Activity Impairment, Work Status, and Work Productivity Loss in Adults 5–7 Years After Burn Injuries

Abstract An important aspect of the rehabilitation of burn patients is social participation, including daily activities and work. Detailed information on long-term activity impairment and employment is scarce. Therefore, we investigated activity impairment, work status, and work productivity loss in adults 5–7 years following burn injuries, and investigated associations with burn-specific health-related quality of life (HRQL) domains. Adult participants completed the Work Productivity and Activity Impairment General Health questionnaire and the Burn Specific Health Scale-brief (BSHS-B) 5–7 years post-burn. Outcomes were compared between participants with mild/intermediate and severe burns (>20% total body surface area burned). Seventy-six (36%) of the 213 participants experienced some degree of activity impairment due to burn-related problems 5–7 years post-burn. Seventy percent of the population was employed; 12% of them experienced work productivity loss due to burn-related problems. Nineteen percent reported changes in their work situation (partly) because of the burn injury. A higher proportion of participants with severe burns had activity impairments (56% vs 29%; P = .001) and work productivity loss (26% vs 8%; P < .001) compared to participants with mild/intermediate burns. Activity impairment and work productivity loss were both associated with burn-related work problems and lower mood, measured with the BSHS-B. In conclusion, a substantial part of the study population experienced activity impairment and work productivity loss, was unemployed, and/or reported changes in their work situation due to their injury. Particularly patients with severe burns reported productivity loss and had lower employment rates. This subscribes the importance of addressing work-related functioning in the rehabilitation of burn patients.

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Development of A Framework for Managing Severe Burns Through A 17-Year Retrospective Analysis of Burn Epidemiology and Outcomes

10.21203/rs.3.rs-145485/v1 ◽

2021 ◽

Author(s):

ling chen ◽

xiaochong he ◽

jishu xian ◽

jianmei liao ◽

yue luo ◽

...

Keyword(s):

Retrospective Analysis ◽

Medical Cost ◽

Total Body Surface Area ◽

Older Age ◽

Burn Injuries ◽

Burn Severity ◽

Age Difference ◽

Burn Patients ◽

Full Thickness ◽

Severe Burns

Abstract Background Burns are one of the most common injuries in daily life for all ages of population. This study was to investigate the epidemiology and outcomes among burn patients in one of the largest burn centers in the southwest of China. Methods The study was performed at the Institute of Burn Research in the first affiliated with the Army Medical University (AMU). A total of 17939 burn patients were included in this retrospective study. Information regarding demographic, burn characteristics, and the burn severity of ABSI were collected, calculated and compared. Results The age ranged from 257 days to 95 years old. Scalding and flame were the two most common causes to burn injuries, comprising of 91.96% in total. Limbs, head/face/neck, and trunk were the most frequently occurred burn sites, with the number and the percent of 12324 (68.70%), 7989 (44.53%), and 7771 (43.32%), respectively. The average total body surface area (TBSA) was 13.64 ± 16.83% (median 8%) with a range of 0.1 ~ 100%. A total of 874 (4.9%) patients had TBSA > 50%. The presence of a burn with an inhalation injury was confirmed in 543 patients (3.03%). The average LOS was 32.11 ± 65.72 days (median: 17days). The gender of male, the older age and the full-thickness burns were significant contributors to high medical cost. The gender of male, the older age and the full-thickness burns were significantly associated with high medical cost and were contributors to the mortality. Eventually, the retrospective analysis resulted in the development of a framework of burn management continuum used for developing strategies to prevent and manage severe burns. Conclusion The annual number of burn injuries has kept decreasing while the cure rates of severe burns have improved; However, the burn severity and the economic burden were still in a high level. The gender difference and age difference should be considered when making individualized interventions and rehabilitative treatments.

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Development of a Framework for Managing Severe Burns Through a 17-year Retrospective Analysis of Burn Epidemiology and Outcomes

10.21203/rs.3.rs-145350/v1 ◽

2021 ◽

Author(s):

Ling Chen ◽

Xiaochong He ◽

Jishu Xian ◽

Jianmei Liao ◽

Xuanji Chen ◽

...

