Female patients display poorer burn-specific quality of life 12 months after a burn injury
Introduction
It is not uncommon for patients with moderate to severe burn injury to undergo numerous acute and reconstructive surgeries and participate in a multifaceted burn-specific rehabilitation program involving medical, nursing and allied health professionals. The use of surgical and non-surgical burn care interventions can often extend beyond the immediate acute phase to many months and/or years; with their impact potentially impairing general and burn-specific health related quality of life (HRQoL) [1].
The focus on generic and burn-specific HRQoL has continued to not only gain clinical momentum because of the development of sophisticated trauma care systems [2] and high survival rates [3], [4], but HRQoL focus has played an important role in mapping the long-term health of survivors with burn injury [5], [6], [7], [8], [9]. A further focus for research has also been to better understand the factors that contribute to variations in burn-specific HRQoL, with gender emerging as a potentially influential factor.
Whilst gender differences in health-related HRQoL have been closely examined in other disciplines such as cardiovascular health and trauma [10], [11], the research in burns care has focused heavily on various physiological and immunological differences impacting on burn morbidity and mortality [12], [13], [14], [15], [16], [17]. In more recent times, there has been a number of researchers who have focused on the importance of this emerging field and have found women to experience a reduction in generic and burn-specific HRQoL, independent of injury severity and mechanism [18], [19].
Given these findings and the limited data currently available, this study aimed to examine the relationship between gender and generic and burn-specific HRQoL at 3, 6 and 12 months post-burn, but also ascertain if potential gender-specific outcomes changed and progressed over defined time periods.
Section snippets
Setting
The Victorian Adult Burns Service (VABS) is a state-wide adult burns service located at The Alfred Hospital, one of two designated major trauma services for adults in Victoria, Australia.
Study design and inclusion criteria
A prospective cohort study design was used to recruit patients admitted to VABS between February 2008 and October 2009. Patients who fulfilled the following criteria were recruited during their inpatient stay:
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Age ≥18years
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Burns involving >10% total body surface area burned (TBSA) or
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Burns to the face requiring
Results
Between February 2008 and October 2009, 540 patients with an acute burn injury were admitted to the VABS. Of these, 400 were excluded for the following reasons: TBSA <10% with low potential for functional impairment (n = 241), complex social issues (n = 15), insufficient English (n = 4), previous burn injury requiring re-admission (n = 17), death within 24 h (n = 13), conservative burn wound management (n = 39), other diagnoses (i.e. burn-like conditions such as toxic epidermal necrolysis, n = 17) or missed (n =
Discussion
The aim of this study was to assess gender-based differences in generic and burn specific HRQoL at 3, 6 and 12 months, but also to ascertain if gender altered the trajectory of recovery over time. Despite there being no gender differences in pre-burn physical health status, burn severity and received medical interventions, female patients reported greater impairments in generic health and burn-specific HRQoL as well as greater psychological distress post-injury when compared to their male
Conflict ofinterest
None.
Acknowledgements
This project was kindly supported by a Monash University Faculty Strategic Grant. Belinda Gabbe was supported by a National Health and Medical Research Council of Australia Career Development Fellowship (APP1048731).
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