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.

T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S2-S3
Author(s):  
Callie Abouzeid ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Mental Health ◽  
Hospital Stay ◽  
National Database ◽  
Time Points ◽  
Patient Reported ◽  
Burn Survivors ◽  
Population Demographic ◽  
The Impact ◽  
Over Time

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. 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 then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.

81 Inhalation Injury Is Associated with Long-term Physical, Satisfaction with Life, and Employment Outcomes: A Longitudinal National Database Study

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S52-S53
Author(s):  
Olivia Stockly ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Barclay T Stewart ◽  
Nicole S Gibran ◽  
...  
Keyword(s):  
Satisfaction With Life ◽  
Short Form ◽  
Inhalation Injury ◽  
Satisfaction With Life Scale ◽  
National Database ◽  
Life Outcomes ◽  
Post Injury ◽  
Composite Scale ◽  
Burn Survivors

Abstract Introduction The effects of inhalation injury on mortality are well established. However, little is known about the long-term impacts of inhalation injuries on survivors. This study aims to describe the inhalation injury population and examine differences in long-term physical, mental, employment, and satisfaction with life outcomes between adult burn survivors with and without inhalation injury. Methods Data from the Burn Model System National Database (1993–2019) were analyzed. Demographic and clinical characteristics of those with and without inhalation injury were assessed. The Physical Health Composite Scale (PCS) and Mental Health Composite Scale (MCS) of the Short Form-12 Health Survey, Employment Status, and Satisfaction with Life Scale (SWLS) were analyzed at 24 months post-injury. Regression analyses assessed whether inhalation injury was associated with each outcome, which were adjusted for age, gender, race, ethnicity, and burn size. Results The analysis included 4,045 individuals (452 with inhalation injury, 3,593 without inhalation injury). Those with inhalation injury had larger burn size, longer hospital lengths of stay, and more operations; they were less likely to be employed at injury and injured at work, and took longer to gain employment after injury (Table 1). Two years after injury, individuals with inhalation injury were half as likely to be working (OR = 0.49, p< 0.001), and had worse PCS (β=-2.51, p=0.021) and SWL scores (β=-2.35, p=0.006) compared to those without inhalation injury. MCS scores did not differ between groups. Conclusions Burn survivors with inhalation injuries experience lower rates of employment, worse physical functioning, and worse satisfaction with life outcomes at 24 months post-injury compared to those without inhalation injuries. Applicability of Research to Practice Burn survivors with an inhalation injury may require supplementary resources and treatment as well as monitoring of sequelae long-term.

572 Examination of Gender Differences in Return to School and PROMIS-25® Outcomes for Pediatric Burn Survivors

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S127-S128
Author(s):  
Olivia Stockly ◽  
Audrey E Wolfe ◽  
Nicole S Gibran ◽  
Colleen M Ryan ◽  
Jeffrey C Schneider
Keyword(s):  
Gender Differences ◽  
Health Outcomes ◽  
Clinical Characteristics ◽  
Burn Injury ◽  
National Database ◽  
Post Injury ◽  
Burn Survivors ◽  
School Status ◽  
The Impact

Abstract Introduction Gender differences in pediatric burn outcomes are not well-known. Long-term physical and mental health outcomes, in addition to school status, serve as important markers in recovery for school-aged burn survivors. This study aimed to assess the impact of gender on school status and health outcomes in pediatric burn survivors. Methods Data from pediatric burn survivors, age 8–17 years at time of injury that are participating in the Burn Model System National Database (2015–2019) were analyzed. Descriptive statistics were generated for demographic and clinical characteristics. Scores on the seven subscales of the PROMIS-25 (physical function, anxiety, depression, fatigue, peer support, pain interference, and pain intensity) and school status at 12 months post-injury were examined. All demographic, clinical, and outcome data were compared by gender using Chi-square tests of association and two-sample t-tests for categorical and continuous variables, respectively. Results A total of 104 individuals (76 male, 28 female) were included in the demographic analysis. Additionally, 60 individuals had complete PROMIS-25® data at 12 months post-injury and were included in analysis. Demographic and clinical characteristics including age at time of burn injury, race/ethnicity, burn etiology, burn location and burn size did not differ by gender. No differences were found in PROMIS-25® subscales (p=0.22–0.87; Table 1) or school status by gender. Nearly 80% of male and female burn survivors were in school at 12-months post-injury (76.6% male vs. 88.2% female; p=0.307). Conclusions In this study, burn survivors between the ages of 8 and 17 years old did not experience any differences in long-term PROMIS-25® outcomes or school status at 12 months post-injury based on gender. Applicability of Research to Practice Preliminary data suggest similar physical, mental, and school outcomes for school aged children based on gender. A more robust examination of long-term pediatric outcomes and school status are needed in the future.