Keyword(s):

Retrospective Analysis ◽

Total Body Surface Area ◽

Inhalation Injury ◽

Burn Injuries ◽

Burn Severity ◽

Annual Number ◽

Age Difference ◽

Burn Patients ◽

Severe Burns ◽

High Level

Abstract Background Burns are one of the most common injuries in daily life for all ages of population. This study was to investigate the epidemiology and outcomes among burn patients in one of the largest burn centers in the southwest of China. Methods The study was performed at the Institute of Burn Research in the first affiliated with the Army Medical University (AMU). A total of 17939 burn patients were included in this retrospective study. Information regarding demographic, burn characteristics, and the burn severity of ABSI were collected, calculated and compared.Results The age ranged from 257 days to 95 years old. Scalding and flame were the two most common causes to burn injuries, comprising of 91.96% in total. Limbs, head/face/neck, and trunk were the most frequently occurred burn sites, with the number and the percent of 12324 (68.70%), 7989 (44.53%), and 7771 (43.32%), respectively. The average total body surface area (TBSA) was 13.64±16.83% (median 8%) with a range of 0.1~100%. A total of 874 (4.9%) patients had TBSA >50%. The presence of a burn with an inhalation injury was confirmed in 543 patients (3.03%). The average LOS was 32.11±65.72 days (median: 17days). Eventually, the retrospective analysis resulted in the development of a framework of burn management continuum used for developing strategies to prevent and manage severe burns.Conclusions The annual number of burn injuries has kept decreasing, which was partially attributed to the increased awareness and education of burn prevention and the improved burn-preventative circumstances. However, the burn severity and the economic burden were still in a high level. And the gender difference and age difference should be considered when making individualized interventions and rehabilitative treatments.

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Development of a framework for managing severe burns through a 17-year retrospective analysis of burn epidemiology and outcomes

Scientific Reports ◽

10.1038/s41598-021-88507-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ling Chen ◽

Xiaochong He ◽

Jishu Xian ◽

Jianmei Liao ◽

Xuanji Chen ◽

...

Keyword(s):

Retrospective Analysis ◽

Total Body Surface Area ◽

Inhalation Injury ◽

Burn Injuries ◽

Annual Number ◽

Age Difference ◽

Burn Patients ◽

Burn Prevention ◽

Severe Burns ◽

High Level

AbstractBurns are one of the most common injuries in daily life for all ages of population. This study was to investigate the epidemiology and outcomes among burn patients in one of the largest burn centers in the southwest of China. The study was performed at the Institute of Burn Research in the first affiliated with the Army Medical University (AMU). A total of 17,939 burn patients were included in this retrospective study. Information regarding burn epidemiology and outcomes in 17 years were collected, calculated and compared. The age ranged from 257 days to 95 years old. Scalding and flame were the two most common causes to burn injuries, comprising of 91.96% in total. Limbs, head/face/neck, and trunk were the most frequently occurred burn sites, with the number and the percent of 12,324 (68.70%), 7989 (44.53%), and 7771 (43.32%), respectively. The average total body surface area (TBSA) was 13.64 ± 16.83% (median 8%) with a range of 0.1–100%. A total of 874 (4.9%) patients had TBSA > 50%. The presence of a burn with an inhalation injury was confirmed in 543 patients (3.03%). The average LOS was 32.11 ± 65.72 days (median: 17 days). Eventually, the retrospective analysis resulted in the development of a burn management continuum used for developing strategies to prevent and manage severe burns. The annual number of burn injuries has kept decreasing, which was partially attributed to the increased awareness and education of burn prevention and the improved burn-preventative circumstances. However, the burn severity and the economic burden were still in a high level. And the gender difference and age difference should be considered when making individualized interventions and rehabilitative treatments.

