An Examination of Follow-up Services Received by Vulnerable Burn Populations: A Burn Model System National Database Study

Engaging Burn Survivors, Their Families, and the Burn Community in Patient-Centered Outcomes Research: A Burn Survivor- and Burn Community Stakeholder-Generated and Prioritized Research Agenda

Burn survivors are involved in burn research, but typically in the role of research subject. We believe that the outcomes and impact of burn research can be improved by engaging survivors as collaborators in the planning, implementation, and dissemination of burn research. The goal of this work was to produce the first burn research agenda generated and prioritized by burn survivors and other stakeholders from the burn community. A series of structured focus groups covering 5 topics (Patient and Family Education, Aftercare, Navigating the Healthcare System, Recovery: Physical and Psychosocial, and Barriers to Research) were held with burn survivors and their family members. Specific research questions/topics were identified from the transcripts and prioritized via an anonymous survey of burn survivors, their caregivers, and other stakeholders from the burn community. From these sessions, 37 specific research questions/topics were identified and ranked. In addition, 19 research barriers were identified and ranked. This work presents an innovative approach to burn research through co-production with survivors and other stakeholders. Burn survivors and their caregivers are experts in their lived experiences. By involving them in burn research as collaborators and contributors from the very first steps of research and throughout the continuum of the research planning, conducting projects, and distributing findings, we believe that the research will be both more successful and more impactful. We have taken the first steps in burn research co-production with this novel stakeholder-generated research agenda for the burn community.

Exploring the gaps: A scoping review of burn injury research in skin of colour

Burn injury management and outcomes reveal observed disparities in individuals with darker skin tones, likely influenced by limited representation in medical literature and clinical research. These gaps may contribute to variations in care quality and outcomes for these populations. A comprehensive literature search was conducted across PubMed, Scopus, and Embase databases, initially yielding 74 articles. Due to limited relevant studies directly addressing the research question, the approach shifted from a systematic review to a scoping review to allow for a broader exploration of potential disparities in burn injury outcomes. Following these criteria, 31 relevant articles were identified and analysed. The analysis suggests an underrepresentation of diverse skin tones in medical textbooks and clinical research, limitations in current burn assessment tools for darker skin, and a lack of tailored treatment protocols. Studies indicate that patients with darker skin tones may face higher risks of complications and varied outcomes, potentially influenced by systemic healthcare challenges and limited guidelines addressing diverse skin types. This scoping review highlights the importance of more inclusive research and clinical practices that consider the specific needs of individuals with darker skin tones. Addressing these observed gaps can support improvements in burn injury management, ultimately contributing to more equitable healthcare for all skin types.

Impact of community-level socioeconomic disparities on quality of life after burn injury: A Burn Model Systems Database study

INTRODUCTION

Individual-level socioeconomic disparities impact burn-related incidence, severity and outcomes. However, the impact of community-level socioeconomic disparities on recovery after burn injury is poorly understood. As a result, we are not yet able to develop individual- and community-specific strategies to optimize recovery. Therefore, we aimed to characterize the association between community-level socioeconomic disparities and long-term, health-related quality of life after burn injury.

METHODS

We queried the Burn Model System National Longitudinal Database for participants who were> 14 years with a zip code and who had completed a health-related quality of life (HRQOL) questionnaire (VR-12) 6 months after injury. BMS data were deterministically linked by zip code to the Distressed Communities Index (DCI), which combines seven census-derived metrics into a single indicator of economic well-being, education, housing and opportunity at the zip code level. Hierarchical linear models were used to estimate the association between community deprivation and HRQOL 6 months after burn injury, as measured by mental (MCS) and physical (PCS) component summary scores of the SF12/VR12.

RESULTS

342 participants met inclusion criteria. Participants were mostly male (n = 239, 69 %) and had a median age of 48 years (IQR 33-57 years). Median %TBSA was 10 (IQR 3-28). More than one-third of participants (n = 117, 34 %) lived in a community within the highest two distress quintiles. After adjusting for age, race/ethnicity, number of trips to the operating room (OR) and pre-injury PCS, neighbourhood distress was negatively associated with 6-month PCS (ß-0.05, 95 % CI [-0.09,-0.01]). Increasing age and lower pre-injury PCS were also negatively associated with 6-month PCS. There was no observed association between neighbourhood distress and 6-month MCS after adjustment for age, participant race/ethnicity, number of trips to the OR and pre-injury MCS. Higher pre-injury MCS was associated with 6-month MCS (ß0.54, 95 % CI [-0.41,0.67]).

CONCLUSIONS

Community distress is associated with lower PCS at 6 months after burn injury but no association with MCS was identified. Pre-injury HRQOL is associated with both PCS and MCS after injury. Further study of the factors underlying the relationship between community distress and physical functional recovery (e.g., access to rehabilitation services, availability of adaptations) is required to identify potential interventions.