64 Temperature Sensitivity Is Associated with Lower Satisfaction with Life After Burns

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S45-S46
Author(s):  
Jamie Oh ◽  
Carolina Seek ◽  
Stephen H Sibbett ◽  
Gretchen J Carrougher ◽  
Colleen M Ryan ◽  
...  
Keyword(s):  
Mental Health ◽  
Temperature Sensitivity ◽  
Satisfaction With Life ◽  
Burn Injury ◽  
Independent Predictor ◽  
Satisfaction With Life Scale ◽  
Discharge Temperature ◽  
Patient Reported ◽  
The Impact

Abstract Introduction Temperature sensitivity is a common problem after burn injury. However, the impact of temperature sensitivity on health-related quality of life (QoL) is unknown. We aimed to describe characteristics associated with temperature sensitivity and determine its association with patient reported QoL. We hypothesized that temperature sensitivity negatively impacts both mental and physical health. Methods We reviewed a multicenter burn database for participants who had been asked about hot or cold temperature sensitivity 6, 12 and 24 months after injury. Outcomes of interest included the Satisfaction with Life Scale (SWLS) score and Veterans RAND 12 (VR-12) physical (PCS) & mental health summary (MCS) scores. Chi square and Kruskal-Wallis tests determined differences in patient and injury characteristics. Generalized linear regression models included burn size (%TBSA), graft size (%TBSA), location of burn, pruritis intensity, amputation status, study site, and review of systems questions at each follow-up visit as covariates to determine the impact of temperature sensitivity on QoL. Results The cohort was comprised of 637 participants. Prevalence of temperature sensitivity at each follow-up period ranged from 48%-54%. Those who experienced temperature sensitivity had larger burns, required more grafting, and had higher intensity of pruritus at discharge. Temperature sensitivity was associated with lower SWLS scores and lower VR-12 PCS and MCS at each follow-up period. After controlling for confounding variables, temperature sensitivity remained a significant independent predictor of lower SWLS scores (OR -3.2, 95% CI -5.4, -1.1) and VR-12 MCS (OR -4.4, 95% CI -7.4, -1.4) at 6 months follow-up. Conclusions Temperature sensitivity is a highly prevalent symptom after burn injury and an independent predictor of worse satisfaction with life and worse mental health recovery.

Temperature sensitivity after burn injury: A Burn Model System National Database Hot Topic

2021 ◽  
Author(s):  
Jamie Oh ◽  
Christopher Madison ◽  
Grace Flott ◽  
Elisha G Brownson ◽  
Stephen Sibbett ◽  
...  
Keyword(s):  
Temperature Sensitivity ◽  
Satisfaction With Life ◽  
Burn Injury ◽  
Model System ◽  
Satisfaction With Life Scale ◽  
National Database ◽  
Linear Regression Models ◽  
Chi Square ◽  
Related Quality ◽  
Over Time

Abstract Background People living with burn injury often report temperature sensitivity. However, its epidemiology and associations with health-related quality of life (HRQOL) are unknown. We aimed to characterize temperature sensitivity and determine its impact on HRQOL to inform patient education after recovery from burn injury. Methods We used the multicenter, longitudinal Burn Model System National Database to assess temperature sensitivity at 6, 12 and 24 months after burn injury. Chi-square and Kruskal-Wallis tests determined differences in patient and injury characteristics. Multivariable, multi-level generalized linear regression models determined the association of temperature sensitivity with Satisfaction with Life Scale (SWL) scores and Veterans RAND 12 (VR-12) physical (PCS) and mental health summary (MCS) component scores. Results The cohort comprised 637 participants. Two thirds (66%) experienced temperature sensitivity. They had larger burns (12% TBSA, IQR 4-30 vs 5% TBSA, IQR 2-15; p<0.0001), required more grafting (5% TBSA, IQR 1-19 vs 2% TBSA, IQR 0-6; p<0.0001), and had higher intensity of pruritus at discharge (11% severe vs 5% severe; p=0.002). After adjusting for confounding variables, temperature sensitivity was strongly associated with lower SWL (OR -3.2, 95% CI -5.2, -1.1) and MCS (OR -4.0, 95% CI -6.9, -1.2) at 6-months. Temperature sensitivity decreased over time (43% at discharge, 4% at 24-months) and was not associated with poorer HRQOL at 12 and 24 months. Conclusion Temperature sensitivity is common after burn injury and associated with worse SWL and MCS during the first year after injury. However, temperature sensitivity seems to improve and be less intrusive over time.

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.

