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

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.

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

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

119 Satisfaction with Life and Community Integration Outcomes up to 20 Years after Burn Injury

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S79-S80
Author(s):  
Callie Abouzeid ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Satisfaction With Life ◽  
Burn Injury ◽  
Community Integration ◽  
Satisfaction With Life Scale ◽  
National Database ◽  
Patient Reported ◽  
Burn Survivors ◽  
The Impact ◽  
Over Time

Abstract Introduction Among the many challenges burn survivors face, community integration is often difficult and might affect overall satisfaction with life long-term. The purpose of this study is to examine quality of life, based on life satisfaction and community integration, at long-term follow-ups in the burn population. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and at 5, 10, 15, and 20 years after injury. The Satisfaction with Life Scale (SWLS) was used to measure participants’ satisfaction with life and the Community Integration Questionnaire (CIQ) measured level of community integration. A random intercept model was used to fit the data and generate a score trajectory with 95% confidence intervals to demonstrate the changes in scores over time and the impact of the demographic and clinical covariates on the model. SWLS trajectory is depicted in the Figure. Results The study population included 214 adult burn survivors with a mean age of 45.2 years. The population was mainly male (65.9%) and white (77.1%) with a mean burn size of 22.5% and average length of hospital stay of 34.7 days. This study found that SWLS scores decrease over time, but CIQ scores were relatively stable. The CIQ model with additional covariates were not statistically significant and did not improve the fit of the model. Conclusions Satisfaction with life was significantly worse over time. Community integration showed little or no change over the long term.

The Burn Victim—A Review of Psychosocial Issues

1986 ◽  
Vol 20 (4) ◽  
pp. 413-420 ◽  
Author(s):  
Peter Tucker
Keyword(s):  
Social Factors ◽  
Burn Injury ◽  
Psychological Aspects ◽  
Personal Health ◽  
Psychosocial Issues ◽  
Long Term Outcomes ◽  
Acute Hospitalisation

Over recent decades, with the introduction of specialist units for the treatment of severely burnt patients, a volume of literature on psychological aspects of burns has accumulated, containing anecdote and opinion as well as research of varying quality. This literature is reviewed under three headings: epidemiology and prevention; reactions following acute hospitalisation; and long-term outcomes. Adverse personal, health, and social factors may predispose to burn injury. In hospital, the psychological course of the patient proceeds in stages that can be related to the well-recognised reactions to loss and overwhelming stress, modified by the major physiological insult. Reactions of family and staff are of great significance. In the longer term, rehabilitation prospects are generally good, although recovery may be complicated by a gradually subsiding level of neurotic symptoms and relationship difficulties.

Evaluating Burn Recovery Outcomes in Children with Neurodevelopmental Symptoms

2021 ◽  
Author(s):  
Farzin Sadeq ◽  
Alexa Riobueno-Naylor ◽  
Matthew A DePamphilis ◽  
Martha Lydon ◽  
Robert L Sheridan ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
Burn Injury ◽  
Burn Injuries ◽  
Learning Problems ◽  
Post Discharge ◽  
Recovery Curves ◽  
Burn Prevention ◽  
Parents And Children ◽  
Injury Recovery

Abstract Neurodevelopmental symptoms (NS) including attention and behavioral problems, developmental delays, intellectual disabilities and learning problems are prevalent in children with burn injuries. The presence of NS may predispose children to poorer burn injury recovery outcomes compared to children without these symptoms (non-NS). The Multi-Center Benchmarking Study (MCBS) monitored recovery outcomes in children with burn injuries in real time utilizing the Burn Outcomes Questionnaire (BOQ). The objective of this study was to retrospectively assess the long term burn recovery outcomes in NS patients versus non-NS patients from the MCBS population. This study assessed parent-reported BOQ outcomes in a sample of 563 patients aged 5 to 18 years who were admitted for burn injuries to a pediatric burn center. A subsample of patients had reported NS (n=181). Analyses compared BOQ outcomes within the NS subsample and the non-NS subsample (n=382) across three longitudinal points post-discharge. The prevalence rate of NS was 32.1% in the full sample. Findings revealed statistically significant improvement in the recovery curves in all five BOQ subscales for the non-NS group and all subscales except for Compliance for the NS group across all longitudinal points. When compared to non-NS patients, NS patients had significantly poorer burn recovery outcomes on the Satisfaction and Compliance subscales. Although it is important to educate all clinicians, parents, and children on burn prevention efforts, targeted education is necessary for children with NS since they may be at greater risk for burn injury as well as worse recovery outcomes.

