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. 2020 Jan 29;20(1):121.
doi: 10.1186/s12889-020-8233-8.

Improved and standardized method for assessing years lived with disability after burns and its application to estimate the non-fatal burden of disease of burn injuries in Australia, New Zealand and the Netherlands

Inge Spronk  1   2   3 , Dale W Edgar  4   5   6 , Margriet E van Baar  7   8 , Fiona M Wood  4   6 , Nancy E E Van Loey  9   10 , Esther Middelkoop  11   12 , Babette Renneberg  13 , Caisa Öster  14 , Lotti Orwelius  15 , Asgjerd L Moi  16   17 , Marianne Nieuwenhuis  18   19 , Cornelis H van der Vlies  20   21 , Suzanne Polinder  7 , Juanita A Haagsma  7
Affiliations

Improved and standardized method for assessing years lived with disability after burns and its application to estimate the non-fatal burden of disease of burn injuries in Australia, New Zealand and the Netherlands

Inge Spronk et al. BMC Public Health. .

Abstract

Background: Burden of disease estimates are an important resource in public health. Currently, robust estimates are not available for the burn population. Our objectives are to adapt a refined methodology (INTEGRIS method) to burns and to apply this new INTEGRIS-burns method to estimate, and compare, the burden of disease of burn injuries in Australia, New Zealand and the Netherlands.

Methods: Existing European and Western-Australian health-related quality of life (HRQL) datasets were combined to derive disability weights for three homogenous burn injury groups based on percentage total body surface area (%TBSA) burned. Subsequently, incidence data from Australia, New Zealand, and the Netherlands from 2010 to 2017 were used to compute annual non-fatal burden of disease estimates for each of these three countries. Non-fatal burden of disease was measured by years lived with disability (YLD).

Results: The combined dataset included 7159 HRQL (EQ-5D-3 L) outcomes from 3401 patients. Disability weights ranged from 0.046 (subgroup < 5% TBSA burned > 24 months post-burn) to 0.497 (subgroup > 20% TBSA burned 0-1 months post-burn). In 2017 the non-fatal burden of disease of burns for the three countries (YLDs/100,000 inhabitants) was 281 for Australia, 279 for New Zealand and 133 for the Netherlands.

Conclusions: This project established a method for more precise estimates of the YLDs of burns, as it is the only method adapted to the nature of burn injuries and their recovery. Compared to previous used methods, the INTEGRIS-burns method includes improved disability weights based on severity categorization of burn patients; a better substantiated proportion of patients with lifelong disability based; and, the application of burn specific recovery timeframes. Information derived from the adapted method can be used as input for health decision making at both the national and international level. Future studies should investigate whether the application is valid in low- and middle- income countries.

Keywords: Burden of disease; Burn injuries; Disability weights; Methodology.

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Conflict of interest statement

EM received honoraria for speaking at Med Skin Solutions symposia. The other authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Methodology to derive years lived with disability adapted from INTEGRIS method from Haagsma et al. [10]. 1Disabilty weights and life expectancies are adjusted for age and sex [8]. TBSA = total body area burned
Fig. 2
Fig. 2
Estimates of the non-fatal burden of disease expressed as years lived with disability (YLD) per case for Australia, New Zealand and the Netherlands in 2010 to 2017
Fig. 3
Fig. 3
Estimates of the non-fatal burden of disease expressed as years lived with disability (YLD) for the total population of Australia, New Zealand and the Netherlands in 2010 to 2017. Note. Not all burn units in Australia were contributing until 2017; and not all burn units in New Zealand were contributing until 2013 [46]
Fig. 4
Fig. 4
Methodology to derive years lived with disability adapted from the INTEGRIS method developed by Haagsma et al. [10]. 1Disabilty weights are adjusted for age and gender. TBSA = total body area burned
See this image and copyright information in PMC

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