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AB0727 WORK OUTCOMES AND ASSOCIATED FACTORS IN ANKYLOSING SPONDYLITIS PATIENTS IN CHINA

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1650 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1658.1-1658

Author(s):

L. Tu ◽

Y. Xie ◽

Q. Lv ◽

M. Yang ◽

Z. Liao ◽

...

Keyword(s):

Quality Of Life ◽

Ankylosing Spondylitis ◽

Disease Duration ◽

Productivity Loss ◽

Work Productivity ◽

Work Outcomes ◽

Activity Impairment ◽

Factors Associated ◽

The Impact

Background:Poorer work productivity due to pain and functional impairment is commonly seen in ankylosing spondylitis (AS) patients, which may contribute to huge social economic burden. However, data about work outcomes and associated factors in Chinese AS patients were barely reported.Objectives:To assess work outcomes and identify factors associated with poor work productivity in patients with AS in China.Methods:A cross-sectional study was conducted in China. Adult patients (aged ≥ 18 years) fulfilled the 1984 New York modified criteria of AS were enrolled from rheumatology center from Jan 2017 to Aug 2017. All participants completed questionnaires about socio-demographic characteristics, disease characteristics, quality of life and the Work productivity and activity impairment questionnaire in AS (WPAI:SpA) to accesses the impact of chronic health conditions on job performance and productivity. Factors associated with work outcomes were evaluated.Results:A total of 91 patients with AS were included: 87.8% males, 78.02% employed, mean age and disease duration of 30 and 10 years respectively. The mean (SD) activity impairment of all patients was 48.57% (22.02%). For patients with employed work, mean (SD) absenteeism, presenteeism and work productivity loss were 10.22% (19.44%), 43.86% (22.48%) and 47.92% (25.81%) respectively. In multivariable analysis, activity impairment was associated with Bath Ankylosing Spondylitis Functional Index (BASFI) (P<0.01) and Ankylosing Spondylitis Quality of Life (ASQoL) (P<0.01). Absenteeism was associated with disease duration (P=0.03). Presenteeism was associated with disease duration (P=0.04), BASFI (P<0.01) and ASQoL (P<0.01). Work productivity loss was associated with BASFI (P<0.01) and ASQoL (P<0.01).Conclusion:Longer disease duration, reduced physical function and poorer quality of life are associated with reduced work productivity in Chinese AS patients.References:[1]Boonen A, van der Heijde D, Landewe R, Spoorenberg A, Schouten H, Rutten-van Molken M, et al. Work status and productivity costs due to ankylosing spondylitis: comparison of three European countries. Annals of the rheumatic diseases. 2002;61(5):429-37.[2]Martindale J, Shukla R, Goodacre J. The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity. Best Pract Res Clin Rheumatol. 2015;29(3):512-23.[3]Castillo-Ortiz JD, Ramiro S, Landewe R, van der Heijde D, Dougados M, van den Bosch F, et al. Work Outcome in Patients With Ankylosing Spondylitis: Results From a 12-Year Followup of an International Study. Arthritis Care Res (Hoboken). 2016;68(4):544-52.[4]Sag S, Nas K, Sag MS, Tekeoglu I, Kamanli A. Relationship of work disability between the disease activity, depression and quality of life in patients with ankylosing spondylitis. J Back Musculoskelet Rehabil. 2018;31(3):499-505.[5]Goh Y, Kwan YH, Leung YY, Fong W, Cheung PP. A cross-sectional study on factors associated with poor work outcomes in patients with axial spondyloarthritis in Singapore. Int J Rheum Dis. 2019;22(11):2001-8.Disclosure of Interests:None declared

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OMERACT Filter Evidence Supporting the Measurement of At-work Productivity Loss as an Outcome Measure in Rheumatology Research

The Journal of Rheumatology ◽

10.3899/jrheum.141077 ◽

2015 ◽

Vol 43 (1) ◽

pp. 214-222 ◽

Cited By ~ 16

Author(s):

Dorcas E. Beaton ◽

Sarah Dyer ◽

Annelies Boonen ◽

Suzanne M.M. Verstappen ◽

Reuben Escorpizo ◽

...