A Scoping Review on the Long-Term Outcomes in Persons with Adult-Acquired Burn Injuries

2019 ◽  
Vol 41 (3) ◽  
pp. 472-502
Author(s):  
Stephanie R Cimino ◽  
Jorge N Rios ◽  
Matthew Godleski ◽  
Sander L Hitzig
Keyword(s):  
Community Participation ◽  
Scoping Review ◽  
The United States ◽  
Community Dwelling ◽  
Burn Injuries ◽  
Computer Assisted ◽  
Long Term Outcomes ◽  
Burn Survivors ◽  
The Impact

Abstract Adult-acquired burn injuries are a life-altering event that can lead to debilitating functional or psychological impairments. With advancements in health care resulting in decreased mortality rates, survivors of burn injuries can expect to live longer. This warrants a shift in focus to better understand what happens to adults once they are discharged from the hospital into the community. Therefore, the purpose of this scoping review was to map the literature regarding the long-term outcomes of community-dwelling adult-acquired burn survivors. A computer-assisted literature search was conducted on literature from January 1, 2000 to August 31, 2018 utilizing four large databases (MEDLINE, EMBASE, CINHAL, and PsycINFO). Articles were included if they had a minimum of five individuals with a burn injury as a result of an accidental injury who were at least 18 years of age at the time of injury. Fifty-four articles were found suitable for inclusion in this review. The majority of studies were conducted in the United States and were longitudinal in design. Four themes were apparent from the articles: postburn complications, psychosocial outcomes, quality of life, and community participation. Data are lacking with respect to outcomes more than 5 years postburn as well as qualitative research. Furthermore, more literature is needed to understand the impact of postburn complications, coping strategies, and posttraumatic growth as well as barriers to community participation. Overall, there is an emerging body of literature that describes the long-term outcomes of adult-acquired burn survivors up to 5 years postburn.

Severe Burn Injuries and Their Long-Term Implications

2014 ◽  
Author(s):  
Eva C Diaz ◽  
Celeste C Finnerty ◽  
David N Herndon
Keyword(s):  
Burn Injury ◽  
Recombinant Human Growth Hormone ◽  
Human Growth ◽  
Adverse Outcomes ◽  
Burn Injuries ◽  
Endocrine Function ◽  
Growth Delay ◽  
Negative Effects ◽  
Severe Burn Injuries

Burn injury is notable for the degree and duration of pathophysiological alterations that it induces. Burn triggers profound changes in metabolism, immune function, and endocrine function, leading to a host of negative effects, including catabolism of muscle and bone and insulin resistance. These changes may persist or evolve for years after the injury has occurred, delaying recovery. This chapter discusses all of these consequences of burn injury, along with other adverse outcomes, specifically growth delay in children and hypertrophic scarring. Particular attention is placed on what is known about the mechanisms underlying each of these pathological changes and, in some cases, current practice in their management. A description is also provided of some of the pharmacologic (i.e. oxandrolone and recombinant human growth hormone) and non-pharmacologic (i.e. exercise therapy) approaches that hold promise in the treatment of burn injury and its consequences.

scholarly journals Effect of small molecular weight soybean protein-derived peptide supplementation on attenuating burn injury-induced inflammation and accelerating wound healing in a rat model

RSC Advances ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 1247-1259 ◽  
Author(s):  
Fen Zhao ◽  
Wei Liu ◽  
Yonghui Yu ◽  
Xinqi Liu ◽  
Huinan Yin ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Wound Healing ◽  
Rat Model ◽  
Burn Injury ◽  
Soybean Protein ◽  
Burn Injuries ◽  
Small Molecular Weight

The populations most afflicted by burn injuries have limited abilities to support the significant specialized requirements and costs for acute and long-term burn injury care.

scholarly journals Neuronal Plasticity Associated with Burn Injury and Its Relevance for Perception and Management of Pain in Burn Patients

2000 ◽  
Vol 5 (3) ◽  
pp. 205-213
Author(s):  
Terence J Coderre ◽  
Manon Choinière
Keyword(s):  
Neuronal Plasticity ◽  
Pain Perception ◽  
Burn Injury ◽  
Clinical Care ◽  
Strong Support ◽  
Burn Injuries ◽  
Burn Patients ◽  
Pain Mechanisms ◽  
Gate Control Theory

Through the introduction of the gate control theory and various subsequent works, Ronald Melzack has inspired many investigators worldwide to realize two important facts about pain. First, incoming pain messages are subject to both negative and positive modulation, which significantly affect its perception. Second, the progression of knowledge about the basic mechanisms underlying persistent and chronic pain is critically dependent on the increased understanding of the complexity of the symptoms experienced by pain patients. The present paper examines these two very important issues in an effort to understand better the mechanisms that underlie the pain suffered by burn patients. The physiological responses to burn injury involve many different mediators and mechanisms, all of which contribute to pain perception and development of neuronal plasticity underlying short and long term changes in pain sensitivity. While experimental burn injuries in humans and animals are typically well controlled and mild, in burn victims, the severity is much more variable, and clinical care involves repeated traumas and manipulations of the injured sites. Recurrent inputs from damaged and redamaged tissue impinge on a nervous system that becomes an active participant in the initiation of changes in sensory perception and maintenance of long term sensory disturbances. Recently acquired experimental evidence on postburn hyperalgesia, central hyperexcitability and changes in opioid sensitivity provides strong support that burn patients need an analgesic approach aimed at preventing or reducing the 'neural' memory of pain, including the use of more than one treatment modality. Burn injuries offer a unique opportunity to combine experimental and clinical research to understand pain mechanisms better. Over the years, Ronald Melzack has insisted that one of the most laudable enterprises in research is to span the gap between these two often separate worlds.

