Quality of Life Predictors in Persons with Major Burn Injury at 2, 6, and 12 Months Post Hospital Discharge

ObjectiveThis study aimed to examine the long-term outcomes and health-related quality of life in patients with blunt thoracic injuries over 6 months from hospital discharge and develop models to predict long-term patient-reported outcomes.DesignA prospective observational study using longitudinal survey design.SettingThe study recruitment was undertaken at 12 UK hospitals which represented diverse geographical locations and covered urban, suburban and rural areas across England and Wales.Participants337 patients admitted to hospital with blunt thoracic injuries were recruited between June 2018–October 2020.MethodsParticipants completed a bank of two quality of life surveys (Short Form-12 (SF-12) and EuroQol 5-Dimensions 5-Levels) and two pain questionnaires (Brief Pain Inventory and painDETECT Questionnaire) at four time points over the first 6 months after discharge from hospital. A total of 211 (63%) participants completed the outcomes data at 6 months after hospital discharge.Outcomes measuresThree outcomes were measured using pre-existing and validated patient-reported outcome measures. Outcomes included: Poor physical function (SF-12 Physical Component Score); chronic pain (Brief Pain Inventory Pain Severity Score); and neuropathic pain (painDETECT Questionnaire).ResultsDespite a trend towards improving physical functional and pain at 6 months, outcomes did not return to participants perceived baseline level of function. At 6 months after hospital discharge, 37% (n=77) of participants reported poor physical function; 36.5% (n=77) reported a chronic pain state; and 22% (n=47) reported pain with a neuropathic component. Predictive models were developed for each outcome highlighting important data collection requirements for predicting long-term outcomes in this population. Model diagnostics including calibration and discrimination statistics suggested good model fit in this development cohort.ConclusionsThis study identified the recovery trajectories for patients with blunt thoracic injuries over the first 6 months after hospital discharge and present prognostic models for three important outcomes which after external validation could be used as clinical risk stratification scores.

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Telerehabilitation Intervention in Patients with COVID-19 after Hospital Discharge to Improve Functional Capacity and Quality of Life. Study Protocol for a Multicenter Randomized Clinical Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062924 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2924

Author(s):

José-Manuel Pastora-Bernal ◽

María-José Estebanez-Pérez ◽

Guadalupe Molina-Torres ◽

Francisco-José García-López ◽

Raquel Sobrino-Sánchez ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Hospital Discharge ◽

Study Protocol ◽

Functional Capacity ◽

Treatment Method ◽

Current Evidence ◽

Current Standard

COVID-19 can cause important sequels in the respiratory system and frequently presents loss of strength, dyspnea, polyneuropathies and multi-organic affectation. Physiotherapy interventions acquire a fundamental role in the recovery of the functions and the quality of life. Regarding the recovery phases after hospital discharge, the current evidence available is very preliminary. Telerehabilitation is presented as a promising complementary treatment method to standard physiotherapy. The main objective of this research is to evaluate the effectiveness of a personalized telerehabilitation intervention after discharge from hospital for the improvement of functional capacity and quality of life compared to a program of health education and/or care in a rehabilitation center. As secondary objectives, to identify the satisfaction and perception of patients with the telerehabilitation intervention and the presence of barriers to its implementation, as well as to evaluate the cost-effectiveness from the perspective of the health system. This study protocol will be carried out through a single blind multicenter randomized clinical trial in the south of Spain. We hypothesize that the implementation of a telerehabilitation program presents results not inferior to those obtained with the current standard intervention. If the hypothesis is confirmed, it would be an opportunity to define new policies and interventions to address this disease and its consequences. Trial registration NCT04742946.

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Quality of Life for Young Adults Having Survived Pediatric Burn Injury

Journal of Burn Care & Rehabilitation ◽

10.1097/00004630-200203002-00106 ◽

2002 ◽

Vol 23 ◽

pp. S94

Author(s):

M. Rosenberg ◽

F. Berniger ◽

R. S. Robert ◽

C. Thomas ◽

C. E. Holzer ◽

...

Keyword(s):

Quality Of Life ◽

Young Adults ◽

Burn Injury

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86 Impact of Community-Level Socioeconomic Disparities on Quality of Life After Burn Injury: A Burn Model Systems Database Study

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.090 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S59-S60

Author(s):

Stephanie A Mason ◽

Emma L Gause ◽

Helena Archer ◽

Stephen H Sibbett ◽

Radha K Holavanahalli ◽

...

