110 Self-reported Health Measures in Burn Survivors Undergoing Burn Surgery Following Acute Hospitalization

Abstract

Abstract Introduction Perception of mental and physical function in adult burn survivors is decreased following injury. Individuals who undergo post-hospitalization reconstructive surgery may have lower Health Related Quality of Life (HRQoL) that is influenced by the severity of their burns. We sought to characterize self-reported health perceptions in burn survivors undergoing surgery post-hospitalization within 24 months of injury. Methods Patient Reported Outcomes Measurement Information System (PROMIS)-29 Profile v2.0 data were collected from participants from a multi-center longitudinal study at 6, 12, and 24 months post-injury. Surgical operations performed within the 24-month follow-up period were classified as: open wound, contracture release or scar revision. PROMIS-29 domain scores were compared for those undergoing surgery (surgical participants) to those who did not (non-surgical participants) using separate linear regression analysis for open wound versus scar revision/contracture release at each of the 3 follow-up time points. Linear regression was adjusted for age, burn size, range of motion limitation, number of operations during acute treatment, and insurance/payer. Results 727 participants provided complete PROMIS-29 data, of which 227 (31.2%) underwent > 1 operative procedure within 24 months post-injury. PROMIS-29 anxiety and depression scores were worse at 6 months post-injury for participants who underwent contracture release and scar revision compared to non-surgical peers (p< 0.05). At 12 months after injury, individuals who underwent open wound surgery post-initial hospitalization reported worse anxiety, depression, and pain interference (p< 0.05). Participants in the contracture release and scar revision categories reported lower PROMIS-29 scores in all domains 24 months after injury (p< 0.05), even after adjusting for confounders. Conclusions Burn-related reconstructive surgery has the potential to improve the lives of patients including promoting functional recovery and improving cosmetic appearance. Our data suggest that participants who undergo reconstruction surgery after hospital discharge report worse self-reported indicators of health compared to participants who do not undergo surgery after adjusting for known confounders. Applicability of Research to Practice Better understanding of determinants of HRQoL following a burn injury provides a potential opportunity to improve burn survivor outcomes and clinical care.