Læknablaðið - 01.12.2021, Blaðsíða 24

588 L ÆKNABL AÐIÐ 2021/107
R A N N S Ó K N
E N G L I S H S U M M A R Y
Long term effects of burn injury on health-related quality of life of adult burn survivors in Iceland: a
descriptive cross-sectional study and validation of the Icelandic version of the Burn Specific Health
Scale-Brief (BSHS-B)
OBJECTIVES: The aim of the study was to assess the long-term effects of burn injury on the health-
related quality of life of adult burn survivors in Iceland and to validate the translated Icelandic version
of the Burn Specific Health Scale-Brief (BSHS-B).
MATERIALS AND METHODS: The participants of this descriptive cross-sectional study were all burn
survivors, 18 years or older, admitted to hospital for 24 hours or more because of skin burn during a 15
years period (N=196). They completed questionnaire about their health (BSHS-B), health related quality
of life (EQ-5D-5) and additional questions on burn-related symptoms and their burn experience.
RESULTS: Response rate was 34% (N=66). Men were 77%, mean age 45.7 years (sf=18.3 and range
18-82 years), mean age when burned was 34.0 (sf=20,1, range 1-75), median time from burn accident
was 11.5 years (range 1-44 years) and 32% had been burned when under 18 years of age. Burn-
specific health was 4.4-4.0 (median) and health on the EQ5D-5vas scale was 80 (median, range
10-100). Those who lost a body part or had skin transplantation had more negative body image and
needed more selfcare than others (p<0.05). A significant proportion of participants reported physical
and psychosocial symptoms such as itch (48%), persistent pain (37%), anxiety/depression (29%) and
negative self-image (37%). Majority (67%) believed they did not get enough information, follow-up, or
support after discharge from hospital. The Icelandic version of the Burn Specific Health Scale-Brief
(BSHS-B) was reliable, but more research is needed to establish its validity.
CONCLUSION: These findings suggest that most Icelandic burn survivors report acceptable health and
health-related quality of life. The study identified a subgroup of survivors that experience persistent
physical and psychosocial symptoms. Team approach with holistic support after discharge, for a
prolonged period of time aiming at preventing physical and psychiatric morbidity, is recommended.
doi 10.17992/lbl.2021.12.665
Heimildir
1. World Health Organization. Burns. WHO who.int/news-room/fact-sheets/detail/burns -
september 2021.
2. Smolle C, Cambiaso-Daniel J, Forbes AA, et al. Recent trends in burn epidemiology world-
wide: A systematic review. Burns 2017; 43: 249-57.
3. Falder S, Browne A, Edgar D, et al. Core outcomes for adult burn survivors: a clinical
overview. Burns 2009; 35: 618-41.
4. euroburn.org/wp-content/uploads/EBA-Guidelines-Version-4-2017.pdf - september 2021.
5. ameriburn.org/wp-content/uploads/2017/05/burncenterreferralcriteria.pdf - september
2021
6. Ter Smitten MH, de Graaf R, Van Loey NE. Prevalence and co-morbidity of psychiatric
disorders 1-4 years after burn. Burns 2011; 37: 753-61.
7. Connell KM, Phillips M, Coates R, et al. Sexuality, body image and relationships following
burns: Analysis of BSHS-B outcome measures. Burns 2014; 40: 1329-37.
8. Duke JM, Rea S, Boyd JH, et al. Mortality after burn injury in children: a 33-year
population-based study. Pediatrics 2015; 135: e903-e910
9. Spronk I, Legemate CM, Dokter J, et al. Predictors of health-related quality of life after
burn injuries: a systematic review. Critical Care 2018; 22: 160.
10. Gauffin E, Öster C, Sjöberg F, et al. Health-Related Quality of Life (EQ-5D) early after
injury predicts long-term pain after burn. Burns 2016; 42: 1781-8.
11. Moi AL, Haugsmyr E, Heisterkamp H. Long-term study of health and quality of life after
burn injury. Ann Burns Fire Dis 2016; 29: 295-9.
