns; Hand; Health status