Hospital-acquired complications alter quality of life in adult burn survivors: Report from a burn model system

Abstract

Introduction: Successful burn care should facilitate comprehensive, functional recovery after an injury. But we have a poor understanding of which risk factors influence long-term outcomes after burn injury. Studies have correlated hospital-acquired complications (HACs) with poor long-term outcomes in some populations. The purpose of this study was to determine whether HACs alter patient-reported quality of life in adult burn survivors. Methods: We followed 496 adults with major burn injury longitudinally as part of a burn outcomes study (1993–2014). Study participants completed SF-12® Health Surveys providing mental (MCS) and physical (PCS) component summary scores at discharge, 12- and 24-months following injury. We reviewed inpatient medical records for complications during the acute care of a thermal injury. Complications were identified using discharge summary and chart ICD-9 codes. We used descriptive statistics to compare demographic and injury characteristics. Stepwise linear regression analyses determined the impact of significant variables on longitudinal MCS and PCS scores. Burn and graft total body surface area, age, and gender were included as predictor variables in univariate models and added to multivariate models when they were significant. Results: Patients who suffered urinary tract infection, venousthromboembolism, pulmonary complications and renal failure during hospitalization for their burn injury reported decreased quality of life as indicated by lower SF-12® PCS scores at 12 and 24 months after injury. Conclusions: We demonstrate that inpatient complications negatively impact long-term quality of life, especially physical functioning for patients with burn injuries. Our data confirm the need to consider the influence of hospital-acquired complications on patient-reported long-term outcomes and to support national efforts to reduce complications in burn patients.