The Impact of Facial Burns on Long Term Outcomes in Young Adults: A Five-Year Study
*Cornelia Griggs1, *Austin Lee2, *Frederick Stoddard1, *Nien Chen Li2, *Gabriel Shapiro2, *Tina Palmieri3, *Chao Wang4, *Walter J Meyer, III5, *Frank S Pidcock6, Robert L Sheridan1, *Debra A Reilly7, *Jeffrey C Schneider8, *Lewis E Kazis2, Ronald G Tompkins1, Colleen M Ryan1
1Massachusetts General Hospital, Boston, MA;2Boston University, Boston, MA;3Shriners Hospitals for Children of California, Sacramento, CA;4Shriners Hospitals for Children of Boston, Boston, MA;5Shriners Hospitals for Children - Galveston, Galveston, TX;6Kennedy Krieger Institute, Baltimore, MD;7Nebraska Medical Center, Omaha, NE;8Spaulding Rehabilitation Hospital, Boston, MA
Objective: To examine the outcomes of young adults with facial burns across multiple domains of functional status as compared to those without facial burns. Design: A prospective multi-center study using the Young Adult Burn Outcome Questionnaire (YABOQ). Setting: Patients were recruited across five burn centers (Sacramento, Boston, North Carolina, Nebraska, and Baltimore) between 2003 and 2008. Patients: English-speaking patients with burns that occurred on or after their 17th birthday and were between the ages of 19 and 30 years at the time of survey. Interventions: Administration of the YABOQ, summarizing functional status across 15 domains, with follow up administration at 2 weeks and 6, 12, 24, and 36 months from initial enrollment. Main Outcome Measure: Using canonical discriminant analysis, this study used a composite score to summarize the 15 domain scores of the YABOQ and traced patterns of change over a three-year recovery period. Results: A total of 153 burned (31% with face burns) and 112 non-burned subjects completed 620 questionnaires. Canonical analysis showed that early post-burn, facial burns were associated with a difference in outcome, but this overall difference diminished over time. Regression analysis showed that for survivors with facial injury, Emotion and Sexual Function scores were persistently lower (worse), while Religion scores were persistently higher. Satisfaction with Role was initially better than the non-face burned group, but over time got worse, while Perceived Appearance was initially worse in the face burned group but this difference diminished over time. Conclusions: The overall difference in recovery between survivors with and without facial burns diminished over time while individual domains had various patterns of recovery.
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