Quality-of-life loss of people admitted to burn centers, United States

Purpose: To estimate quality-of-life loss per serious burn survivor in a large U.S. cohort. Methods: Longitudinal functional assessments of all 1,587 people receiving primary treatment in 5 burn centers between 2000 and 2009 included pre-burn (retrospective), at time of discharge, and 6, 12, and 24 months post-injury. We assessed adults with RAND Short Form (SF) 12 and children with SF-10 or Child Health Questionnaire, the child surveys scored using standard norms-based scoring. A literature review identified 20 quality-adjusted life year utility scorings for SF-12 and 27 scorings for EQ-5d response distributions predicted from SF-12 scores. We computed composite scores for each patient and time period by applying 32 scorings that met quality/non- duplication criteria. Results: Mean quality-of-life scores were 0.805 4 weeks pre-burn, 0.562 at discharge, rebounded through 1 year, and stabilized at 0.735 (0.750 for TBSA burned below 25 %, 0.722 for TBSA burned of 25-50 %, and 0.695 for larger burns). As a percentage of initial levels, burns reduced short-term quality of life by 30 %. Long-term loss averaged 11 %, ranging from 9 % for TBSA burned below 25-13 % for TBSA burned above 50 %. Children recovered faster and more fully. Conclusion: Burns cause substantial losses in quality of life, with long-term losses comparable to traumatic brain injury.