Recovery of health-related quality of life after burn injuries: An individual participant data meta-analysis

Abstract

Background A prominent outcome measure within burn care is health related quality of life (HRQL). Until now, no model for long-term recovery of HRQL exists for adult burn patients which requires large samples with repeated measurements. Re-use and the combination of existing data is a way to achieve larger data samples that enable the estimation of long-term recovery models. The aim of this secondary data analysis was to assess the recovery of HRQL after a burn injury over time. Methods and findings Data from ten European studies on generic HRQL assessed in adult burn patients (either with the EQ-5D or SF-36) from five different countries were merged into one dataset. SF-36 outcomes were transformed into EQ-5D outcomes. A 24-month recovery of HRQL (EQ-5D utility) was modeled using a linear mixed-effects model and adjusted for important patient and burn characteristics. Subgroups of patients with mild and intermediate burns (�20% total body surface area (TBSA) burned) and with major burns (>20% TBSA burned) were compared. The combined database included 1687 patients with a mean age of 43 (SD 15) years and a median %TBSA burned of 9% (IQR 4-18). There was large improvement in HRQL up to six months after burns, and HRQL remained relatively stable afterwards (studied up to 24 months post burn). However, the estimated EQ-5D utility scores remained

Improved and standardized method for assessing years lived with disability after burns and its application to estimate the non-fatal burden of disease of burn injuries in Australia, New Zealand and the Netherlands

“…Two other important differences between our method and the existing methods is the breakdown of recovery after burns and the use of 24 months as the time point on which disabilities caused by burns are either resolved or permanent. According to the recovery of HRQL in burn patients [13,19], we derived four short-term disability weights up to 24 months for each homogenous group, whereas other methods only provide one 12-month disability weight per group. Earlier methods used 12 months as time point to consider a disability lifelong, even though, it is shown that 12-months is too short for the recovery of burns and for the maturation of scars [13,50].…”

“…Two different datasets were combined to form the dataset for the present study. The first dataset consisted of health-related quality of life (HRQL) data from 10 different European studies on HRQL in burn patients [19]. This dataset was created for an earlier study in which authors of European studies on HRQL studies were asked to provide their data to study the recovery of HRQL of burn patients [19].…”

“…The combined dataset included adult burn patients (≥18 years old) who were admitted to a burn center. Data was collected between 1995 and 2019, originated from Australia, Belgium, Germany, Norway, Sweden and The Netherlands, and was anonymously shared (Table 1) [19]. In all data sets, patients with cognitive impairment were excluded.…”

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

“…Our findings regarding the high pre-burn HRQL levels are in line with the broader literature, given that recalled pre-injury HRQL of patients with a variety of injuries produced systematically higher HRQL than population norms both in international research and within the Dutch population [ 37 , 38 ]. Consequently, these findings also suggest that the use of recalled pre-burn HRQL may further improve the accuracy of recovery estimation models [ 39 ].…”

Transcriptional re-programming in rat central nervous system two weeks after burn trauma: the impact of nephrilin treatment on the expression of oxidative stress-related genes

“…3 , 4 Burn injury has been implicated in the development of long-term neurodegenerative conditions such as severe depression. 5 , 6 In this study, we set out to look at the role of oxidative stress in nephrilin peptide’s protective mechanisms post-burn in the central nervous system (CNS) of rats. Nephrilin’s mechanism of action has previously been shown to involve protection from excessive oxidative stress in kidney.…”