69 Identifying Longitudinal Outcome Domains Post-Burn Injury: A Systematic Review of Validated Patient-Reported Outcome Measures

TL;DR

This study reviews validated patient-reported outcome measures used to assess long-term physical and psychological outcomes in burn survivors.

Contribution

The study identifies gaps in burn-specific PROMs and highlights the need for new measures addressing psychological and functional domains.

Findings

Burn-specific PROMs focus mainly on scar management, with limited coverage of psychological and functional outcomes.

Combination studies using both burn- and non-burn-specific PROMs better capture psychological and functional recovery aspects.

The most commonly used burn-specific PROM in combination studies was the Burn Specific Health Scale (BSHS).

Abstract

Burn injuries represent a significant public health concern. Patient-reported outcome measures (PROMs) are used to assess physical and psychological outcomes. We reviewed the literature to identify (1) commonly-used PROMs that assess long-term outcomes and (2) domains of interest not addressed by burn-specific PROMs.

We searched 3 databases (PubMed, Embase, Web of Science) from 1979-July 2024. Eligible articles studied adult burn patients (≥18 years) with a follow-up period of 13-24 months using either a burn-specific or combination of burn- and non-burn-specific, validated PROMs. Six reviewers independently screened articles; three conducted quality assessments using JBI critical appraisal of bias tools. We used COVIDENCE for article screening and Microsoft Excel for data analysis.

Our initial search yielded 29,644 articles. Following title, abstract, and full-text screening, 7 studies containing 706 patients were eligible for inclusion. Burn injury types included thermal, electrical, and chemical. TBSA was listed as a mean of ≤50% in two (n=2) studies and >50% in two (n=2) studies, a median of 5% in one (n=1) study, and not listed in two (n=2) studies. Four (n=4, 57%) studies used a combination of validated burn and non-burn-specific PROMs (“combination studies”), such as Burn Specific Health Scale (BSHS), Hospital Anxiety and Depression Scale (HADS), and Impact of Event Scales (IES). Three (n=3) studies used only validated burn-specific questionnaires: Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS)]. Studies using only burn-specific PROMs focused on outcomes related to burn scar treatment and management. Combination studies assessed psychological and functional aspects of patient recovery such as anxiety and depression (HADS, n=1) and PTSD symptoms (IES, n=2). The most common burn-specific questionnaire used in combination studies was the BSHS (n=4). Of the three (n=3) studies that used only burn-specific questionnaires, two (n=2) used one PROM each to assess burn scars [VSS (n=1), POSAS (n=1)] and one (n=1) study used both to help address “physical restriction” and “psychological strain” of scars as well as “general scar assessment.” Substantial data heterogeneity prevented meta-analysis.

Burn-specific PROMs primarily assess scar management, necessitating combined use of burn- and non-burn-specific PROMs to assess psychological, functional, and emotional impacts of burn injury and long-term outcomes. Burn research and patient care could benefit from creating and validating a burn-specific PROM assessing psychological and functional domains vital to the long-term well-being of burn survivors.

This research provides data on burn- and non-burn-specific PROMs to assess long-term outcomes of burn survivors.

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