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Annals of Surgery

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Objective: To assess the association of burn size and community participation as measured by the LIBRE Profile.

Summary of background data: Burn size is an established clinical predictor of survival after burn injury. It is often a factor in guiding decisions surrounding early medical interventions, however, literature is inconclusive on its relationship to quality of life outcomes.

Methods: This is a secondary data analysis of a cross-sectional survey of adult burn survivors. Self-reported data were collected between October 2014 and December 2015 from 601 burn survivors aged ≥18 years with ≥5% total body surface area (TBSA) or burns to critical areas. Sociodemographic characteristics were compared between participants with small burns (≤40% TBSA burned) and large burns (>40% TBSA burned). Ordinary least squares regression models examined associations between burn size and LIBRE Profile scale scores with adjustments for sex, current work status, burns to critical areas, and time since burn injury.

Results: The analytic sample comprised 562 participants with data available for burn size. 42% of respondents had large burns (>40% TBSA burned) and 58% reported smaller burns (TBSA ≤40%). In adjusted regression models, patients with large burns tended to score lower on the Social Activities and Work & Employment scales (P < 0.05) and higher on the Family & Friends scale (P < 0.05). Participants with burns >40% TBSA scored lower for several individual items in the Social Activities scale and one item in the Work & Employment scale (P < 0.05).

Conclusions: Increasing burn size was found to be negatively associated with selected items of Work & Employment, and Social Activities, but positively associated with aspects of Family & Friend Relationships. Future longitudinal studies are necessary to assess and understand the long-term social impact of burn injuries on adult populations.


Colleen M Ryan, Gabriel D Shapiro, Camerin A Rencken, Cornelia Griggs, James C Jeng, William L Hickerson, Molly Marino, Jeremy Goverman, Lewis E Kazis, Jeffrey C Schneider, LIBRE Advisory Board