Self-reported health measures in burn survivors undergoing burn surgery following acute hospitalization: A burn model system national database investigation |
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| Institution: | 1. Department of Surgery, University of Washington, Seattle, WA, United States;2. Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, CA, United States;3. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States;4. Department of Surgery, Harvard Medical School, Boston, MA, United States;1. Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran;2. Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;3. Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran;4. Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran;5. Laboratory of Experimental Therapies in Oncology, IRCCS Istituto Giannina Gaslini, Genova, Italy;6. Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran;7. Department of Infectious Diseases, Imam Musa Kazem Hospital, Isfahan University of Medical Sciences, Isfahan, Iran;1. Department of Nursing, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran;2. Department of Medical Informatics, faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran;3. Department of Health Education and Promotion, Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, Rasht, Iran;4. Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran;5. School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran;6. Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran;7. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran;1. Department of Plastic Surgery, Fujian Maternal and Child Health Hospital, Fuzhou, Fujian 350000, China;2. Department of Pediatric Burn and Plastic Surgery, Fujian Children''s Hospital, Fuzhou, Fujian 350000, China;1. Department of Clinical Pharmacy, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran;2. Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran;1. Department of Plastic Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China;2. Department of Plastic and Aesthetic Surgery, Affiliated Changzhi People’s Hospital of Changzhi Medical College, Changzhi 046000, Shanxi, China;1. Faculty of Engineering, University of Sydney, Sydney, Australia;2. Burns Unit, Concord Repatriation General Hospital, Sydney, Australia;3. ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia;4. Concord Clinical School, University of Sydney, Sydney, Australia |
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| Abstract: | IntroductionHealth Related Quality of Life (HRQoL) surveys such as PROMIS-29 may facilitate shared decision-making regarding surgery after burn injury. We aimed to examine whether scar revision and contracture release surgery after index hospitalization was associated with differences in HRQoL.MethodsPatient and PROMIS-29 Profile v2.0 data were extracted from the Burn Model System (BMS) at 6-, 12-, and 24-months after burn. PROMIS-29 measures 7 health-related domains. Linear regression was performed to identify associations between independent burn patient variables (e.g. scar-related surgery) and PROMIS-29 scores. Socio-demographic and injury variables were analyzed using logistic regression to determine the likelihood of undergoing burn-related surgery.ResultsOf 727 participants, 201 (27.6%) underwent ≥ 1 scar/contracture operation within 24 months of injury. Number of operations at index hospital admission and range of motion (ROM) deficit at discharge were correlated with an increased likelihood of undergoing subsequent scar/contracture surgery (p < 0.05). Participants undergoing scar/contracture surgery and those that were Medicaid insured reported significantly worse HRQoL for PROMIS domains: anxiety, depression, and fatigue (p < 0.05).ConclusionsAfter adjusting for burn severity and available confounders, participants who underwent scar-related burn reconstructive surgery after index hospitalization reported overall worse Health-Related Quality of Life (HRQoL) in multiple domains. |
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| Keywords: | Burn Quality of life Patient-reported outcome Reconstruction Scar Contracture |
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