564 Adults with Head and Neck Burns Have Worse Long-Term Psychosocial Outcomes

TL;DR

Adults with head and neck burns face worse long-term mental health and life satisfaction compared to those with other burns.

Contribution

This study identifies head and neck burns as a marker for worse psychosocial outcomes, suggesting early psychological intervention.

Findings

Head and neck burn patients had higher anxiety, depression, and lower life satisfaction at 12 months.

Body image issues persisted for up to 24 months in head and neck burn survivors.

Early psychological screening and treatment are recommended for this group to improve outcomes.

Abstract

People living with burns of the head and neck (H&N) often experience serious physical (e.g., microstomia, ectropion) and psychological sequelae (e.g., adjustment and mood disorders). We aimed to compare long-term outcomes in key psychosocial domains between adults with and without H&N burns.

Adults with burn injuries after 2014 enrolled in the Burn Model System national longitudinal, multicenter database were included. Survey responses using the PROMIS-29 (Anxiety, Depression, and Participation in Social Roles), Satisfaction with Life Scale (SWL), and Burn Specific Health Scale (BSHS) at 6-, 12-, and 24 months post-injury were analyzed. Differences between participants with and without H&N burns were examined with non-parametric tests.

This study included 1,247 participants: 579 had H&N burns and 668 had non-H&N burns. Compared to those with non-H&N burns, participants with H&N burns had significantly larger burn size (22.3 ±18.2 vs. 8.6 ±11.0 % total body surface area (TBSA), p< 0.001) and longer hospital stays (32.6 ±38.3 vs. 16.9 ±16.5 days, p< 0.001). At 12 months, participants with H&N burns reported significantly worse anxiety (51.2 ±10.6 vs. 48.3 ±9.4, p=0.001), depression (50.4 ±10.6 vs. 47.8 ±9.4, p=0.0026), and SWL (17.9 ±7.6 vs. 19.6 ±6.5, p< 0.001). Participants with H&N burns also reported significantly worse body image at 6 months (2.5 ±1.3 vs. 3.0 ±1.2, p< 0.001), 12 months (2.5 ±1.3 vs. 3.2 ±1.1, p< 0.001), and 24 months (2.7 ±1.3 vs. 3.1 ±1.2, p< 0.001).

Participants with H&N burns reported significantly worse outcomes in several psychosocial domains, including anxiety, depression, life satisfaction, and body image. These findings and evidence from early psychological intervention suggest that the presence of H&N burns is a potentially useful screening tool to identify an adult population who might benefit from early evaluation and treatment for psychological stress, coping and adjustment (e.g., cognitive processing therapy).

In addition to future studies, this study may be used when considering recommendations for psychotherapy or counseling services available to people living with H&N burns.

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