Dr Lincoln Tracy1, Associate Professor Dale Edgar2,3, Ms Rebecca Schrale4, Miss Heather Cleland5, Professor Belinda Gabbe1,6
1School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia, 2State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Australia, 3Burn Injury Research Node, The University of Notre Dame, Fremantle, Australia, 4Tasmanian Burns Unit, Royal Hobart Hospital, Hobart, Australia, 5Victorian Adult Burns Service, The Alfred, Melbourne, Australia, 6Farr Institute, Swansea University Medical School, Swansea University, Swansea, Wales
Introduction: Itch is a common complaint of patients with burn injuries, and can significantly impact on their lives. This study aimed to describe the prevalence and predictors of moderate/severe itch, and establish the association between itch and patient-reported outcomes to 12-months post-burn.
Methods: Adult burns patients were recruited from five BRANZ sites and were followed-up at 1-, 6-, and 12-months post-injury. Moderate/severe itch was defined as a global itch score ≥4 on a specially-developed scale with anchors of 0 (does not interfere) to 10 (completely interferes). Multivariable mixed effects regression modelling was used to identify key predictors of moderate/severe itch at follow-up.
Results: 328 patients were included, with a mean (SD) age of 42.1 (16.7) years. Most patients were male (70%) and had sustained a flame burn (47%). The median (IQR) %TBSA of the burn was 5% (1-12%). The prevalence of moderate/severe itch increased from 26% at 1-month, to 36% at 6-months, and 48% at 12-months. The adjusted odds of reporting moderate/severe itch were 1.77 (95% CI 1.14, 2.75) and 3.41 (95% CI 2.10, 5.54) times higher at 6- and 12-months respectively compared to 1-month. The adjusted odds of reporting moderate/severe itch were 38% lower for patients who received a skin graft.
Discussion and conclusions: Almost half of patients reported moderate/severe itch at 12-months, and time since injury and grafting status were important predictors of itch. Additional research is required to enhance our understanding of potentially modifiable factors that impact itch, which may lessen the overall burden of burn injuries.
Dr Lincoln Tracy is a Research Fellow in the School of Public Health and Preventive Medicine at Monash University, where he currently works on the Burns Registry of Australia and New Zealand (BRANZ). He completed his PhD at Monash University in 2017, focusing on modulating the psychological and physiological aspects of pain experience.