Longitudinal Trajectories of Health-Related Quality of Life and Life Satisfaction after Major Burn Injury: A Multicenter Cohort Study

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Advances in burn care have markedly improved survival after major injuries. However, survivors often experience significant physical and psychosocial sequelae. We aimed to characterize long-term health-related quality of life (HRQoL) among burn survivors to inform expected trajectories, rehabilitation needs, and common impairments. Adult burn survivors from a multicenter, longitudinal cohort study were stratified into 20.0%-49.9%, 50.0%-69.9%, and ≥70.0% total body surface area burn size groups. Patient-reported HRQoL and life satisfaction were assessed using validated outcome measures at discharge (pre-injury recall), 6, 12, 24 months, and 5 years post-injury. Standardized summary scores were derived using validated bridges. Mixed-effects linear regression models evaluated longitudinal changes and between-group differences. A total of 1113 participants were analyzed. All outcomes declined early after injury but improved progressively thereafter. Notably, by 24 months, mental-HRQoL and life satisfaction approached pre-injury levels across all burn size groups. Physical-HRQoL deficits were greater with increasing burn size, with significant net differences relative to the 20.0%-49.9% reference group (P < .0001). Mental-HRQoL and life satisfaction outcomes showed minimal between-group differences overall, though individuals with the largest burns exhibited significantly better relative mental-HRQoL at 24 months (P < .05). Although outcomes improve over time following major burn injury, persistent physical deficits support the classification of major burns as a chronic condition. These findings characterize burn size–specific recovery trajectories and demonstrate that, despite persistent physical deficits, mental health and life satisfaction can return to near pre-injury levels even after the most extensive injuries.

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