Adolescents with and without head and neck burns: comparison of long-term outcomes in the burn model system national database

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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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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Cesium-131 brachytherapy in high risk and recurrent head and neck cancers: first report of long-term outcomes

Journal of Contemporary Brachytherapy ◽

10.5114/jcb.2015.56764 ◽

2015 ◽

Vol 6 ◽

pp. 445-452 ◽

Cited By ~ 1

Author(s):

Anthony Pham ◽

Shruthi Arora ◽

Gabriella Wernicke ◽

David I. Kutler ◽

Marc Cohen ◽

...

Keyword(s):

High Risk ◽

Head And Neck ◽

Head And Neck Cancers ◽

Long Term Outcomes ◽

First Report ◽

Recurrent Head

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Long-term outcomes of induction chemotherapy followed by chemoradiotherapy vs chemoradiotherapy alone as treatment of unresectable head and neck cancer: follow-up of the Spanish Head and Neck Cancer Group (TTCC) 2503 Trial

Clinical & Translational Oncology ◽

10.1007/s12094-020-02467-8 ◽

2020 ◽

Author(s):

R. Hitt ◽

◽

L. Iglesias ◽

A. López-Pousa ◽

A. Berrocal-Jaime ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Induction Chemotherapy ◽

Neck Cancer ◽

Long Term Outcomes ◽

Cancer Group

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Long-Term Outcomes and Toxicity of Concurrent Paclitaxel and Radiotherapy for Locally Advanced Head-and-Neck Cancer

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2008.09.053 ◽

2009 ◽

Vol 74 (4) ◽

pp. 1040-1046 ◽

Cited By ~ 24

Author(s):

Deborah Citrin ◽

John Mansueti ◽

Anna Likhacheva ◽

Linda Sciuto ◽

Paul S. Albert ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Locally Advanced ◽

Advanced Head ◽

Long Term Outcomes

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Long-Term Outcomes of Personalized Stereotactic Ablative Brachytherapy for Recurrent Head and Neck Adenoid Cystic Carcinoma after Surgery or External Beam Radiotherapy: A 9-Year Study

Journal of Personalized Medicine ◽

10.3390/jpm11090839 ◽

2021 ◽

Vol 11 (9) ◽

pp. 839

Author(s):

Yi Chen ◽

Jinzhao Dai ◽

Yuliang Jiang ◽

Zhe Ji ◽

Ping Jiang ◽

...

Keyword(s):

Adenoid Cystic Carcinoma ◽

Head And Neck ◽

Local Control ◽

External Beam Radiotherapy ◽

Objective Response ◽

External Beam ◽

Long Term Outcomes ◽

Adenoid Cystic ◽

Recurrent Head

The management of recurrent head and neck adenoid cystic carcinoma (HNACC) remains a problematic challenge. This study aims to evaluate the long-term outcomes of personalized stereotactic ablative brachytherapy (SABT) as a salvage treatment for recurrent HNACC after surgery or external beam radiotherapy (EBRT). 21 patients with recurrent HNACC after surgery or EBRT successfully underwent iodine-125 (I-125) seed SABT from May 2011 to November 2019. The objective response rate (ORR), disease control rate (DCR), local control time (LCT), overall survival (OS), symptomatic relief and adverse events (AEs) were analyzed. Following SABT, the ORR and DCR were 85.7% and 100%, respectively. The 3-, and 5-year LCT rates were 68.8% and 55.1%, respectively, and the 3- and 5-year OS rates were 85.9% and 66.2%, respectively. Furthermore, univariate analyses showed that higher D90 (>137.1 Gy) was a strong positive prognostic factor of LCT (p < 0.05). The pain disappeared in one patient 3 months after SABT and partial pain improvement was observed in nine patients 1 to 6 months after SABT. Additionally, dyspnea was relieved in one patient with the tumor involving the trachea. The major AEs were mild intraoperative hemorrhage and skin/mucosal toxicities which were generally graded ≤2 and well-tolerated. Personalized SABT was an effective and safe alternative option for recurrent HNACC after the previous failure of surgery or EBRT. The parameter of D90 may influence the local control.

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