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Health-related quality of life (EQ-5D) early after injury predicts long-term pain after burn
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Linkoping Univ, Burn Ctr, Dept Hand Plast & Intens, S-58185 Linkoping, Sweden..
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
Linkoping Univ, Burn Ctr, Dept Hand Plast & Intens, S-58185 Linkoping, Sweden..
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
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2016 (Engelska)Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, nr 8, s. 1781-1788Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Chronic pain after burn can have severe physical and psychological effects on former patients years after the initial injury. Although the issue of pain after burn has gained increased attention over the past years, prospective, longitudinal studies are scarce. Our aim was to prospectively investigate consecutive burn patients for pain severity over time and to evaluate the prevalence and characteristics of post-burn pain to 2-7 years after the burn. As an additional aim, the effects of burn and individual-related factors, especially health related Quality of Life (HRQoL), were investigated.

Method: Sixty-seven consecutive burn patients were assessed during acute care at 3, 6, 12 and 24 months, as well as at 2-7 years post-burn. HRQoL, symptoms of post-traumatic stress disorder (PTSD) and other psychiatric disorders were investigated. During the interviews that took place 2-7 years after the injury (mean 4.6 1.9 years), current chronic post-burn pain was assessed using the Brief Pain Inventory-Short Form (BPI-SF).

Results: One-third of the patients still reported pain 2-7 years after the injury. Pain severity and interference with daily life were mainly mild to moderate though they were found to be associated with significantly lower HRQoL. Chronic pain after bum was associated with both burn- and individual-related factors. In logistic regression analysis HRQoL at 3 and 12 months and symptoms of PTSD at 12 months were independent factors in predicting chronic pain after burn.

Conclusion: Pain after burn becomes a chronic burden for many former burn patients and decreases HRQoL. A novel finding in this study was that HRQoL assessed early after burn was a predictor for the development of chronic pain. This finding may help to predict future pain problems and serve as an indicator for pain preventive measures.

Ort, förlag, år, upplaga, sidor
2016. Vol. 42, nr 8, s. 1781-1788
Nyckelord [en]
Burns, Pain, Brief Pain Inventory-Short Form, Health-related quality of life, Post-traumatic stress disorder
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:uu:diva-314419DOI: 10.1016/j.burns.2016.05.016ISI: 000391073900021OAI: oai:DiVA.org:uu-314419DiVA, id: diva2:1071835
Forskningsfinansiär
VetenskapsrådetForte, Forskningsrådet för hälsa, arbetsliv och välfärdTillgänglig från: 2017-02-06 Skapad: 2017-02-02 Senast uppdaterad: 2019-04-12Bibliografiskt granskad
Ingår i avhandling
1. Long-term outcome after burn: Pruritus, pain, personality and perceived health
Öppna denna publikation i ny flik eller fönster >>Long-term outcome after burn: Pruritus, pain, personality and perceived health
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

This thesis investigated the role of burn-specific and individual-related factors for long-term outcome after burn with emphasis on pruritus, pain, personality and perceived health.

Consecutive adult patients, admitted to the Uppsala University Burn Center between 2000 and 2009, were included. Patients were assessed during hospitalization, at 3, 6, 12 and 24 months and finally at 2-7 and 10-17 years post-burn.

Pruritus was prevalent in half of the patients 2-7 years post-burn. Of the patients with pruritus, half had severe pruritus, which was independently related to full thickness burn and health-related quality of life (HRQoL) at 3 months post-burn. One third scratched to the point of bleeding. Such scratching was independently related to full thickness burns and the personality trait Impulsiveness, but did not necessarily imply more severe pruritus. Results suggest that many patients lack adequate treatment.

 Pain was prevalent in one third of the patients 2-7 years post-burn. Severity levels generally decreased over time and was at follow-up mostly regarded as mild to moderate. Post-burn pain has a negative effect on HRQoL and at 3 months post-burn, HRQoL was independently related to the reporting of post-burn pain at 2-7 years.

Personality trait scores in burn patients deviated little from norm values. Personality traits remained largely stable the first year after burn injury, except for an increase in the trait Stress Susceptibility, which was scored lower during the acute care phase but normalized at 12 months post-burn.

In qualitative interviews 10-17 years post-burn, participants reported living a near normal life. The subscales of the burn-specific health scale brief were in general still applicable at this time point. Additional areas playing an important role for post-burn health and outcome were skin-related problems, morphine de-escalation, the importance of work, stress and avoidance, mentality and the healthcare system.

Certain subgroups of burn patients are more vulnerable and likely to develop post-burn sequalae and this is dependent on both burn severity and individual characteristics. In general, however, many former burn patients recover well in the long run.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2019. s. 65
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1569
Nyckelord
Burns, Pruritus, Pain, Personality, Quality of Life, Health Status, Wounds and injuries, Patient Reported Outcome Measures, Rehabilitation
Nationell ämneskategori
Medicin och hälsovetenskap
Forskningsämne
Psykiatri; Kirurgi
Identifikatorer
urn:nbn:se:uu:diva-381618 (URN)978-91-513-0643-8 (ISBN)
Disputation
2019-06-05, Gunnesalen, Entrance 10, Akademiska sjukhuset, Uppsala, 13:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2019-05-15 Skapad: 2019-04-12 Senast uppdaterad: 2019-06-17

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Gauffin, EmelieÖster, CaisaGerdin, BengtEkselius, Lisa

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