Keyword(s):

Outcome Measurement ◽

Contextual Factors ◽

Productivity Loss ◽

Work Productivity ◽

Contextual Factor ◽

Nominal Group ◽

Future Research ◽

Specific Work ◽

Worker Productivity ◽

Activity Impairment

Objective.Indicators of work role functioning (being at work, and being productive while at work) are important outcomes for persons with arthritis. As the worker productivity working group at OMERACT (Outcome Measures in Rheumatology), we sought to provide an evidence base for consensus on standardized instruments to measure worker productivity [both absenteeism and at-work productivity (presenteeism) as well as critical contextual factors].Methods.Literature reviews and primary studies were done and reported to the OMERACT 12 (2014) meeting to build the OMERACT Filter 2.0 evidence for worker productivity outcome measurement instruments. Contextual factor domains that could have an effect on scores on worker productivity instruments were identified by nominal group techniques, and strength of influence was further assessed by literature review.Results.At OMERACT 9 (2008), we identified 6 candidate measures of absenteeism, which received 94% endorsement at the plenary vote. At OMERACT 11 (2012) we received over the required minimum vote of 70% for endorsement of 2 at-work productivity loss measures. During OMERACT 12 (2014), out of 4 measures of at-work productivity loss, 3 (1 global; 2 multiitem) received support as having passed the OMERACT Filter with over 70% of the plenary vote. In addition, 3 contextual factor domains received a 95% vote to explore their validity as core contextual factors: nature of work, work accommodation, and workplace support.Conclusion.Our current recommendations for at-work productivity loss measures are: WALS (Workplace Activity Limitations Scale), WLQ PDmod (Work Limitations Questionnaire with modified physical demands scale), WAI (Work Ability Index), WPS (Arthritis-specific Work Productivity Survey), and WPAI (Work Productivity and Activity Impairment Questionnaire). Our future research focus will shift to confirming core contextual factors to consider in the measurement of worker productivity.

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Prevalence of Psychiatric Disorders in Burn Patients in a Tertiary Care Hospital

10.53350/pjmhs2115113389 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3389-3391

Author(s):

Imran Khan ◽

Taimur Khan ◽

Shakil Asif ◽

Syed Azhar Ali Kazmi ◽

Subhan Ullah ◽

...

Keyword(s):

Surface Area ◽

Body Surface Area ◽

Body Surface ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Total Body Surface Area ◽

Burn Injuries ◽

Care Hospital ◽

Burn Patients ◽

Total Body

Background and Aim: Burn injuries patients generally suffer from various psychological and mental disorders especially in lower socio-economic groups. It can adversely affect their wellbeing and health. Proper consultation and clinical diagnosis need to be carried out on burns injuries patients from the early critical phase to rehabilitation phase recovery. The current study's aim was to determine the prevalence of psychiatric disorders in burn patients in a tertiary care hospital. Materials and Methods: This cross-sectional study was conducted on 82 attempted burn suicides, adult patients in Khattak Medical Center Peshawar, Khyber Teaching Hospital Peshawar and Divisional Headquarter hospital, Mirpur AJK for duration of six months from June 2020 to December 2020. All the patients admitted with suicides burns were of either gender and had ages above 15 years. The convenience technique was used for sampling. The patients’ demographic details such as psychiatric illness, self-immolation act motivation, burn injury depth, burn total body surface area, inhalation injury, hospitalization duration, and mortality was recorded on pre-designed proforma. Data analysis was carried out with SPSS version 20. Results: The mean age of all 82 patients was 28.9±5.2 with an age range of 14 to 55 years. Of the total, 66 (80.5%) were female while 16 (19.5%) were male. In this study, the most frequent suicidal attempt was made by the marital conflicted patients 50 (61%) followed by love affair failure 8 (9.7%). An overall mean of 53.6±19.6 was observed for total body surface area affected with a range of 15-100%. The hospital duration mean was 8.2±5.9 with a range of 1-38 days. Young, married, and rural area illiterate housewives were the most common self-inflicted/suicide burn injuries. The prime cause of such injuries was getting married. The mortality rate was found at 82.3%. Conclusion: Our study concluded that patient’s well-being and mental health could be severely affected by burn injuries. Prevalent depression was noted among severe burn injuries patients. Depression related to deformity could be prevented with early grafting, wound management, proper splinting, coping ability, intense physiotherapy, and long-term rehabilitation. Keywords: Burn; Depressed mood, Psychiatric morbidity, Posttraumatic stress disorder

