McAleavey Andrew A, Wyka Katarzyna, Peskin Melissa, Difede JoAnn
Department of Psychiatry, Weill Cornell Medical College, 525 E. 68th St., New York, NY 10065, USA.
Department of Psychiatry, Weill Cornell Medical College, 525 E. 68th St., New York, NY 10065, USA; Department of Epidemiology and Biostatistics, City University of New York, 55 W. 125th St., New York, NY 10027, USA.
Burns. 2018 Jun;44(4):793-799. doi: 10.1016/j.burns.2017.12.011. Epub 2018 Feb 1.
While burn injuries can have dramatic effect on patients' physical health, they can also lead to intense psychological distress, loss of important social and role functioning, and alterations in outward appearance. We aimed to identify potential leading indicators of recovery in the post-discharge period following acute burn injury and hospitalization.
Using data derived from the Burn Model System National Database, we identified five outcomes of interest measured at four time points (Pre-burn/Discharge, 6 months, 12 months, and 24 months post-discharge), including mental health, physical functioning, community integration, life satisfaction, and satisfaction with appearance. We applied cross-lagged panel analysis to the sample of 1052 injured patients admitted to burn intensive care units.
Overall, there was little mean change in the five measures after the 6-month assessment. A time-varying panel model was superior to a time-invariant model, showing that the process of recovery itself may change over the course of two years post-burn. Physical functioning is an important predictor throughout this period, while satisfaction with appearance is quite predictive of other factors at discharge, but somewhat less predictive later. Overall mental health functioning is less predictive at discharge but at later intervals was a meaningful leading predictor of the other outcomes.
Recovery from burn injury is complex and the most important facets of recovery change over time. Future research should focus on developing treatments to help patients adjust to post-burn appearance in the early post-discharge period, and mental health interventions may be effective as patients progress in recovery.
烧伤不仅会对患者的身体健康产生显著影响，还会导致严重的心理困扰、重要社会功能和角色功能的丧失以及外貌改变。我们旨在确定急性烧伤损伤和住院后出院期间恢复的潜在领先指标。
利用烧伤模型系统国家数据库中的数据，我们确定了在四个时间点（烧伤前/出院时、出院后6个月、12个月和24个月）测量的五个感兴趣的结果，包括心理健康、身体功能、社区融入、生活满意度和对外貌的满意度。我们对1052名入住烧伤重症监护病房的受伤患者样本应用了交叉滞后面板分析。
总体而言，在6个月评估后，这五项指标的平均变化不大。时变面板模型优于时不变模型，表明烧伤后两年内恢复过程本身可能会发生变化。在此期间，身体功能是一个重要的预测指标，而对外貌的满意度在出院时对其他因素有很强的预测性，但在后期预测性有所降低。总体心理健康功能在出院时的预测性较低，但在后期是其他结果的一个有意义的领先预测指标。
烧伤后的恢复是复杂的，恢复的最重要方面会随时间变化。未来的研究应侧重于开发治疗方法，以帮助患者在出院后的早期适应烧伤后的外貌，并且随着患者恢复进程的推进，心理健康干预可能会有效。
