The Impact of Facial Burns on Short- and Long-Term Quality of Life and Psychological Distress-A Prospective Matched Cohort Study

Abstract

Burn injuries are a major healthcare challenge worldwide, with up to 50% of all minor burns located on the head and neck. With this study, we sought to describe the effect of facial burns (FB) on health-related quality of life through a prospective and matched cohort study design. Patients completed the 36 Item Short Form (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Results were analyzed based on the distribution of datasets. In total, 55 patients with FB and 55 age-and sex-matched candidates were recruited. The most common mechanism of thermal injury was burns from flames. The FB group scored lower in physical and psychological dimensions than the control group, both acutely and one year after injury. An analysis of each domain showed that subjects in the FB group trended toward improvements in their score after one-year post-burn in physical functioning (acute: 71.0 ± 29.2; one-year: 83.7 ± 23.9; p = 0.02) and bodily pain (acute: 58.5 ± 30.3; one-year: 77.9 ± 30.5; p = 0.01) domains. Additionally, the FB group had significanlyt higher scores for anxiety (FB: 4.8 ± 3.2; control: 2.5 ± 2.8; p = <0.002) and depression (FB: 3.9 ± 3.5; control: 2.1 ± 2.7; p = 0.01) compared to the control. In conclusion, facial burns are associated with physical and psychosocial deficits, as well as elevated levels of psychological distress.

Keywords: burn injury; facial burn; quality of life.

Figure 1

Short (acute) and long-term (one year) assessment of SF-36 scores after facial burn. Visualization of the analysis of FB patient scores versus a healthy cohort. FB, facial burn; PF, physical functioning; RP, physical role functioning; BP, bodily pain; GH, general health perception; VT, vitality; SF, social role functioning; RE, emotional role functioning; MH: mental health; PSC, physical summary scale; MSC, mental summary scale; * <0.5, ** <0.01, **** <0.0001.

Figure 2

Short and long-term (one-year) results after severe burn injury with facial involvement. This patient suffered from a severe burn injury with the development of hypertrophic scarring in the face and neck area.

Figure 3

Short (acute) and long-term (one year) assessment of HADS scores after facial burn. Visualization of the scores in facial burn patients versus healthy cohort. HADS, Hospital Anxiety and Depression Scale; FB, facial burn; ns, not significant; * <0.5, ** <0.01, **** <0.0001.