Predictors of health status and health-related quality of life 12 months after severe burn

被引:74
作者
Wasiak, J. [1 ,2 ]
Lee, S. J. [3 ]
Paul, E. [4 ]
Mahar, P. [5 ]
Pfitzer, B. [5 ]
Spinks, A.
Cleland, H. [1 ,6 ]
Gabbe, B. [4 ]
机构
[1] Monash Univ, Alfred Hosp, Victorian Adult Burns Serv, Melbourne, Vic 3181, Australia
[2] Monash Univ, Alfred Hosp, Sch Publ Hlth & Prevent Med, Melbourne, Vic 3181, Australia
[3] Monash Univ, Alfred & Cent Clin Sch, Monash Alfred Psychiat Res Ctr, Melbourne, Vic 3004, Australia
[4] Monash Univ, Alfred Hosp, Alfred Ctr, Sch Publ Hlth & Prevent Med,Dept Epidemiol & Prev, Melbourne, Vic 3181, Australia
[5] Alfred Hosp, Victorian Adult Burns Serv, Melbourne, Australia
[6] Monash Univ, Alfred Hosp, Dept Surg, Melbourne, Vic 3181, Australia
关键词
Burns; Health-related quality of life; FUNCTIONAL OUTCOMES; CLINICAL-RESEARCH; MAJOR TRAUMA; INJURY; SURVIVORS; DISTRESS; REHABILITATION; MORTALITY; RECOVERY; GENDER;
D O I
10.1016/j.burns.2014.01.021
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: 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-bum and 12-months after burn injury Short Form 36 Medical Outcomes Survey (SF-36v2). These patients also completed the Bum 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 bums 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 bum 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. (C) 2014 El evier Ltd and ISM. All rights reserved.
引用
收藏
页码:568 / 574
页数:7
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