Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, California, USA.
Regional Burn Center at Santa Clara Valley Medical Center, California, USA.
J Burn Care Res. 2021 Nov 24;42(6):1081-1086. doi: 10.1093/jbcr/irab139.
Burn survivors experience barriers to returning to work. For those who do return to work, little is known regarding whether they achieve preinjury productivity (i.e., equivalent or gain in income compared to preinjury income). Identifying patients at risk of not achieving preinjury productivity is important for targeting services that support this population. They extracted occupational and income data through 24 months postinjury from the multicenter, longitudinal Burn Model System National Database. Annual income was reported in six groups: <$25k, $25k-50k, $50k-99k, $100k-149k, $150k-199k, and $>199k. Participants were classified by change in income at each follow-up (i.e., gain, loss, and equivalent). Explanatory variables included demographics, injury characteristics, insurance payer, employment status, and job type. Multilevel, multivariable logistic regression was used to model return to productivity. Four hundred fifty-three participants provided complete income data at discharge and follow-up. Of the 302 participants employed preinjury, 180 (60%) returned to work within 24 months postinjury. Less than half (138) returned to productivity (46% of participants employed preinjury; 77% of those who returned to work). Characteristics associated with return to productivity included older age (median 46.9 vs 45.9 years, OR 1.03, P = .006), Hispanic ethnicity (24% vs 11%, OR 1.80, P = 0.041), burn size >20% TBSA (33.7% vs 33.0%, OR 2.09, P = 0.045), and postinjury employment (54% vs 26%, OR 3.41, P < 0.001). More than half of employed people living with burn injury experienced loss in productivity within 24 months postinjury. Even if they return to work, people living with burn injuries face challenges returning to productivity and may benefit from vocational rehabilitation and/or financial assistance.
烧伤幸存者在重返工作岗位时会遇到障碍。对于那些确实重返工作岗位的人，对于他们是否能达到受伤前的生产力（即与受伤前的收入相比收入相等或增加）知之甚少。确定有无法达到受伤前生产力风险的患者对于为支持这一人群的服务提供目标非常重要。他们通过烧伤模型系统国家数据库（Burn Model System National Database）从多中心、纵向研究中提取了受伤后 24 个月的职业和收入数据。年收入分为六组报告：<$25k、$25k-50k、$50k-99k、$100k-149k、$150k-199k 和>$199k。参与者根据每次随访时收入的变化进行分类（即增加、减少和相等）。解释变量包括人口统计学特征、损伤特征、保险支付方、就业状况和工作类型。使用多层次多变量逻辑回归模型来模拟恢复生产力。453 名参与者在出院和随访时提供了完整的收入数据。在 302 名受伤前就业的参与者中，有 180 名（60%）在受伤后 24 个月内重返工作岗位。不到一半（138 人）恢复了生产力（受伤前就业人数的 46%；重返工作岗位人数的 77%）。与恢复生产力相关的特征包括年龄较大（中位数 46.9 岁与 45.9 岁，OR 1.03，P =.006）、西班牙裔（24%与 11%，OR 1.80，P = 0.041）、烧伤面积>20%TBSA（33.7%与 33.0%，OR 2.09，P = 0.045）和受伤后就业（54%与 26%，OR 3.41，P <0.001）。超过一半的烧伤后就业的人在受伤后 24 个月内经历了生产力下降。即使他们重返工作岗位，烧伤后就业的人在恢复生产力方面也面临挑战，可能受益于职业康复和/或经济援助。