12. Vetrichevvel TP, Randall SM, Fear MW, et al. Burn injury and long-term nervous system
morbidity: a population-based cohort study. BMJ Open 2016; 6: e012668.
13. Barrett LW, Fear VS, Waithman JC, et al. Understanding acute burn injury as a chronic
disease. Burns & Trauma 2019; 7: 23.
14. Simko LC, Espinoza LF, McMullen K et al. Fatigue following burn injury: A burn model
system national database study. J Burn Care Res 2018; 39: 450-6.
15. Duke JM, Randall SM, Vetrichevvel TP, et al. Long-term mental health outcomes after
unintentional burns sustained during childhood: a retrospective cohort study. Burns &
Trauma 2018; 6: 32.
16. Lawrence JW, Fauerbach JA, Thombs BD. Frequency and correlates of depression
symptoms among long-term adult burn survivors. Rehabil Psychol 2006; 51 306-13.
17. Al-Tarrah K, Hewison M, Moiemen N, et al. Vitamin D status and its influence on
outcomes following major burn injury and critical illness. Burns & Trauma 2018; 6: 3-11.
18. Meyer WJ, Blakeney P, Thomas CR, et al. Prevalence of major psychiatric illness in young
adults who were burned as children. Psychosom Med 2007; 69: 377-82.
19. Ryan CM, Lee A, Kazis LE, et al. Recovery trajectories after burn injury in young adults:
Does burn size matter? J Burn Care Res 2015; 36: 118-29.
20. Martin L, Byrnes M, McGarry S, et al. Social challenges of visible scarring after severe
burn: A qualitative analysis. Burns 2017; 43: 76-83.
21. Ryan CM, Lee A, Stoddard FJ et. al. The effect of facial burns on long-term outcomes in
young adults: A 5- year study. J Burn Care Res 2018; 39: 497-506.
22. Stubbs KT, James LE, Daugherty MB, et al. Psychosocial impact of childhood face burns: A
multicenter, prospective, longitudinal study of 390 children and adolescents. Burns 2011;
37: 387-94.
23. Guðmundsson S, Þorgrímsson S, Einarsson Ó. Faraldsfræði alvarlegra brunaáverka á
Íslandi 1988–1992. Læknablaðið 1997; 83: 503-9.
24. Elísdóttir R, Lúðvígsson P, Einarsson Ó, et al. Brunaslys barna á Íslandi: Innlagnir á árun-
um 1982-1995. Læknablaðið 1997; 83: 303-8.
25. Baldursdóttir L, Thorsteinsson LS, Auðólfsson G, et al. Brunaslys barna: Innlagnir á
Landspítala 2000-2008. Læknablaðið 2010; 96: 683-9.
26. Kildal M, Andersson G, Fugl-Meyer AR, et al. Development of a brief version of the Burn
Specific Health Scale (BSHS-B). J Trauma 2001; 51: 740-6.
27. Yoder LH, Nayback AM, Gaylord K. The evolution and utility of the burn specific health
scale: a systematic review. Burns 2010; 36: 1143-56.
28. Friðriksdóttir V. Íslensk þýðing Burn Specific Health Scale-Brief (Líðan og lífsgæði einstak-
linga með brunaáverka), þróun viðbótarspurninga og forprófun spurningalista. Óbirt
MS-ritgerð. Háskóli Íslands, hjúkrunarfræðideild, 2019.
29. Gojowy D, Kauke M, Ohmann T, et al. Early and late-recorded predictors of health-related
quality of life of burn patients on long-term follow-up. Burns 2019; 45: 1300-10.
30. Spronk I, Van Loey NEE, Sewalt C, et al. Recovery of health-related quality of life after
burn injuries: An individual participant data meta-analysis. PLOS ONE 2020; 15: 1.
31. Öster C, Willebrand M, Ekselius L. Health-related quality of life 2 years to 7 years after
burn injury. J Trauma 2011; 71: 1435-41.