833 The Importance of Trajectory Curves for the Implementation of Outcome Benchmarks in a Clinical Setting

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S254-S255
Author(s):  
Brian M Kelter ◽  
Audrey E Wolfe ◽  
Mary D Slavin ◽  
Lewis Kazis ◽  
Colleen M Ryan ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Literature Review ◽  
Social Participation ◽  
Burn Injury ◽  
Patient Specific ◽  
Clinical Settings ◽  
Patient Reported ◽  
Burn Survivors ◽  
Analytical Approaches ◽  
Over Time

Abstract Introduction The creation of individualized treatment plans that address social participation in burn survivors requires an understanding of the expected changes over time from the original burn injury. The Life Impact Burn Recovery Evaluation (LIBRE) Profile is a patient-reported outcome measure for social participation after burn injury. Visual representation of expected change over time of a population is achieved through the development of trajectory curves (TCs), serving as benchmarks for recovery. In order to optimize the implementation of LIBRE Profile TCs, a literature review was conducted to examine utilization of TCs in other clinical settings. Methods A review of studies published from 2014–2019, demonstrating TCs as growth or treatment models in clinical settings, was performed. Literature was identified by searching “trajectory curves,” “trajectory models,” and “clinic” or “clinical” in PubMed. Articles focusing on three areas of inquiry were included: 1) measuring individual patient growth; 2) comparing progress for similar patient cohorts to provide contextualized reference for personal growth; 3) predictive medicine/risk assessment for interventional care in various conditions. Results The initial literature review identified 141 manuscripts. A total of 107 were excluded and 34 manuscripts were reviewed and categorized based on the three areas of inquiry (Figure 1; Table 1). Positive results from TCs in all areas of inquiry were noted in 22 of the 34 the chosen studies. General trends for each area of inquiry include: an increased ability for parents and clinicians to track individual patient progress in what was primarily anthropometric studies; articles relating to comparative cohort tracking show that trajectory-driven analytical approaches offer displays of progress across similar clinical groups of recovery for given conditions. Use of TCs in predictive care or risk assessment typically relate to acute conditions such as asthma, traumatic brain injury, or degenerative conditions (neurocognitive or musculoskeletal). For the most part, these diagnoses depict a positive trend for clinicians to identify future outcomes using fitted trajectories. Conclusions These findings support the clinical use of trajectory curves to present patient-specific, cohort-relative, and predictive treatment for outcome-based results post-burn for burn survivors. Applicability of Research to Practice Future research will assess the use of LIBRE Profile recovery trajectories as benchmarks for optimization of social participation outcomes.

scholarly journals 44 Examining the Impact of the COVID-19 Pandemic on Participants in a Longitudinal Study of Burn Outcomes

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S32-S33
Author(s):  
Brian M Kelter ◽  
Audrey E Wolfe ◽  
Callie Abouzeid ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Propensity Score ◽  
Sample Size ◽  
Satisfaction With Life Scale ◽  
National Database ◽  
Cross Sectional ◽  
Time Points ◽  
Outcome Scores ◽  
The Impact ◽  
Time Point

Abstract Introduction The COVID-19 pandemic has had widespread effects on healthcare and society at large. There are limited data on the impact of the pandemic on the long-term recovery of the burn survivor. This study aims to compare physical and psychosocial outcomes of the burn survivor population before and during the COVID-19 pandemic. Methods Data from the Burn Model System National Database (2015-present) were analyzed. Data were divided into pre- and during-pandemic groups (before and after March 1st, 2020). Outcomes were compared at four cross-sectional time points: 6, 12, 24, and 60 months after burn injury. The following patient reported outcome measures were examined: SF-12 Health Survey, PROMIS-29, Post-Traumatic Growth Indicator, Community Integration Questionnaire, Patient Civilian Checklist, Satisfaction with Life Scale, Burn Specific Health Scale, NeuroQOL Stigma, 4-D Itch, and CAGE Questionnaire (drug/alcohol misuse). Given the cross-sectional design, potential differences in clinical and demographic characteristics were examined for each group at each time point. Adjusted mean outcome scores at each time point were compared between groups using a two stage multi-variable regression model with propensity score matching. For each time point, subjects from each group were matched. The propensity score was calculated using the following matching variables: gender, age, race, ethnicity, etiology, length of stay, and burn size. The mean score difference of outcomes within each matched sample was examined. Results Sample sizes varied by time point with a range from 420 at 6 months to 94 at 60 months. The during-COVID group comprised 10% of the total sample size. There were no significant differences in demographic and clinical characteristics between the groups at any time point. There were no significant differences between the groups in adjusted mean outcome scores across the different time points. Conclusions This preliminary examination showed no differences in myriad long-term outcomes at multiple time points after injury among burn survivors before and during the start of the COVID-19 pandemic. The results may suggest an element of resilience, however given the sample size and cross-sectional limitations further investigation is required to better understand the impact of COVID-19 on the burn population.

