Health-related quality of life 6 months after burns among hospitalized patients: Predictive importance of mental disorders and burn severity

Burns. 2015 Jun;41(4):742-8. doi: 10.1016/j.burns.2014.11.006. Epub 2015 Feb 13.

Abstract

Rationale: Major burns are likely to have a strong impact on health-related quality of life (HRQoL). We investigated the level of and predictors for quality of life at 6 months after acute burn.

Methods: Consecutive acute adult burn patients (n=107) admitted to the Helsinki Burn Centre were examined with a structured diagnostic interview (SCID) at baseline, and 92 patients (86%) were re-examined at 6 months after injury. During follow-up 55% (51/92) suffered from at least one mental disorder. The mean %TBSA was 9. TBSA of men did not differ from that of women. Three validated instruments (RAND-36, EQ-5, 15D) were used to evaluate the quality of life at 6 months.

Results: All the measures (RAND-36, EQ-5, 15D) consistently indicated mostly normal HRQoL at 6 months after burn. In the multivariate linear regression model, %TBSA predicted HRQoL in one dimension (role limitations caused by physical health problems, p=0.039) of RAND-36. In contrast, mental disorders overall and particularly major depressive disorder (MDD) during follow-up (p-values of 0.001-0.002) predicted poor HRQoL in all dimensions of RAND-36. HRQoL of women was worse than that of men.

Conclusion: Self-perceived HRQoL among acute burn patients at 6 months after injury seems to be mostly as good as in general population studies in Finland. The high standard of acute treatment and the inclusion of small burns (%TBSA<5) in the cohort may partly explain the weak effect of burn itself on HRQoL. Mental disorders strongly predicted HRQoL at 6 months.

Keywords: Burn; Health-related quality of life; Mental disorders.

MeSH terms

  • Adult
  • Aged
  • Alcoholism / complications
  • Alcoholism / psychology
  • Anxiety Disorders / complications
  • Anxiety Disorders / psychology
  • Burns / complications
  • Burns / pathology
  • Burns / psychology*
  • Cohort Studies
  • Delirium / complications
  • Delirium / psychology
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / psychology
  • Female
  • Follow-Up Studies
  • Health Status*
  • Hospitalization
  • Humans
  • Linear Models
  • Male
  • Mental Disorders / complications
  • Mental Disorders / psychology*
  • Middle Aged
  • Personality Disorders / complications
  • Personality Disorders / psychology
  • Prospective Studies
  • Psychotic Disorders / complications
  • Psychotic Disorders / psychology
  • Quality of Life / psychology*
  • Risk Factors
  • Schizophrenia / complications
  • Sex Factors
  • Stress Disorders, Post-Traumatic / complications
  • Stress Disorders, Post-Traumatic / psychology
  • Surveys and Questionnaires
  • Trauma Severity Indices