Self-reported health measures in burn survivors undergoing burn surgery following acute hospitalization: A burn model system national database investigation. Issue 3 (May 2023)

• Record Type: Journal Article
• Authors: Luna BS, Eli; Sheckter, Clifford C.; Carrougher, Gretchen J.; Stewart, Barclay; Schneider, Jeffrey C.; Ryan, Colleen; Gibran, Nicole
• Is Part Of: Burns. Volume 49:Issue 3(2023)
• Page Start: 688
• Page End: 700
• Publication Date: 2023-05
• Subjects: Burn -- Quality of life -- Patient-reported outcome -- Reconstruction -- Scar -- Contracture; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2022.05.010
• Languages: English
• ISSNs: 0305-4179

Abstract

Abstract: Introduction: Health 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. Methods: Patient 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. Results: Of 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). Conclusions: After 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. Highlights: Burn survivors undergoing scar surgery demonstrated worse Health-Related Quality of Life (HRQoL) in multiple domains. Self-pay burn survivors were less likely to undergo reconstructive scar surgery than commercially insured peers. Joint contracture and number of operations were the greatest predictors of whether a burn survivor underwent scar surgery.