Individual recovery of health-related quality of life during 18 months post-burn using a retrospective pre-burn measurement: an exploratory study

Abstract

Purpose This study explored the individual trajectories of health-related quality of life (HRQL) compared to recalled pre-burn level of HRQL and investigated whether burn severity and post-traumatic stress disorder (PTSD) symptoms increase the risk of not returning to pre-burn level of HRQL. Methods Data were obtained from 309 adult patients with burns in a multicenter study. Patients completed the EQ-5D-3L questionnaire with a Cognition bolt-on shortly after hospital admission, which included a recalled pre-injury measure, and, again, at 3, 6, 12 and 18 months post-burn. Burn severity was indicated by the number of surgeries, and PTSD symptoms were assessed with the IES-R at three months post-burn. Pre- and post-injury HRQL were compared to norm populations. Results Recalled pre-injury HRQL was higher than population norms and HRQL at 18 months post-burn was comparable to population norms. Compared to the pre-injury level of functioning, four HRQL patterns of change over time were established: Stable, Recovery, Deterioration, and Growth. In each HRQL domain, a subset of patients did not return to their recalled pre-injury levels, especially with regard to Pain, Anxiety/Depression, and Cognition. Patients with more severe burns or PTSD symptoms were less likely to return to pre-injury level of functioning within 18 months post-burn. Conclusion This study identified four patterns of individual change. Patients with more severe injuries and PTSD symptoms were more at risk of not returning to their recalled pre-injury HRQL. This study supports the face validity of using a recalled pre-burn HRQL score as a reference point to monitor HRQL after burns.

Prevalence and course of posttraumatic stress disorder symptoms in partners of burn survivors

“…Burn severity, indicated by number of surgeries, was not associated with PTSD symptoms in the acute phase, but in the longer term, predicted a lower decrease in PTSD symptoms over time, in agreement with earlier research (Attoe & Pounds-Cornish, 2015;Bond et al, 2017). More severe burns likely cause more scars and functional limitations, affecting quality of life (Boersma-van Dam et al, 2020), which may hamper the recovery of PTSD symptoms in partners. Future studies may investigate the content of intrusive memories (e.g.…”

Bio-Psychological Predictors of Acute and Protracted Fatigue After Burns: A Longitudinal Study

“…Still, almost one in five burn survivors continued to report severe fatigue at 18 months postburn. Previous research showed that, as a group, burn survivors did not return to retrospectively assessed pre-burn levels of fatigue and quality of life ( Simko et al, 2018 ; Boersma-van Dam et al, 2021 ) and that population norms may be unrepresentative of pre-trauma health ( Wilson et al, 2012 ). Together, these findings emphasize the need to look beyond mean population levels to accurately describe health and recovery after burns over time and call for research aimed to establish adequate cutt-offs for early screening of moderate and severe fatigue in burn survivors.…”

“…The data from this study were part of a larger longitudinal project in three Dutch and three Belgian burn centers. Previous work focused on quality of life in burn survivors ( Boersma-van Dam et al, 2021 ). Patients were recruited between October 2013 and October 2015 and were followed for 18 months.…”

Current Practices and Beliefs Regarding Screening Patients with Burns for Acute Stress Disorder and Posttraumatic Stress Disorder: A Survey of the American Burn Association Membership

“…Patients with less severe burn injuries were not screened at some institutions. This is worrisome given that patients with minor injuries do develop PTSD [20,21]. In institutions that care for pediatric patients, adolescents were most commonly screened but there was no consensus across institutions on which ages to screen.…”