Quality of life and return to work rates in the first two years following major burn injury

Lincoln M Tracy; Peter A Cameron; Heather J Cleland; Lara Kimmel; Warwick J Teague; Belinda J Gabbe

doi:10.1016/j.burns.2024.107355

Quality of life and return to work rates in the first two years following major burn injury

Burns. 2024 Dec 16;51(3):107355. doi: 10.1016/j.burns.2024.107355. Online ahead of print.

Authors

Lincoln M Tracy¹, Peter A Cameron², Heather J Cleland³, Lara Kimmel⁴, Warwick J Teague⁵, Belinda J Gabbe⁶

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Australia. Electronic address: [email protected].
² School of Public Health and Preventive Medicine, Monash University, Australia; Emergency and Trauma Centre, The Alfred, Australia.
³ Victorian Adult Burns Service, The Alfred, Australia.
⁴ School of Public Health and Preventive Medicine, Monash University, Australia; Allied Health Executive, Alfred Health, Australia.
⁵ School of Public Health and Preventive Medicine, Monash University, Australia; Burns Service, The Royal Children's Hospital, Australia.
⁶ School of Public Health and Preventive Medicine, Monash University, Australia; Population Data Science, Swansea University, Wales.

PMID: 39848117
DOI: 10.1016/j.burns.2024.107355

Abstract

Background: A better understanding of how major burns patients recover following injury is vital in assessing trauma care and informing healthcare and rehabilitation provision. We aimed to describe the longer-term health and return to work status of major burns patients and identify factors associated with positive outcomes i.e., reporting no problems with health-related quality of life, returning to work).

Methods: This registry-based cohort study included adult (≥ 16 years) patients with a burn injury affecting ≥ 20 % total body surface area registered by the Victorian State Trauma Registry with a date of injury from July 1 2009 to June 30 2022. Patients were followed-up at six, 12, and 24 months post-injury, completing the 3-level or 5-level EuroQoL 5 dimensions questionnaire (depending on their date of injury) and return to work-related questions at each time point. Mixed effect regression models were used to predict factors associated with quality of life outcomes. Modified binary Poisson models were used to model the probability of experiencing no problems in each of the quality of life domains, and mixed effects linear regression was used to model the overall utility score.

Results: Two hundred and eighty-seven patients were included; 63 (21.9 %) did not die but were completely lost to follow-up. The prevalence of reporting no problems at 24 months post-injury was 70.2 % for mobility, 77.8 % for self-care, 48.0 % for usual activities, 49.7 % for pain or discomfort, and 51.5 % for anxiety or depression. The predicted probability of reporting no problems in each of the EQ-5D health states was lowest at six-months and increased over time.

Conclusions: The prevalence of ongoing problems - particularly with usual activities, pain, and anxiety/depression - at 24 months post-injury is high, confirming that major burns are often an ongoing disorder. Greater investment in interventions designed to reduce these problems is needed.

Keywords: Burn; Follow-up; Pain; Quality of life; Recovery; Return to work.