Predictors of moderate to severe fatigue 12 months following admission to hospital for a burn injury: Results from the Burns Registry of Australia and New Zealand (BRANZ) long term outcomes project

Belinda Gabbe1,2, Heather Cleland3,4, Dina Watterson1,5, Rebecca Schrale6, Sally McRae7, Susan Taggart8, Anne Darton9, Fiona Wood10, Dale W Edgar10,11, On behalf of the BRANZ Adult Long Term Outcomes pilot project participating sites and working party

1 Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Rd, Melbourne, Victoria, 3004, belinda.gabbe@monash.edu
2 Farr Institute – CIPHER, College of Medicine, Swansea University, Singleton Park, Swansea, Wales, United Kingdom SA28PP

3 Victorian Adult Burns Service, The Alfred, Commercial Rd, Melbourne, Australia 3004
4 Department of Surgery, Monash University, The Alfred Centre, Commercial Rd, Melbourne, Australia 3004
5 Allied Health, Alfred Health, Commercial Rd, Melbourne, Australia 3004
6 Tasmanian Burns Unit, Royal Hobart Hospital, Burns & Surgical Specialities Unit 5A, GPO Box 1061, Hobart Australia 7001
7 Burns Unit, Royal Adelaide Hospital, North Terrace, Adelaide, Australia
8 Burns Unit, Concord Repatriation General Hospital, Missenden Road, Camperdown, Australia 2050
9 Statewide Burn Injury Service, Agency for Clinical Innovation, Royal North Shore Hospital, Reserve Rd, St Leonards Australia 2065
10 State Adult Burn Unit, Fiona Stanley Hospital, 11 Warren Drive, Murdoch, Australia 6150
11 Burn Injury Research Node, The University of Notre Dame, 19 Mouat Street, Fremantle, Australia 6959

Introduction

Fatigue has been identified as an outcome of concern following burn injury but is rarely captured in outcomes studies.  We aimed to describe the prevalence, and predictors, of fatigue in the first 12 months following burn injury.

Methods

Adult burns patients, admitted >24 hours, were recruited from five BRANZ sites. Participants were followed-up at 1-, 6-, and 12-months after injury using the Brief Fatigue Inventory (BFI). Moderate to severe fatigue was defined as a global BFI score of 4-10. Multivariable mixed effects regression modelling was used to identify demographic, socioeconomic, burn size and severity predictors of moderate/severe fatigue at follow-up.

Results

The mean (SD) age of the 330 participants was 42.1 (16.7) years, 70% were male, 51% were flame burns, and the mean (SD) %TBSA was 8.7 (11.2).  The prevalence of moderate/severe fatigue decreased from 37% at 1-month, to 32% at 6-months and 26% at 12-months. The adjusted odds of moderate/severe fatigue were 2.9 (95%CI:1.08-7.99) times higher for women compared to men. Compared to patients in major cities, the adjusted odds of reporting moderate/severe fatigue were 5.2 fold higher (95%CI:1.64-16.69) for patients residing in inner regional areas, and 10.2 fold (95%CI:2.11-49.57) higher for patients living in remote/very remote areas.  At all time points, the physical and mental health summary scores of the SF-36 were significantly lower in patients reporting moderate/severe fatigue.

Discussion and Conclusion

A quarter of participants reported moderate to severe fatigue on the BFI at 12-months and fatigue was strongly associated with poorer health-related quality of life.

Key Words

Burn registry, Outcomes, Cohort study, Fatigue, Quality of life

Biography

Professor Belinda Gabbe is the Head of Prehospital, Emergency and Trauma Research in the Department of Epidemiology and Preventive Medicine, Monash University. She is an NHMRC Career Development Fellow.  Her research focuses on evaluating trauma care and improving understanding injury burden.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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