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Functional and Psychosocial Outcomes of Older Adults After Burn Injury: Results From a Multicenter Database of Severe Burn Injury

Klein, Matthew B. MD, MS*; Lezotte, Dennis C. PhD†; Heltshe, Sonya MS†; Fauerbach, James PhD‡; Holavanahalli, Radha K. PhD§; Rivara, Frederick P. MD, MPH∥; Pham, Tam MD¶; Engrav, Loren MD*

doi: 10.1097/BCR.0b013e318203336a
Original Articles: 2010 ABA Papers

A number of factors increase the susceptibility of older adults to burn injury. The majority of studies of older adults have focused on patient and injury factors related to mortality risk. However, little is known about the long-term functional and psychological outcomes of older adults after severe burn. The purpose of this study is to examine the long-term outcomes of older adults after burn injury. The authors performed an analysis of the outcomes of older adults (age 55 years or older) enrolled in a prospective study of burn injury outcomes. Change in living situation as well as distress, functional impairment, and quality of life were examined at discharge and at 6, 12, and 24 months after hospital discharge. Mixed effects modeling was performed to compare differences across age groups and time as well as to account for missing data. A total of 737 patients aged 55 years or older were enrolled and followed in the National Institute on Disability and Rehabilitation Research burn program. Patients in all age groups had significant deficits in Short Form-36, Functional Independence Measure, and Brief Symptom Inventory scores at time of discharge. Recovery of physical and psychosocial functioning was greatest from discharge to 6 months in patients aged 55 to 74 years and greatest at 1 year for patients aged 75 years or older. This study confirms that severe burn injury significantly impacts both functional outcome and psychosocial quality of life in older adults. However, the impact seems to be age related as are recovery trajectories. Rehabilitation programs lasting up to 1 year after injury could be of tremendous benefit in helping older adults achieve maximal potential recovery.

From the *Burn Center and Division of Plastic Surgery, University of Washington, Seattle; †Department of Preventive Medicine and Biostatistics, University of Colorado Health Sciences Center, Denver; ‡Department of Psychiatry and Behavioral Sciences, Johns Hopkins Burn Center, John Hopkins School of Medicine, Baltimore, Maryland; §University of Texas Southwestern Medical Center, Dallas; ∥Department of Pediatrics and Harborview Injury Prevention and Research Center, University of Washington, Seattle; and ¶Division of Trauma, Harborview Medical Center, University of Washington, Seattle.

Supported by funds from the National Institute on Disability and Rehabilitation Research in the Office of Special Education and Rehabilitative Services in the U.S. Department of Education, the Auth-Washington Research Foundation Endowment, and the National Institutes of Health Roadmap/NCRR 1KL2RR025015-01.

Address correspondence to Matthew B. Klein, MD, Burn Center and Division of Plastic Surgery, University of Washington, Harborview Medical Center, 325, 9th Avenue, Box 359796, Seattle, WA 98104.

© 2011 The American Burn Association