Moving towards zero impact from hand burns.
Dale Edgar Dale Edwick Chelsea Evans Rosemary Kendell Inge Spronk Fiona Wood
Abstract
Aim: To identify the factors influencing outcomes associated with hand burns.
Methods: Patients with a burn between 2012-2022 were included. Host characteristics, allied health care statistics, costs, and outcomes were compared for patients with and without a hand burn. The 12-month responses for quality of life and upper limb recovery were modeled for the SF-36 domains and the QuickDASH respectively, using linear mixed-effects models. .
Results: In total, 2,273 patients with 3,921 outcomes were included, of whom 878 patients had a hand burn (38.6%). Patients with a hand burn were more likely to be male (73% vs 61%, p<0.001); have larger burns (mean %TBSA: 2.5% vs 1.5%, p<0.001); and, more frequently suffer burns to multiple locations (75.1% vs 35.8%, p<0.001). After adjusting for important factors, a hand burn was independently associated with more long-term occupational therapy input (p<0.001), and a poorer 12-month recovery trajectory according to QuickDASH scores (p<0.001) and SF-36 physical role limitations scores (p=0.033). There was no evidence of difference in the remaining domains of the SF36 between the groups. Detailed analyses are ongoing, in addition to value-based profiling, and these results will be presented in relation to multidisciplinary hand burn management and outcomes. Conclusion: This study confirmed the independent association of hand burn with poorer longitudinal outcomes, compared to patients without hand burn in WA. Further research will help determine the optimal multidisciplinary team resource allocation and timing of input, to achieve zero impact due to hand burns.