BACKGROUND: Itch and pain are common complaints of patients with burn injuries. This study aimed to describe the prevalence and predictors of itch and moderate to severe pain in the first 12 months following a burn injury, and determine the association between itch, moderate to severe pain, work-related outcomes, and health-related quality of life following a burn injury.
METHODS: Burns patients aged 18 years and older were recruited from five Australian specialist burn units. Patients completed the 36-item Short Form Health Survey Version 2 (SF-36 V2), the Sickness Impact Profile (SIP) work scale, and a specially developed questionnaire relating to itch at 1-, 6-, and 12-months postinjury. Moderate to severe pain was defined as a score less than 40 on the bodily pain domain of the SF-36 V2. Multivariate mixed effects regression models were used to identify patient and burn injury predictors of itch and moderate to severe pain.
RESULTS: Three hundred and twenty-eight patients were included. The prevalence of itch decreased from 50% at 1-month to 27% at 12-months. Similarly, the prevalence of moderate to severe pain decreased from 23% at 1-month to 13% at 12-months. Compared to patients aged 18-34, the adjusted odds of experiencing any itch were 59% (95% CI: 0.20, 0.82) and 55% (95% CI: 0.22, 0.91) lower for patients aged between 35-49 and ≥ 50 years respectively. Compared to patients aged 18-34, the adjusted odds of experiencing moderate to severe pain were 3.12 (95% CI: 1.35, 7.20) and 3.42 (95% CI: 1.47, 7.93) times higher for patients aged 35-49 and ≥ 50 years respectively.
CONCLUSIONS: Less than 15% of patients reported moderate/severe pain at 12-months, while approximately one quarter of the patients reported itch at the same period. The presence of moderate to severe pain was associated with a greater negative impact on health-related quality of life and work outcomes compared to itch. Further research is needed to improve our ability to identify patients at higher risk of persistent itch and pain who would benefit from targeted review and intervention studies.
Tracy, L.M., Edgar, D.W., Schrale, R., Cleland, H., & Gabbe, B.J., On behalf of the BRANZ Adult Long Term Outcomes pilot, project participating sites, and working party (accepted 18/09/2019). Predictors of itch and pain in the 12 months following burn injury: Findings from the Burns Registry of Australia and New Zealand. Burns & Trauma.