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Abstract P134: Higher Optimal Lifestyle Score is Associated with Greater Workplace Productivity

Circulation ◽

10.1161/circ.125.suppl_10.ap134 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Jackie L Boucher ◽

Jeffrey J VanWormer ◽

Heather R Britt ◽

James M Peacock ◽

Kevin J Graham

Keyword(s):

Productivity Loss ◽

Work Productivity ◽

Economic Benefits ◽

Lifestyle Factor ◽

Full Time ◽

Lifestyle Habits ◽

Activity Impairment ◽

Cross Sectional ◽

Workplace Productivity ◽

The Impact

Introduction: Unhealthy lifestyles are associated with low workplace productivity, but lifestyle risks tend to cluster and the impact of this is not well studied. This analysis examined the cross-sectional association between an optimal lifestyle score (OLS) and overall workplace productivity in the Heart of New Ulm Project. Hypothesis: It was hypothesized that a higher OLS would be associated with higher workplace productivity relative to a lower OLS. Methods: Complete data was available from 2,987 adults age 18-85 years (with ≥0.40 FTE work agreement) without self-reported diabetes or heart disease, who underwent a cardiovascular risk factor screening in 2009. For each participant, an OLS of 0-4 total points was created by summing one point for each of the following factors: non-smoker, ≥150 min/wk of moderately equivalent physical activity, 1-14 alcoholic drinks/wk, and ≥5 serv/d of fruits and vegetables. Overall productivity loss combined absenteeism and presenteeism from the Work Productivity and Activity Impairment questionnaire, reflecting the percentage loss of all available work hours (per work agreement) due to health reasons. Results: After adjustment for age, sex, body mass index, and Perceived Stress Scale score, least squares adjusted mean±SE productivity loss was 9.9±1.9% for an OLS of 0, 5.7±0.6% for an OLS of 1, 4.9±0.4% for an OLS of 2, 4.9±0.4% for an OLS of 3, and 4.7±1.0% for an OLS of 4 (p for trend <0.001). Post hoc comparisons revealed that OLS’s of 0 were significantly different (p =0.05) from all other OLS’s, while OLS’s of 1, 2, 3, or 4 were statistically indistinguishable (p=0.05) from one another. Conclusions: A beneficial threshold of having at least one optimal lifestyle factor was observed. When productivity loss is converted to lost dollars under the assumptions that all employees work full time with an annual salary of $50,000, an OLS of 0 (-$4,950/employee) has over two-fold higher annual estimated workplace productivity losses relative to an OLS of 4 (-$2,350/employee). Employees with no optimal lifestyle habits, however, represent a very small proportion (1.5% of this analysis; 46 of 2,987) of the total workforce. As such, greater absolute economic benefits may be realized by focusing interventions primarily on supporting the maintenance of existing optimal lifestyle habits.

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Microbiology and Infection Profile of Electric Burned Patients in a Referral Burn Hospital in Mexico City

Journal of Burn Care & Research ◽

10.1093/jbcr/irz177 ◽

2019 ◽

Vol 41 (2) ◽

pp. 390-397 ◽

Cited By ~ 1

Author(s):

Luis Esaú López-Jácome ◽

Tatiana Chávez-Heres ◽

Noé Becerra-Lobato ◽

María de Lourdes García-Hernández ◽

Edgar Samuel Vanegas-Rodríguez ◽

...

