• Nancy E van Loey, Ed F van Beeck, Bertus W Faber, Rens van de Schoot, and Marco Bremer.
• From the Department of Psychosocial and Behavioural Research (N.E.L.), Association of Dutch Burns Centres, Beverwijk, The Netherlands; Department of Public Health (E.F.B.), Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Clinical Psychology (B.W.F.), Martini Hospital, Groningen, The Netherlands; Department of Methods and Statistics (R.S.), Utrecht University, The Netherlands; and Burn Centre (M.B.), Martini Hospital, Groningen, The Netherlands.
• J Trauma. 2011 Oct 24.

BackgroundHealth-related quality of life (HRQOL) is an important parameter after medical treatments. Knowledge of (predictors of) diminished quality of life can help improve medical outcome. The aim of this study was to quantify health loss in patients with burns and to assess the contribution of injury extent, age, gender, and psychologic factors to HRQOL and speed of recovery. A multicenter prospective cohort design was used to address these aims. MethodsData were obtained from 260 adults with burns. Patients completed the EQ-5D at 3 weeks, 3, 6, 9, and 18 months after burn and psychologic questionnaires during hospitalization. Patient's scores were compared with an age- and gender-weighted norm population. ResultsPatients suffered from substantial health losses at short term, but after 18 months the majority reached a HRQOL comparable with the norm population with the exception of patients requiring two or more surgeries. The best predictor of long-term HRQOL and the speed of recovery was the number of surgeries, followed by psychologic problems. Both predicted baseline and trajectories of improvement. Symptoms of traumatic stress were most debilitating over time. ConclusionsBoth injury severity and psychologic problems play a pivotal role in reduced HRQOL and the speed of recovery. The number of surgeries seems to give a practically useful indication of the expected recovery speed that could aid in decision making and provides adequate information for patients in the aftermath of their initial surgical treatment. Screening for traumatic stress is recommended.

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