Patterns of recovery over 12 months following a burn injury in Australia

Objective: To describe patients generic health status and health-related quality of life (HRQoL) 12-months following admission to a state-wide burns service. Methods: A total of 114 injured adults with >10 total body surface area burned (TBSA) or burns less than 10 TBSA to smaller anatomical areas such as the hands and feet participated in this study. Retrospective assessment of pre-burn injury status and prospective assessment of generic health and HRQoL were followed up at 3, 6 and 12-months after injury using the 36-item Short Form Health Survey (SF-36 v.2) and Burns Specific Health Scale-Brief (BSHS-B). The SF-36 v.2 was administered retrospectively during the initial hospital stay to assess pre-injury HRQoL. Changes in instruments scores were assessed using multilevel mixed effects regression models. Mean scores were compared over time and between severity groups as defined by 30 TBSA. Results: For the overall sample, the SF-36 v.2 physical component scale (PCS) score between 3 and 12-months post-burn injury were significantly lower than pre-injury scores (p <0.01), with no significant change over time for the mental component scale (MCS) (p = 0.36). Significant TBSA-burden by time interactions highlighted changes from pre-burn injury in overall PCS (p = 0.02), physical functioning (p <0.001) and role-physical (p = 0.03), with subscales worse for the TBSA >30 group. With respect to the BSHS-B, significant improvement from 3 to 12-months post-burn injury was seen for the entire sample in simple abilities (p <0.001), hand function (p = 0.001), work (p = 0.01), and treatment regime (p = 0.004) subscales. The TBSA >30 group showed a greater rate of improvement in simple abilities (p = 0.01) and hand function (p = 0.005) between 3 and 12 months post-burn injury. Conclusions: Whilst certain HRQoL measures improve over the 12-months, in most cases they do not reach pre-morbid levels. Patients face ongoing challenges regarding their physical and psychosocial recovery 12-months post-burn injury with respect to generic health and burn-specific health. These challenges vary at different time periods over the 12-month post-burn period, and may provide windows of opportunity in which to address ongoing issues.