Ms Jane Elliott1,2, Dr Lara Kimmel1,2, Ms Heather Cleland1,3, Prof Belinda Gabbe2
1Alfred Health, Melbourne, Australia, 2Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia, 3Monash University, Melbourne, Australia
Background: Burn injuries lead to devastating physical and psychological morbidity. Advances in burn management have resulted in improved survival, therefore morbidity assessment is paramount.
Methods: A registry-based cohort study was undertaken using data collected by the Victorian State Trauma Registry. Adult major trauma cases with severe burn injury (≥20% total body surface area (TBSA)) admitted to hospital in Victoria (January 2007 – December 2013) were included. Health-related quality of life (HRQoL) using the EuroQoL (EQ-5D), functional outcome (Extended Glasgow Outcome Scale – GOS-E) and ability to return to work (RTW) at 6, 12 and 24 months post-injury were analysed using mixed-effects modelling.
Results: For the 185 cases, mean (SD) age was 43 (18) years, 76% were male, 82% were caused by fire/flames, and 22% died in-hospital. Increasing age was associated with reduced adjusted odds of reporting no problems for all EQ-5D items – mobility (AOR 0.95; 95%CI 0.91, 0.99), self-care (AOR 0.92; 95%CI 0.87, 0.97), usual activities (AOR 0.95; 95%CI 0.91, 0.99), pain (AOR 0.94; 95%CI 0.91, 0.98) and anxiety (AOR 0.94; 95%CI 0.89, 0.99). Increasing age (AOR 0.94; 95%CI 0.90, 0.98) and compensable injury (AOR 0.06; 95%CI 0.01, 0.35) were associated with reduced adjusted odds of good functional recovery (GOS-E). Increasing %TBSA (≥40%TBSA: AOR 0.03; 95%CI <0.001, 0.78) and intentional event (AOR 0.003; 95%CI <0.001, 0.40) were predictive of reduced adjusted odds of RTW.
Conclusion: Patients continue to display problems with self-reported outcomes for years following burn injury. Measuring outcomes is necessary to optimise recovery for burn injured patients.
Jane is the senior physiotherapist at the Victorian Adult Burns Service in Melbourne, Australia.