Keyword(s):

Quality Of Life ◽

Burn Injury ◽

Well Being ◽

Community Level ◽

Model Systems ◽

Socioeconomic Disparities ◽

Injury Incidence ◽

The Impact ◽

Zip Code

Abstract Introduction Individual- and community-level socioeconomic disparities impact overall health and injury incidence, severity, and outcomes. However, the impact of community-level socioeconomic disparities on recovery after burn injury is unknown. We aimed to characterize the association between community-level socioeconomic disparities and health-related quality of life (HRQL) after burn injury. These findings might inform rehabilitation service delivery and policy making at administrative levels. Methods Participants with the NIDILRR Burn Model System who were ≥14 years with a zip code were included. Sociodemographic and injury characteristics and 12-item Short Form Health Survey (SF-12) and Veterans RAND (VR-12) physical (PCS) and mental (MCS) component summary scores 6 months after injury were extracted. Data were deterministically linked by zip code to the Distressed Communities Index (DCI), which combines seven census-derived metrics into a single indicator of economic well-being that ranges from 0 (lowest distress) to 100 (highest distress). Multilevel linear regression models estimated the association between DCI and HRQL. Results The 342 participants were mostly male (239, 69%) had a median age of 48 years (IQR 33–57) and sustained a median burn size of 10% TBSA (IQR 3–28%). More than one-third of participants (117, 34%) lived in a neighborhood within the two most distressed quintiles. After adjusting for age, race/ethnicity, and pre-injury HRQL, increasing neighborhood distress was negatively associated with PCS (ß-0.05, SE 0.02, p=0.01). Age and pre-injury PCS were also significantly associated with 6-month PCS. There was no association between neighborhood distress and 6-month MCS. However, pre-injury MCS was significantly associated with 6-month MCS (0.56, SE 0.07, p< 0.001). Conclusions Neighborhood distress is associated with lower PCS after burn injury but is not associated with MCS. Regardless of neighborhood distress, pre-injury HRQL is significantly associated with both PCS and MCS during recovery.

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Epidemiology of injuries, treatment (costs) and outcome in burn patients admitted to a hospital with or without dedicated burn centre (Burn-Pro): protocol for a multicentre prospective observational study

BMJ Open ◽

10.1136/bmjopen-2018-023709 ◽

2018 ◽

Vol 8 (11) ◽

pp. e023709 ◽

Cited By ~ 1

Author(s):

Esther MM Van Lieshout ◽

Daan T Van Yperen ◽

Margriet E Van Baar ◽

Suzanne Polinder ◽

Doeke Boersma ◽

...

Keyword(s):

Quality Of Life ◽

Observational Study ◽

Prospective Observational Study ◽

Burn Injury ◽

Treatment Costs ◽

Burn Patients ◽

Severe Burns ◽

Referral Criteria ◽

Age Limit

IntroductionThe Emergency Management of Severe Burns (EMSB) referral criteria have been implemented for optimal triaging of burn patients. Admission to a burn centre is indicated for patients with severe burns or with specific characteristics like older age or comorbidities. Patients not meeting these criteria can also be treated in a hospital without burn centre. Limited information is available about the organisation of care and referral of these patients. The aims of this study are to determine the burn injury characteristics, treatment (costs), quality of life and scar quality of burn patients admitted to a hospital without dedicated burn centre. These data will subsequently be compared with data from patients with<10% total bodysurface area (TBSA) burned who are admitted (or secondarily referred) to a burn centre. If admissions were in agreement with the EMSB, referral criteria will also be determined.Methods and analysisIn this multicentre, prospective, observational study (cohort study), the following two groups of patients will be followed: 1) all patients (no age limit) admitted with burn-related injuries to a hospital without a dedicated burn centre in the Southwest Netherlands or Brabant Trauma Region and 2) all patients (no age limit) with<10% TBSA burned who are primarily admitted (or secondarily referred) to the burn centre of Maasstad Hospital. Data on the burn injury characteristics (primary outcome), EMSB compliance, treatment, treatment costs and outcome will be collected from the patients’ medical files. At 3 weeks and at 3, 6 and 12 months after trauma, patients will be asked to complete the quality of life questionnaire (EuroQoL-5D), and the patient-reported part of the Patient and Observer Scar Assessment Scale (POSAS). At those time visits, the coordinating investigator or research assistant will complete the observer-reported part of the POSAS.Ethics and disseminationThis study has been exempted by the medical research ethics committee Erasmus MC (Rotterdam, The Netherlands). Each participant will provide written consent to participate and remain encoded during the study. The results of the study are planned to be published in an international, peer-reviewed journal.Trial registration numberNTR6565.

