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.

Food Insecurity and Mortality in American Adults: Results From the NHANES-Linked Mortality Study

2020 ◽  
pp. 152483992094592 ◽  
Author(s):  
Srikanta Banerjee ◽  
Tim Radak ◽  
Jagdish Khubchandani ◽  
Patrick Dunn
Keyword(s):  
Health Risk ◽  
Food Insecurity ◽  
Public Health Problem ◽  
The United States ◽  
Mortality Data ◽  
Long Term Outcomes ◽  
Interdisciplinary Approaches ◽  
The Impact

Food insecurity is a significant public health problem in the United States leading to substantial social, economic, and health care–related burdens. While studies continue to estimate the prevalence of food insecurity, the long-term outcomes are not extensively explored. The purpose of this study was to assess the impact of food insecurity on mortality. We analyzed data on adults (≥ 20 years) from the 1999–2010 National Health and Nutrition Examination Survey, with mortality data obtained through 2015. Among the total study participants (n = 25,247), 17.6% reported food insecurity. Food-insecure individuals were more likely to be younger in age, minorities, poorer, with lesser education, obese, smokers, and with diabetes compared to food-secure counterparts. During a 10.2-year follow-up, among the food insecure, 821 individuals died (11%). The hazard ratio (HR) for mortality among the food insecure compared with the food secure, with adjustment for age and gender only, was 1.58; 95% confidence interval [CI: 1.25, 2.01]. The adjusted HRs for all-cause mortality, HR = 1.46, CI [1.23, 1.72], p < .001, and cardiovascular mortality, HR = 1.75, CI [1.19, 2.57], p < .01, were statistically significantly higher among food-insecure individuals, after adjustment for multiple demographic and health risk factors. Individuals who are food-insecure have a significantly higher probability of death from any cause or cardiovascular disease in long-term follow-up. Comprehensive and interdisciplinary approaches to reducing food insecurity–related disparities and health risks should be implemented. Including food insecurity in health risk assessments and addressing food insecurity as a determinant of long-term outcomes may contribute to lower premature death rates.

Physical, Psychological, and Social Outcomes in Pediatric Burn Survivors Ages 5 to 18 Years: A Systematic Review

2021 ◽  
Author(s):  
Khushbu F Patel ◽  
Silvanys L Rodríguez-Mercedes ◽  
Gabrielle G Grant ◽  
Camerin A Rencken ◽  
Erin M Kinney ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Functioning ◽  
Psychological Functioning ◽  
Burn Injuries ◽  
Social Outcomes ◽  
Burn Survivors ◽  
Study Characteristics ◽  
Research Findings ◽  
The Impact

Abstract Acute pediatric burn injuries often result in chronic sequelae that affect physical, psychological, and social outcomes. To date, no review has comprehensively reported on the impact of burn injuries across all three domains in school-aged children. The aim of this systematic review was to identify published literature that focuses on the impact of burn injuries on physical, psychological, or social functioning, and report upon the nature of study characteristics and their outcomes. We included literature published after 1980, focusing on burn outcomes in children aged 5 to 18 years. Each eligible study was systematically reviewed and primary outcomes were classified into outcome domains based on existing frameworks. Fifty-eight studies met inclusion criteria, and reported on physical (n = 24), psychological (n = 47), and social (n = 29) domains. The majority of the studies had sample sizes of &lt;100 participants, burn size of &lt;40%, and findings reported by parents and/or burn survivors. Only eight of 107 different measures were used in three or more studies. Parents and burn survivors generally reported better physical and social outcomes and worse psychological functioning compared to non-burn populations. Physical disabilities were associated with psychological and social functioning in several studies. Follow-up data reported improvements across domains. This review demonstrates the importance of physical, psychological, and social status as long-term outcomes in burn survivors. Mixed findings across three outcome domains warrant long-term research. Findings of this review will guide the foundation of comprehensive burn and age-specific instruments to assess burn recovery.

565 Suicidality After Burn Injuries: A Systematic Review

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S123-S124
Author(s):  
Sheera F Lerman ◽  
C Scott Hultman ◽  
Carrie A Cox ◽  
Julie Caffrey
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
The United States ◽  
Burn Injuries ◽  
Psychiatric Comorbidities ◽  
Completed Suicide ◽  
Increased Risk ◽  
Burn Survivors ◽  
The Impact ◽  
Over Time

Abstract Introduction Burn injuries are associated with substantial pain and disability and may lead to significant long term psychological distress including suicidality. Suicide is among the leading causes of death in the United States and burn survivors may be at increased risk due to the nature of their injury and psychiatric comorbidities. The purpose of this review is to assess the evidence as to the prevalence of suicidal ideations and behaviors (attempts and completed suicides) in burn survivors as well as assessment of risk and protective factors for these behaviors. Methods MEDLINE, CINAHL, EMBASE and PsycINFO databases were searched using search terms regarding suicide, suicidality and burn. Studies evaluating self-immolation were excluded unless they also measured suicidality after the injury. Fourteen observational and population-based studies which measured any type of suicidality (ideation, attempts or completed suicide) post-burn injuries underwent critical appraisal. Results Few studies directly measure suicidality after burn injuries, and even fewer measure changes in suicidality over time. Overall, burn survivors demonstrate elevated suicidal ideations with rates as high as 32%. Pain at discharge, perceived level of disfigurement and premorbid psychiatric comorbidities are among the significant risk factors for suicidal ideations. There is mixed evidence as to rates of completed suicide post-burn injury, though rates appear to be relatively low. Conclusions Results of this systematic review shed light on the scarcity of data on rates of suicidality among burn survivors. This is surprising given the multiple risk factors burn survivors possess including chronic pain, sleep disturbances, history of substance abuse, post-traumatic stress disorder, social isolation and depression which are linked to suicidality in the general population. In addition, individuals with self-inflicted burns may be at even higher risk given that previous suicide attempts are of the strongest predictor of future suicidality. More research is needed to better understand the impact of these risk factors in burn survivors and inform their care. Applicability of Research to Practice There is high importance in screening burn survivors for suicidal ideations at discharge from the hospital and following them over time in order to understand the magnitude of this phenomena and offer targeted interventions to vulnerable individuals.

