Predictors at 6 and 12 Months for Social Participation Outcome at 24 Months in the Adult Burn Injury Population: A Burn Model System National Database Study

Abstract

ObjectiveTo identify clinical factors (physical and psychological symptoms and post-traumatic growth) that predict social participation outcome at 24-month after burn injury. DesignA prospective cohort study based on Burn Model System National Database. SettingBurn Model System centers. Participants181 adult participants less than 2 years after burn injury (N=181). InterventionsNot applicable. Main Outcome MeasuresDemographic and injury variables were collected at discharge. Predictor variables were assessed at 6 and 12 months: Post-Traumatic Growth Inventory Short Form (PTGI-SF), Post-Traumatic Stress Disorder Checklist Civilian Version (PCL-C), Patient-Reported Outcomes Measurement Information System (PROMIS-29) Depression, Anxiety, Sleep Disturbance, Fatigue, and Pain Interference short forms, and self-reported Heat Intolerance. Social participation was measured at 24 months using the Life Impact Burn Recovery Evaluation (LIBRE) Social Interactions and Social Activities short forms. ResultsLinear and multivariable regression models were used to examine predictor variables for social participation outcomes, controlling for demographic and injury variables. For LIBRE Social Interactions, significant predictors included the PCL-C total score at 6 months (β=-0.27, P<.001) and 12 months (β=-0.39, P<.001), and PROMIS-29 Pain Interference at 6 months (β=-0.20, P<.01). For LIBRE Social Activities, significant predictors consisted of the PROMIS-29 Depression at 6 months (β=-0.37, P<.001) and 12 months (β=-0.37, P<.001), PROMIS-29 Pain Interference at 6 months (β=-0.40, P<.001) and 12 months (β=-0.37, P<.001), and Heat Intolerance at 12 months (β=-4.55, P<.01). ConclusionsPost-traumatic stress and pain predicted social interactions outcomes, while depression, pain and heat intolerance predicted social activities outcomes in people with burn injury.