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Quality of life of long term ICU patients at 6 months after hospital discharge

Critical Care ◽

10.1186/cc295 ◽

1998 ◽

Vol 2 (Suppl 1) ◽

pp. P166

Author(s):

I Novák ◽

V Šrámek ◽

E Bokrová ◽

M Bílek ◽

M Matejovic ◽

...

Keyword(s):

Quality Of Life ◽

Hospital Discharge ◽

Icu Patients

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Remote Monitoring of Patients with COVID-19 after Hospital Discharge with Connected Health Platform: Outcomes and Quality of Life

Journal of Integrative Cardiology Open Access ◽

10.31487/j.jicoa.2020.05.05 ◽

2020 ◽

pp. 1-5

Author(s):

César Morcillo Serra ◽

Domingo Marzal Martín ◽

Jorge Velázquez Moro ◽

José Francisco Tomás Martínez

Keyword(s):

Quality Of Life ◽

Oxygen Saturation ◽

Hospital Discharge ◽

Remote Monitoring ◽

Vital Signs ◽

Medical Team ◽

Mobile Phone Application ◽

Connected Health ◽

Video Consultation

Background: Telemonitoring with applications and connected devices facilitates a more accessible and efficient attention. Its implementation has been accelerated thanks to the pandemic by COVID-19, where they have allowed the continuity of care. Objective: To evaluate the efficacy of a remote monitoring platform for the outpatient follow-up after hospital discharge by COVID-19. Methods: Prospective observational study of patients discharged from the hospital with COVID-19 infection between March 23 and May 25, 2020, who were followed for one month with the Connected Health telemonitoring platform. The mobile phone application connected to a pulse oximeter, allowed to measure vital signs and answer health questionnaires (EQ5D3L and CAT) daily, and alert the medical team that could be contacted by video consultation. Results: 95 patients (64% male) with a mean age of 54 (SD 26-81) years were included. The application allowed the detection of alerts for pain (80% of patients) and a decrease in oxygen saturation (12%). No patient required hospital readmission or presented complications. The application allowed strict monitoring of symptoms and quality of life. The main symptom was severe pain (59% of patients) followed by anxiety or depression (25%). The average state of health was 65 (SD 20-100). COVID-19 caused a low impact on the quality of life of 62% of the patients, although 8% reported a significant limitation, due to shortness of breath and leaving the house. Conclusion: telemonitoring allows a safe remote monitoring of patients after hospital discharge by COVID-19. The Connected Health application has allowed the measurement of oxygen saturation, symptoms and quality of life, and the detection and management of alerts by the medical team through video consultation.

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Nutritional differences in malnourished patients according to their liquid-intake habits after hospital discharge

Nutrición Hospitalaria ◽

10.20960/nh.310 ◽

2016 ◽

Vol 33 (3) ◽

Author(s):

Cristina Casals ◽

María Ángeles Vázquez Sánchez ◽

José Luis Casals Sánchez ◽

Ernesto Suárez-Cadenas

Keyword(s):

Quality Of Life ◽

Body Mass Index ◽

Nutritional Status ◽

Hospital Discharge ◽

Body Mass ◽

Short Form ◽

Functional Dependency ◽

The Body ◽

Liquid Intake

Introduction: Malnutrition is a serious and relatively common problem among hospitalized patients; moreover, it is known that a good hydration state contributes to health and wellbeing. Objective: The aim of this study was to determine the relationship between nutritional status, functional dependency, quality of life and liquid-intake habits in malnourished patients after hospital discharge. Methods: Cross-sectional descriptive study in 91 patients (45 males) who presented malnutrition at hospital discharge. The patients were grouped according to their liquid intake estimated through the Mini Nutritional Assessment questionnaire: 3-5 glasses (n = 42), and > 5 glasses (n = 46); removing from analysis < 3 glasses of liquid intake (n = 3). The body mass index, weight, Malnutrition Universal Screening Tool (MUST), functional dependency (Barthel questionnaire), and quality of life (Short Form 12 Health Survey [SF-12]) were assessed 2-months after discharge. Results: The > 5 glasses liquid intake group showed better nutritional status than the 3-5 glasses intake group, for weight (p < 0.001), body mass index (p = 0.001), and MUST scale (p = 0.020). Additionally, the > 5 glasses liquid intake group signifi cantly scored higher values in the total SF-12 questionnaire (p = 0.013), presenting better self-reported quality of life, and higher functional independency in the Barthel index (p = 0.037) than the 3-5 glasses liquid intake group (p = 0.013). Conclusions: Although further research is needed to elucidate the characteristics of this relationship, descriptive comparisons between groups showed favorable nutritional status, functional independency and quality of life for the > 5 glasses of liquid intake compared with the 3-5 glasses of liquid intake group during a 2-months follow-up.

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