Keyword(s):

Mexico City ◽

Total Body Surface Area ◽

Multidrug Resistant ◽

Burn Injuries ◽

Burn Patients ◽

Gram Negative ◽

Young Males ◽

Total Body ◽

Electric Burns ◽

Complications And Mortality

Abstract Electrical burn injuries are one of the most severe forms of trauma. This study aims to investigate the infection complications in electrical burn patients in a referral hospital in Mexico City. A longitudinal retrospective study was conducted, involving electrical burn patients admitted from April 2011 to December 2016. Demographic and clinical data including type of electric burns, infection complications, and mortality was sought. Data were collected at admission and daily until discharge. Number and type of infections and microorganism isolations were sought. Risk factors for death were analyzed. A total of 111 patients were included, of which 96.4% were males, mean age of 31.6±16.22, most injuries were high voltage associated. The total body surface area average was 27.8% ± 19.63. The overall infection rate was 72.9 cases per 100 patients. Mortality was observed in 4 (3.6%) patients. About 59.1% (443/749) had growth for Gram-negative bacteria. Multidrug-resistant Pseudomonas aeruginosa was the most frequent microorganism isolated. Fungi were present in 4.9% of cases. Electrical burn injuries occurred in young males in our study. Infection was frequent, most of them caused by Gram-negative rods with an important rate of antimicrobial resistance; however, an important microbial diversity was present.

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Impact of constipation on opioid therapy management among long-term opioid users, based on a patient survey

Journal of Opioid Management ◽

10.5055/jom.2015.0282 ◽

2015 ◽

Vol 11 (4) ◽

pp. 325 ◽

Cited By ~ 16

Author(s):

Shaloo Gupta, MS ◽

Haridarshan Patel, PharmD ◽

Justin Scopel, MD, MBA ◽

Reema R. Mody, MBA, PhD

Keyword(s):

Quality Of Life ◽

Medication Adherence ◽

Treatment Satisfaction ◽

Linear Models ◽

Productivity Loss ◽

Work Productivity ◽

Opioid Therapy ◽

Activity Impairment ◽

Cross Sectional

Objective: The authors sought to characterize health-related quality of life (HRQoL), medication adherence, productivity losses, and treatment satisfaction associated with modifications to opioid therapy due to opioid-induced constipation (OIC).Design: A cross-sectional, between-subjects design was used to examine health outcomes among US noncancer participants currently taking opioids.Patients, participants: Participants were adults in the 2012 US National Health and Wellness Survey, who reported currently using opioids (>30 days) and experiencing constipation. Respondents were categorized as making modifications to opioid therapy due to OIC (modifiers, n = 244) or making no modifications (nonmodifiers, n = 247).Main outcome measures: Patient Assessment of Constipation Quality of Life (PAC-QoL) and Symptoms (PAC-Sym), Morisky Medication Adherence Scale (MMAS-4), Work Productivity and Activity Impairment, and the Treatment Satisfaction Questionnaire for Medication (TSQM II) for OIC treatment were administered. Generalized linear models were adjusted to control for baseline characteristics (age, gender, comorbidities, opioid strength, etc). Results: Modifiers reported poorer HRQoL (PAC-QoL total: 1.74 vs 1.44, p < 0.001), worse constipation (PAC-Sym total: 1.56 vs 1.35, p = 0.003), more pain-related resource use (surgery: odds ratio (OR) = 3.72, p = 0.002; emergency room visits: OR = 1.88, p = 0.049; hospitalizations: OR = 2.47, p = 0.033), and lower adherence (MMAS-4 pain: OR = 0.12, p < 0.001; MMAS-4 OIC: OR = 0.39, p < 0.001) than nonmodifiers. Modifiers reported greater presenteeism (49.75 percent vs 38.28 percent, p = 0.038), but no significant differences were found for activity impairment or OIC treatment satisfaction.Conclusions: Treating OIC effectively may help prevent inadequate pain management secondary to opioid therapy modification, help increase HRQoL, lessen OIC symptoms, decrease productivity loss, and improve adherence to opioid and OIC treatments.

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