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烧伤后老年人的功能和心理社会结局:来自严重烧伤多中心数据库的结果

Functional and psychosocial outcomes of older adults after burn injury: results from a multicenter database of severe burn injury.

作者信息

Klein Matthew B, Lezotte Dennis C, Heltshe Sonya, Fauerbach James, Holavanahalli Radha K, Rivara Frederick P, Pham Tam, Engrav Loren

机构信息

Burn Center and Division of Plastic Surgery, University of Washington, Seattle, WA 98104, USA.

出版信息

J Burn Care Res. 2011 Jan-Feb;32(1):66-78. doi: 10.1097/BCR.0b013e318203336a.

Abstract

A number of factors increase the susceptibility of older adults to burn injury. The majority of studies of older adults have focused on patient and injury factors related to mortality risk. However, little is known about the long-term functional and psychological outcomes of older adults after severe burn. The purpose of this study is to examine the long-term outcomes of older adults after burn injury. The authors performed an analysis of the outcomes of older adults (age 55 years or older) enrolled in a prospective study of burn injury outcomes. Change in living situation as well as distress, functional impairment, and quality of life were examined at discharge and at 6, 12, and 24 months after hospital discharge. Mixed effects modeling was performed to compare differences across age groups and time as well as to account for missing data. A total of 737 patients aged 55 years or older were enrolled and followed in the National Institute on Disability and Rehabilitation Research burn program. Patients in all age groups had significant deficits in Short Form-36, Functional Independence Measure, and Brief Symptom Inventory scores at time of discharge. Recovery of physical and psychosocial functioning was greatest from discharge to 6 months in patients aged 55 to 74 years and greatest at 1 year for patients aged 75 years or older. This study confirms that severe burn injury significantly impacts both functional outcome and psychosocial quality of life in older adults. However, the impact seems to be age related as are recovery trajectories. Rehabilitation programs lasting up to 1 year after injury could be of tremendous benefit in helping older adults achieve maximal potential recovery.

摘要

多种因素会增加老年人烧伤的易感性。大多数针对老年人的研究都集中在与死亡风险相关的患者和损伤因素上。然而,对于严重烧伤后老年人的长期功能和心理结果却知之甚少。本研究的目的是探讨老年人烧伤后的长期结果。作者对纳入烧伤损伤结果前瞻性研究的老年人(年龄55岁及以上)的结果进行了分析。在出院时以及出院后6个月、12个月和24个月时,对生活状况的变化以及痛苦、功能障碍和生活质量进行了检查。采用混合效应模型来比较不同年龄组和时间的差异,并处理缺失数据。共有737名年龄55岁及以上的患者被纳入国立残疾与康复研究所烧伤项目并接受随访。所有年龄组的患者在出院时的简短健康调查问卷-36、功能独立性测量和简明症状量表得分均有显著缺陷。55至74岁患者从出院到6个月时身体和心理社会功能的恢复最大,75岁及以上患者在1年时恢复最大。本研究证实,严重烧伤会显著影响老年人的功能结果和心理社会生活质量。然而,这种影响似乎与年龄有关,恢复轨迹也是如此。受伤后长达1年的康复计划可能对帮助老年人实现最大程度的潜在恢复有巨大益处。

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