Abstract P189: Long-term Blood Pressure Variability And Risk Of Cardiovascular Disease Events Among Community-dwelling Elderly

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Michael E Ernst ◽  
Enayet K Chowdhury ◽  
Lawrie Beilin ◽  
Karen L Margolis ◽  
Mark R Nelson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Ischemic Stroke ◽  
Blood Pressure Variability ◽  
The United States ◽  
Community Dwelling ◽  
Main Trial ◽  
All Cause Mortality ◽  
The Impact

Greater blood pressure variability (BPV) in midlife increases risk of future cardiovascular disease (CVD) events, but the impact of BPV in adults who have reached older ages while remaining free of CVD is unknown. We examined risk of overall incident CVD, ischemic stroke subgroup, and all-cause mortality associated with long-term, visit-to-visit BPV in participants of the ASPirin in Reducing Events in the Elderly study, a randomized primary prevention trial of daily low-dose aspirin in community-dwelling adults in Australia and the United States (US) aged 70 and older (65 if US minority) without evidence of CVD. The mean of three blood pressures (BP) using an automated cuff was recorded at baseline and annually. CVD was a prespecified composite secondary endpoint of ASPREE, and included fatal coronary heart disease, nonfatal MI, fatal or nonfatal stroke, or hospitalization for heart failure. All CVD events were adjudicated as part of the main trial. This analysis included participants who survived without CVD to the second annual visit and had BP recorded at baseline, years 1 and 2 (n=16,482). BPV was defined as within-individual standard deviation of mean systolic BP across these visits. Cox proportional hazards regression adjusting for confounders was used to calculate hazard ratios (HR) according to tertile of estimated BPV, with year 2 as time zero to minimize immortal time bias. Our results (Table) show that higher visit-to-visit BPV in older adults without previous CVD is associated with increased risk of future CVD events, ischemic stroke, and all-cause mortality, suggesting that BPV in older ages should be considered a potential therapeutic target for CVD risk-lowering.

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

Examining the Impact of the Disabled Youth Peer Development Initiative: What are the Long-Term Outcomes?

2003 ◽  
Author(s):  
Teresa Garate-Serafini ◽  
Jose Mendez ◽  
Patty Arriaga ◽  
Larry Labiak ◽  
Carol Reynolds
Keyword(s):  
Long Term Outcomes ◽  
The Disabled ◽  
The Impact

THE INFLUENCE OF SCOTTISH ACCOUNTANTS IN THE UNITED STATES: THE EARLY CASE OF THE SOCIETY OF ACCOUNTANTS IN EDINBURGH

1997 ◽  
Vol 24 (1) ◽  
pp. 117-141 ◽  
Author(s):  
T. A. LEE
Keyword(s):  
United States ◽  
General Theory ◽  
Research Program ◽  
The United States ◽  
The World ◽  
Early Case ◽  
The Impact ◽  
Chartered Accountants ◽  
The U.S

This study represents part of a long-term research program to investigate the influence of U.K. accountants on the development of professional accountancy in other parts of the world. It examines the impact of a small group of Scottish chartered accountants who emigrated to the U.S. in the late 1800s and early 1900s. Set against a general theory of emigration, the study's main results reveal the significant involvement of this group in the founding and development of U.S. accountancy. The influence is predominantly with respect to public accountancy and its main institutional organizations. Several of the individuals achieved considerable eminence in U.S. public accountancy.

scholarly journals Impact of established cardiovascular disease on 10-year death after coronary revascularization for complex coronary artery disease

2021 ◽  
Author(s):  
Rutao Wang ◽  
Scot Garg ◽  
Chao Gao ◽  
Hideyuki Kawashima ◽  
Masafumi Ono ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Revascularization ◽  
Long Term Outcomes ◽  
Vital Status ◽  
Increased Risk ◽  
Artery Disease ◽  
The Impact

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract

scholarly journals Neuroimaging at Term Equivalent Age: Is There Value for the Preterm Infant? A Narrative Summary

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 227
Author(s):  
Rudaina Banihani ◽  
Judy Seesahai ◽  
Elizabeth Asztalos ◽  
Paige Terrien Church
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Preterm Infant ◽  
Resonance Imaging ◽  
Long Term Outcomes ◽  
Equivalent Age ◽  
Current State ◽  
Patterns Of Injury ◽  
The Impact

Advances in neuroimaging of the preterm infant have enhanced the ability to detect brain injury. This added information has been a blessing and a curse. Neuroimaging, particularly with magnetic resonance imaging, has provided greater insight into the patterns of injury and specific vulnerabilities. It has also provided a better understanding of the microscopic and functional impacts of subtle and significant injuries. While the ability to detect injury is important and irresistible, the evidence for how these injuries link to specific long-term outcomes is less clear. In addition, the impact on parents can be profound. This narrative summary will review the history and current state of brain imaging, focusing on magnetic resonance imaging in the preterm population and the current state of the evidence for how these patterns relate to long-term outcomes.

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