Impact of Burn-Related Amputations on Return to Work: Findings From the Burn Injury Model System National Database

Amputations following a burn injury, although infrequent, may affect community reintegration and create a barrier to returning to work. The objective of this study was to compare patient and injury characteristics, quality of life, and employment status for those with and without amputation using a national longitudinal database of people with burn injuries. In this retrospective review of prospectively collected data, group differences were examined using descriptive statistics. We used linear and logistic regression models to identify factors significantly associated with amputation, factors associated with return to work rates, and SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores over time. Of 2682 records, 180 individuals underwent at least one amputation (6.7%). Amputations were associated with two injury etiologies: electrical injuries (OR 8.71, 95% CI 5.5-13.7) and contact with hot object (OR 5.57, 95% CI 3.1-10.1). Employment at 12 months postburn was associated with working before injury (OR 11.4, 95% CI 8.1-15.3). People with amputations were more likely to be unemployed 12 months postburn than those without amputations (OR 4.95, 95% CI 2.8-8.7). Amputation was a statistically significant predictor of SF-12 scores at 6 months for both PCS (β = .10, P = .003) and MCS (β = -.07, P = .04) scores. Amputations are relatively rare following burn injury and are more often associated with electrical and contact injuries. Whereas, people with amputations were less likely to be employed at 12 months postburn, those who were employed before the injury were more likely to return to work regardless of amputation status.