scholarly journals Evidence on the Bidirectional Relationship Between Health and Life Satisfaction in Older Adults

2021 ◽  
Author(s):  
Darío Moreno-Agostino ◽  
Francisco José Abad ◽  
Francisco Félix Caballero
Keyword(s):  
Older Adults ◽  
Life Satisfaction ◽  
Structural Equation ◽  
Satisfaction With Life ◽  
Satisfaction With Life Scale ◽  
Theory Approach ◽  
Cross Sectional ◽  
Bidirectional Relationship ◽  
The Impact ◽  
Over Time

AbstractPrevious research on health and life satisfaction in older adults has suggested a bidirectional relationship. However, most evidence either is based on cross-sectional data, being unsuitable for inferring any directionality on the results, or disregards the within-person stability of both variables over time, thus providing potentially biased results. We analysed data from 11,667 older adults interviewed between 2008 and 2016 within the English Longitudinal Study of Ageing. A health measure including self-reported and measured tests on cognitive and physical performance was computed using a Bayesian multilevel item-response theory approach. Life satisfaction was assessed with the Satisfaction with Life Scale. Cross-lagged models using a Structural Equation Modelling approach were used to analyse the longitudinal interrelation between health and life satisfaction. Models accounting and not accounting for the within-person stability in the measures were computed. Additional sensitivity models were ran using an exclusively self-reported measure of health. Health and life satisfaction were significant longitudinal predictors of one another only when the within-person stability was not considered. The effect of life satisfaction on health became negligible once that stability was modelled. The impact of not accounting for within-person stability was larger when health was measured exclusively with self-reported information. Our study suggests that health and life satisfaction are not bidirectionally related in older adults, but only health predicts a better life satisfaction over time. Thus, policies aimed at fostering older adults’ life satisfaction by focusing on health enhancement and maintenance may be fruitful, whereas the opposite may not.

853 Microblading in Patients with Facial Burn Injuries

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S264-S265
Author(s):  
Melissa Brown ◽  
Lori Turgeon ◽  
Branko Bojovic
Keyword(s):  
Body Image ◽  
Burn Injury ◽  
Scar Tissue ◽  
Self Esteem ◽  
Post Treatment ◽  
Non Invasive ◽  
Patient Reported ◽  
The Impact ◽  
Over Time ◽  
Facial Burn

Abstract Introduction The experience of a burn injury is devastating. Physical and emotional recovery can be lengthy and often difficult. Many patients tire of constant surgical interventions required to achieve optimal functional and cosmetic outcomes. Identifying non-invasive interventions for patients with extensive facial burns that positively affect quality of life is appealing. Microblading, semi-permanent eyebrow tattooing, is one such option. Little research exists on the durability and longevity of microblading in burns, or its impact on body-image and self-esteem. The purpose of this case review is to identify possible benefits microblading may have physically and psychologically. Methods Case report looking at the impact of microblading on a young adult female over 18 years, who sustained a facial burn injury at age one year. Following consultation with her plastic surgeon, she was referred to a licensed body art facility to assess the viability of microblading over scar tissue. First treatment occurred at the facility in March of 2019 with a second session in May, as is standard practice. Patient photos obtained before and after procedures assessed longevity of microblading over scar tissue. Self-reported patient outcomes obtained following the procedure addressed the impact on perceived self-esteem and body-image. Results Photos were taken pre-treatment, directly post-treatment, 2 months, and 6 months post-treatment. Comparisons of photos immediately post treatment to those 6 months out showed appearance of tattooing remains the same. Eyebrows did not fade with time and continue to hold the same color and shape. Assessment of psychological impact was conducted through patient interview and self-report. Patient reported satisfaction with the procedure and cosmetic appearance following initial treatment. Over time, patient noted feeling more positive about body image and improvement in self-esteem. Conclusions Eyebrows are a critically important part of facial expression, which can be lost following a devastating facial burn. Initial data demonstrate the effectiveness of tattooing in recreating the appearance and function of eyebrows over scar tissue. Over time, the eyebrows maintained color without fading and shape did not change, demonstrating durability and longevity in this patient population. Early reports of improved self-image also remained unchanged over time. Microblading presents a possible low risk, inexpensive, effective alternative to expensive or potentially ineffective cosmetic surgery. This case establishes a need for further research on efficacy of microblading over scar tissue, with the hope of incorporating it into burn reconstruction as an alternative therapy and advocate for insurance coverage for qualifying patients. Applicability of Research to Practice Research supports microblading as a potential non-invasive, inexpensive treatment modality for loss of eyebrows.

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