The impact of discharge contracture on return to work after burn injury: A burn model system investigation

Model System:

Burn

Reference Type:

Journal article

Accession No.:

J84582

Journal:

Burns

Year, Volume, Issue, Page(s):

2020 , 46, 3, 539-545

Publication Website:

Abstract:

Study examined the association of extremity contractures with employment after burn injury. Data were obtained from the Burn Model System database for adult patients who were working prior to injury and discharged with and without a contracture in one of the major extremity joints (shoulder, elbow, wrist, hip, knee and ankle). Contracture severity was classified according to mild, moderate, and severe categories. Descriptive analyses and predictive modeling were performed to identify injury and patient factors associated with return to work (RTW) at 6, 12, and 24 months. A total of 1,203 participant records met criteria for study inclusion. Of these, 415 (35 percent) had developed a contracture at discharge: 9 percent mild, 12 percent moderate, and 14 percent severe. Among 801 (67 percent) participants who had complete data at 6 months after discharge, 70 percent of patients without contracture had returned to work compared to 45 percent of patients with contractures. RTW increased at each subsequent follow-up time point for the contracture group, however, it remained significantly lower than in no-contracture group. In multivariable analyses, female sex, non-Caucasian ethnicity, larger burn size, alcohol abuse, number of in-hospital operations, amputation, and in-hospital complications were associated with a lower likelihood of employment. In adjusted analyses, discharge contracture was associated with a lower probability of RTW at all 3 time points, although its impact significantly diminished at 24 months.

Author(s):