Edward J R Watson1, Klára Nenadlová2, Olivia H Clancy3, Mena Farag3, Naz A Nordin4, Agnes Nilsen2, Ashley R T Mehmet2, Ahmed Al-Hindawi5, Sundhiya Mandalia5, Lisa M Williams3, Trudi L Edginton6, Marcela P Vizcaychipi5. 1. Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK. Electronic address: edward.watson@imperial.ac.uk. 2. Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Psychology Department, Westminster University, London, UK. 3. Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK. 4. Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Department of Anaesthesia, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, UK. 5. Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK. 6. Psychology Department, Westminster University, London, UK; Department of Psychology, City, University of London, UK.
Abstract
INTRODUCTION: An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns. METHODS: A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks. RESULTS: 15 patients (11M, 4F; 41±14 years; TBSA 38.4%±18.5) and comparators (11M, 4F; 40±13 years) were recruited. Burns patients reported worse QoL (Neuro-QoL Short Form v2, patient 30.1±8.2, control 38.7±3.2, p=0.0004) and cognitive function (patient composite z-score 0.01, IQR -0.11 to 0.33, control 0.13, IQR 0.47-0.73, p=0.02). Compared to estimated premorbid FSIQ, patients dropped an equivalent of 8 IQ points (p=0.002). Cognitive function negatively correlated with burn severity (rBaux score, p=0.04). QoL strongly correlated with depressive symptoms (Rho=-0.67, p=0.009) but not cognitive function. CONCLUSIONS: Severe burns injuries are associated with a significant, global, cognitive deficit. Patients also report worse QoL, depression and post-traumatic stress. Perceived QoL from cognitive impairment was more closely associated with depression than cognitive impairment. Crown
INTRODUCTION: An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns. METHODS: A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks. RESULTS: 15 patients (11M, 4F; 41±14 years; TBSA 38.4%±18.5) and comparators (11M, 4F; 40±13 years) were recruited. Burns patients reported worse QoL (Neuro-QoL Short Form v2, patient 30.1±8.2, control 38.7±3.2, p=0.0004) and cognitive function (patient composite z-score 0.01, IQR -0.11 to 0.33, control 0.13, IQR 0.47-0.73, p=0.02). Compared to estimated premorbid FSIQ, patients dropped an equivalent of 8 IQ points (p=0.002). Cognitive function negatively correlated with burn severity (rBaux score, p=0.04). QoL strongly correlated with depressive symptoms (Rho=-0.67, p=0.009) but not cognitive function. CONCLUSIONS: Severe burns injuries are associated with a significant, global, cognitive deficit. Patients also report worse QoL, depression and post-traumatic stress. Perceived QoL from cognitive impairment was more closely associated with depression than cognitive impairment. Crown
Authors: Elise Boersma-van Dam; Rens van de Schoot; Helma W C Hofland; Iris M Engelhard; Nancy E E Van Loey Journal: Qual Life Res Date: 2020-10-22 Impact factor: 4.147