Exploring the Burn Model System National Database: Burn injuries, substance misuse, and the CAGE questionnaire

Abstract While disparities in healthcare outcomes and services for vulnerable populations have been documented, the extent to which vulnerable burn populations demonstrate disparities in long-term care is relatively underexplored. This study’s goal was to assess for differences in long-term occupational or physical therapy (OT/PT) and psychological service use after burn injury in vulnerable populations. Data from the Burn Model System National Database (2006–2015) were analyzed. The vulnerable group included participants in one or more of these categories: 65 years of age or older, nonwhite, no insurance or Medicaid insurance, preinjury receipt of psychological therapy or counseling, preinjury alcohol and/or drug misuse, or with a preexisting disability. Primary outcomes investigated were receipt of OT/PT and psychological services. Secondary outcomes included nine OT/PT subcategories. Outcomes were examined at 6, 12, and 24 months postinjury. One thousand one hundred thirty-six burn survivors (692 vulnerable; 444 nonvulnerable) were included. The vulnerable group was mostly female, unemployed at time of injury, and with smaller burns. Both groups received similar OT/PT and psychological services at all time points. Adjusted regression analyses found that while the groups received similar amounts services, some vulnerable subgroups received significantly more services. Participants 65 years of age or older, who received psychological therapy or counseling prior to injury, and with a preexisting disability received more OT/PT and psychological or peer support services at follow-up. Overall, vulnerable and nonvulnerable groups received comparable OT/PT and psychological services. The importance of long-term care among vulnerable subgroups of the burn population is highlighted by this study. Future work is needed to determine adequate levels of follow-up services.

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455 The Long-Term Outcomes of Electrical Burn Injuries: A Burn Model Systems National Database Study

Journal of Burn Care & Research ◽

10.1093/jbcr/iry006.377 ◽

2018 ◽

Vol 39 (suppl_1) ◽

pp. S200-S200

Author(s):

L F Espinoza ◽

L C Simko ◽

D N Herndon ◽

M Rosenberg ◽

L Rosenberg ◽

...

Keyword(s):

Burn Injuries ◽

Model Systems ◽

National Database ◽

Long Term Outcomes ◽

Database Study

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Quantifying Contracture Severity at Hospital Discharge in Adults: A Burn Model System National Database Study

Journal of Burn Care & Research ◽

10.1093/jbcr/irx027 ◽

2018 ◽

Vol 39 (4) ◽

pp. 604-611 ◽

Cited By ~ 9

Author(s):

Matthew Godleski ◽

Austin F Lee ◽

Jeremy Goverman ◽

David N Herndon ◽

Oscar E Suman ◽

...

Keyword(s):

Hospital Discharge ◽

Model System ◽

National Database ◽

Database Study

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547 Long-term Outcomes of Chemical Burn Injuries: A Burn Model System National Database Study

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.175 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S113-S114

Author(s):

Gabrielle G Grant ◽

Olivia Stockly ◽

Audrey E Wolfe ◽

Steven E Wolf ◽

Jeffrey C Schneider ◽

...

Keyword(s):

Employment Status ◽

Satisfaction With Life ◽

Burn Injury ◽

Burn Injuries ◽

National Database ◽

Chemical Burn ◽

Long Term Outcomes ◽

Chemical Injuries ◽

Fire Flame

Abstract Introduction Information on long-term outcomes following chemical burn injury is sparse. This study aims to examine whether or not there are differences in long-term outcomes for individuals with chemical burn injuries compared to those with fire/flame injuries. Methods Data from the Burn Model System (BMS) National Database (1997–2019) were used for analysis. Demographic and clinical characteristics of adult burn survivors with chemical injuries and fire/flame injuries were compared. Regression analyses for the Mental Health Composite Scale (MCS) and the Physical Health Composite Scale (PCS) of the Short Form Health Survey-12, employment status, and Satisfaction with Life Scale (SWLS) were conducted at 12 and 24 months post-burn, adjusting for age, gender, race, and burn size. Results A total of 2,522 database participants (96 with chemical burns; 2,426 with fire/flame injuries) were included in the analyses. Those with chemical injuries had smaller burn sizes, shorter hospital stays, and fewer ventilator days (p< 0.0001, p=0.0034, and p=0.0005, respectively). Chemical burn survivors were more likely to be employed at the time of the burn (p< 0.0001), to have sustained an employment-related injury (p< 0.0001), and to have been discharged to their own home following their acute stay (p< 0.0001). No significant differences in the MCS, PCS, employment status or SWLS were found at either 12 or 24 months post-burn between groups in the regression analyses. Conclusions Chemical burn injuries were not found to have a significant difference on mental health, physical health, employment status, and satisfaction with life outcomes compared to fire/flame injuries. However, the effects of chemical burn injury on long-term outcomes may be difficult to detect due to the relatively small sample size of this population. Applicability of Research to Practice Further investigation is needed to better understand long-term outcomes following chemical injuries. Individuals with chemical burn injuries may require more specific assessment tools to improve how these types of injuries are studied.

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The Presence of Scarring and Associated Morbidity in the Burn Model System National Database

Annals of Plastic Surgery ◽

10.1097/sap.0000000000001826 ◽

2019 ◽

Vol 82 ◽

pp. S162-S168 ◽

Cited By ~ 1

Author(s):

Jeremy Goverman ◽

Waverley He ◽

Geoffrey Martello ◽

Ann Whalen ◽

Edward Bittner ◽

...

Keyword(s):

Model System ◽

National Database

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Identifying Risk Factors That Increase Analgesic Requirements at Discharge Among Patients With Burn Injuries

Journal of Burn Care & Research ◽

10.1093/jbcr/irab179 ◽

2021 ◽

Author(s):

Celine Yeung ◽

Alex Kiss ◽

Sarah Rehou ◽

Shahriar Shahrokhi

Keyword(s):

Risk Factors ◽

Substance Misuse ◽

Burn Injuries ◽

Patient Specific ◽

Care Providers ◽

Gender History ◽

Patient Risk ◽

Burn Care ◽

Mixed Regression ◽

History Of

Abstract Patients with burn injuries require large doses of opioids and gabapentinoids to achieve pain control and are often discharged from hospital with similar amounts. This study aimed to identify patient risk factors that increase analgesic requirements among patients with burn injuries and to determine the relationship between opioid and gabapentinoid use. Patient charts from July 1, 2015 to 2018 were reviewed retrospectively to determine analgesic requirements 24 hours before discharge. Linear mixed regression models were performed to determine patient risk factors (age, gender, history of substance misuse, TBSA of burn, length of stay in hospital, history of psychiatric illness, or surgical treatment) that may increase analgesic requirements. This study found that patients with a history of substance misuse (P = .01) or who were managed surgically (P = .01) required higher doses of opioids at discharge. Similarly, patients who had undergone surgical debridement required more gabapentinoids (P < .001). For every percent increase in TBSA, patients also required 14 mg more gabapentinoids (P = .01). In contrast, older patients (P = .006) and those with a longer hospital stay (P = .009) required fewer amounts of gabapentinoids before discharge. By characterizing factors that increase analgesic requirements at discharge, burn care providers may have a stronger understanding of which patients are at greater risk of developing chronic opioid or gabapentinoid misuse. The quantity and duration of analgesics prescribed at discharge may then be tailored according to these patient specific risk factors.

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