TY - JOUR
T1 - Physical and psychosocial outcomes among burn-injured people with heterotopic ossification
T2 - A burn model system study
AU - Won, Paul
AU - Pickering, Trevor A.
AU - Schneider, Jeffrey C.
AU - Kowalske, Karen
AU - Ryan, Colleen M.
AU - Carrougher, Gretchen J.
AU - Stewart, Barclay T.
AU - Yenikomshian, Haig A.
N1 - Publisher Copyright:
© 2024 Elsevier Ltd and International Society of Burns Injuries
PY - 2024/5
Y1 - 2024/5
N2 - Introduction: Heterotopic ossification (HO), or ectopic bone formation in soft tissue, is a not so rare and poorly understood debilitating sequela of burn injury. Individuals developing HO following burn injuries to their hands often experience reductions in mobility, significant contractures, and joint pain. This study identifies demographic characteristics of individuals who develop HO and compares their physical and psychosocial outcomes to the general burn population. Methods: Participant demographics, injury characteristics, and PROMIS-29 scores across three time points (discharge, six- and 12- months after injury) were extracted from the Burn Model System National Longitudinal Database representing participants from 2015–2022. Mixed-effects linear regression models were used to compare PROMIS scores across all three longitudinal measurements. Models were adjusted for age, sex, race/ethnicity, HO status, and burn size. Results: Of the 861 participants with data concerning HO, 33 were diagnosed with HO (3.8% of participants). Most participants with HO were male (n = 24, 73%) and had an average age of 40 + /− 13 years. Participants with HO had significantly larger burn size (49 +/−23% Total Body Surface Area (TBSA)) than those without HO (16 +/−17%). Participants with HO reported significantly worse physical function, depression, pain interference and social integration scores than those without HO. After adjusting for covariables, participants with HO continued to report statistically significantly worse physical function than those without HO. Although physical functioning was consistently lower, the two populations did not differ significantly among psychosocial outcome measures. Conclusions: While HO can result in physical limitations, the translation to psychosocial impairments was not evident. Targeted treatment of HO with the goal of maximizing physical function should be a focus of their rehabilitation.
AB - Introduction: Heterotopic ossification (HO), or ectopic bone formation in soft tissue, is a not so rare and poorly understood debilitating sequela of burn injury. Individuals developing HO following burn injuries to their hands often experience reductions in mobility, significant contractures, and joint pain. This study identifies demographic characteristics of individuals who develop HO and compares their physical and psychosocial outcomes to the general burn population. Methods: Participant demographics, injury characteristics, and PROMIS-29 scores across three time points (discharge, six- and 12- months after injury) were extracted from the Burn Model System National Longitudinal Database representing participants from 2015–2022. Mixed-effects linear regression models were used to compare PROMIS scores across all three longitudinal measurements. Models were adjusted for age, sex, race/ethnicity, HO status, and burn size. Results: Of the 861 participants with data concerning HO, 33 were diagnosed with HO (3.8% of participants). Most participants with HO were male (n = 24, 73%) and had an average age of 40 + /− 13 years. Participants with HO had significantly larger burn size (49 +/−23% Total Body Surface Area (TBSA)) than those without HO (16 +/−17%). Participants with HO reported significantly worse physical function, depression, pain interference and social integration scores than those without HO. After adjusting for covariables, participants with HO continued to report statistically significantly worse physical function than those without HO. Although physical functioning was consistently lower, the two populations did not differ significantly among psychosocial outcome measures. Conclusions: While HO can result in physical limitations, the translation to psychosocial impairments was not evident. Targeted treatment of HO with the goal of maximizing physical function should be a focus of their rehabilitation.
KW - Burns outcomes
KW - Heterotopic ossification
KW - PROMIS-29
KW - Recovery
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U2 - 10.1016/j.burns.2024.01.017
DO - 10.1016/j.burns.2024.01.017
M3 - Article
C2 - 38267289
AN - SCOPUS:85183157547
SN - 0305-4179
VL - 50
SP - 957
EP - 965
JO - Burns
JF - Burns
IS - 4
ER -