scholarly journals Long-Term Outcomes in COVID-19 ICU Patients: A Prospective Cohort Study

2021 ◽  
Author(s):  
Nadine Van Veenendaal ◽  
Ingeborg Van der Meulen ◽  
Marisa Onrust ◽  
Wolter Paans ◽  
Willem Dieperink ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Psychological Functioning ◽  
Employment Status ◽  
Family Members ◽  
Well Being ◽  
Long Term Outcomes ◽  
Icu Discharge

Abstract BACKGROUNDThe COVID-19 pandemic causes high rates of intensive care unit (ICU) admissions. After ICU-discharge patients and family members can suffer from persisting impairments known as ‘Post Intensive Care Syndrome’ (PICS) and PICS-family. Since COVID-19 is relatively new, there is barely any knowledge on the long-term outcomes of COVID-19 ICU-survivors and their family members.OBJECTIVESThis study aims to gain insight in the long-term physical, social and psychological functioning of COVID-19 ICU-survivors and their family members at three- and six-months following ICU discharge.METHODSA single-center, prospective cohort study was conducted in COVID-19 ICU-survivors and their family members. Enrolled participants received questionnaires at three and six months after ICU discharge. The MOS Short-Form General Health Survey, Clinical Frailty Scale, spirometry tests, McMaster Family Assessment Device (FAD-GF6+), the Hospital Anxiety and Depression Scale and return to work were used to evaluate physical, social and psychological functioning.RESULTSSixty COVID-19 ICU-survivors and 78 family members participated. Physical functioning was impaired in ICU-survivors as reflected by a score of 33.3 (IQR 16.7-66.7) and 50 (IQR 16.7-83.3) on the physical functioning subscale at 3- and 6-months follow-up respectively. Diffusion lung capacity was reduced in 69% of patients. Ninety percent of the ICU-survivors reported persistent symptoms after 6 months. Social functioning was impaired as 90% of the COVID-19 ICU-survivors did not reach their pre-ICU employment level, 6 months after ICU-discharge. Psychological functioning in ICU-survivors was normal. Family members experienced worse employment status in 35% and 34% including a decrease in employment rate of 18.3% and 7.4% at 3- and 6-months post ICU-discharge, respectively. Psychologically, 63% of the family members reported ongoing impaired well-being due to the COVID-19 related mandatory physical distance to their relatives.CONCLUSIONWe have shown that COVID-19 ICU-survivors suffer from a prolonged burden of disease, prominent in physical- and social functioning, worse employment status and persisting symptoms in 90%. In addition, family members also report long term effects expressed by a reduction in return to work and impaired well-being. Further research needs to extend the follow up and to study the effects of standardized rehabilitation in COVID-19 patients and their family members.

scholarly journals Chemical injuries from assaults: An increasing trend in a developing country

2008 ◽  
Vol 41 (01) ◽  
pp. 20-23
Author(s):  
Peter B. Olaitan ◽  
Bernard C Jiburm
Keyword(s):  
Suicide Attempts ◽  
Gentian Violet ◽  
Late Presentation ◽  
Burn Injuries ◽  
Engine Oil ◽  
Chemical Burn ◽  
Sources Of Information ◽  
The People ◽  
Burn Unit ◽  
Chemical Injuries

ABSTRACT Objective: This paper describes chemical injuries, which presented to us and were managed at a burn unit in Nigeria. The purpose of this paper is to highlight the etiologies of these injuries, the extent of the injuries as well as to suggest possible ways to prevent chemical injuries in our environment.Materials and Methods: We carried out a retrospective review of chemical burns treated at our center. Our sources of information were the burn unit admission registers, case notes of the patients and operation registers. The results were collated and then analyzed.Results: Twenty eight patients presented with chemical burn injuries during the study period between January 2000 and December 2003, constituting 5.7% of all patients with burns treated within that period. Seventeen (60.7%) of the patients were males while 11 (29.3%) were females with a mean age of 20.6 years. The injuries were sustained from assault in 21 (75%), armed robbery attacks in five (17.8%) and suicide attempts in two (7.1%). The agents were usually unknown. Late presentation was observed in all the patients. Raw eggs, palm oil, gentian violet and engine oil were the substances applied immediately after the injuries. Complications observed included septicemia, respiratory distress, blindness, renal failure, mentosternal contractures, ectropion, axillary contractures, hypertrophic scars, keloids and skin depigmentation.Conclusion: Chemical burn injuries are mainly due to assaults in Nigeria and are usually extensive and presented late. Education of the people and penalty for any offender will reduce the current spate of such injuries.

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