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Impairment after burns: a two-center, prospective report
B A Costa1, L H Engrav, R Holavanahalli
1Division of Plastic Surgery, Department of Surgery, University of Washington Burn Center, Harborview Medical Center, 325 Ninth Avenue, 98104, Seattle, WA, USA.
Burns : Journal of the International Society for Burn Injuries
|October 15, 2003
Summary
Burn impairment ratings, while common for trauma, are rarely studied. This research found whole person impairment (WPI) correlated with burn severity and work absence but not psychosocial outcomes, suggesting a need for standardized rating methods.
Area of Science:
- Medical assessment
- Burn injury evaluation
- Rehabilitation medicine
Background:
- Impairment ratings are standard for trauma but not burn injuries.
- Prospective data on burn impairment and its relation to outcomes is limited.
- Standardization of burn impairment ratings across institutions is not well-established.
Purpose of the Study:
- To prospectively collect and report impairment ratings for burn patients.
- To correlate impairment ratings with psychosocial and functional outcomes.
- To compare burn impairment data between two burn centers for standardization.
Main Methods:
- Prospective data collection from 139 patients at University of Washington (UW) Burn Center and 100 patients at UT Southwestern Burn Center.
- Calculation of average whole person impairment (WPI) ratings.
- Correlation analysis between WPI and functional/psychosocial outcome measures (BSI, FIM, SF-36, SWLS, CIQ).
Main Results:
- Average WPI ratings were 17% at UW and 19% at UT Southwestern.
- WPI correlated with total body surface area burned and days off work.
- WPI did not correlate with BSI, FIM, SF-36, SWLS, or CIQ scores.
- Specific components of impairment ratings varied between the two centers.
Conclusions:
- Whole person impairment ratings in burn patients correlate with physical factors like burn size and work absence.
- Current impairment rating methods do not consistently reflect psychosocial or functional status.
- Standardization recommendations include using the AMA Guides to the Evaluation of Permanent Impairment and incorporating sensory impairment.
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