32. Stolle A, Ripper S, Magdanz J, et al. Validation of the Ludwigshafen German Version of the
Burn Specific Health Scale-Brief. J. Burn Care Res 2018; 39: 252-60.
33. Currens JAB, Coats TJ. The timing of disability measurements following injury. Injury, Int.
J. Care Injured 2000; 31: 93-8.
34. Browne AL, Andrews A, Schug SA, et al. Persistent pain outcomes and patient satisfaction
with pain management after burn injury. Clin J Pain 2011; 27: 136-44.
35. Dauber A, Osgood PF, Breslau AJ, et al. Chronic persistent pain after severe burns: A sur-
vey of 358 burn survivors. Pain Med 2002; 3: 6-16.
36. Summer GJ, Puntillo KA, Miaskowski C, et al. Burn injury pain: the continuing challenge. J
Pain 2007; 8: 533-48.
37. Lerman SF, Sylvester S, Hultman S, et al. Suicidality after burn injuries: A systematic revi-
ew. J Burn Care Res 2021; 42: 357-64.
38. Stefánsson KH. Fjöldaþróun örorkulífeyrisþega. Öryrkjabandalag Íslands, 2019. obi.is/
static/files/skjol/pdf-skyrslur/2019-09-sky-rsla-fjo-ldathro-un-o-bi-khs-utg-1.pdf - septem-
ber 2021.

Jardiance þolist almennt vel2
Jardiance er ætlað fullorðnum til meðferðar við langvinnri
hjartabilun með einkennum og skertu útfallsbroti2*
1. Með bættri meðferð er átt við marktæka lækkun á samsetta aðalendapunktinum sem samanstendur af dauðsföllum af völdum hjarta- og æðasjúkdóma eða sjúkrahúsinnlögn af völdum
hjartabilunar, heildarfjöldi innlagna vegna hjartabilunar sem og breyting til batnaðar á nýrnastarfsemi hjá sjúklingum með hjartabilun, þegar Jardiance er bætt við hefðbunda meðferð.3
2. Samantekt á eiginleikum Jardiance, www.serlyfjaskra.is.
3. Packer M, Anker SD, Butler J, et al; EMPEROR-Reduced Trial Investigators. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020;383(15):1413-1424.
VIÐ HJARTABILUN
MEÐ JARDIANCE®
BÆTT MEÐFERÐ 1,3
Jardiance
• 25% hlutfallsleg áhættuminnkun dauðsfalla af völdum
hjarta- og æðasjúkdóma eða sjúkrahúsinnlagna vegna
hjartabilunar ef gefið sem viðbót við hefðbundna meðferð.2†‡
• Dregur marktækt úr lækkun á áætluðum gaukulsíunarhraða
(eGFR) með tímanum.2¶
* Fullorðnir sjúklingar með langvinna hjartabilun (New York Heart
Association [NYHA] flokkur II, III eða IV) og skert útfallsbrot (LVEF ≤40%).2
† Hefðbundin meðferð: Allir sjúklingar fengu hefbundna meðferð
við hjartabilun, þ.m.t. með þvagræsilyfjum, lyfjum sem hemla
renín-angíótensínkerfið og neprilýsínhemlum, betablokkum,
saltsteraviðtakablokkum og tækjum fyrir hjartað samkvæmt ábendingu.2
‡ Í EMPEROR-Reduced® rannsókninni, sem var slembiröðuð, tvíblind
rannsókn með samanburði við lyfleysu og samhliða hóp sem var gerð hjá
3.730 sjúklingum með langvinna hjartabilun með einkennum og skertu
útfallsbroti, var verkun og öryggi 10 mg af JARDIANCE® (N=1.863) metið
miðað við lyfleysu (N=1.867). Samsetti aðalendapunkturinn
var annaðhvort dauðsfall vegna hjarta- og æðasjúkdóms eða
sjúkrahúsinnlögn vegna hjartabilunar, metið sem tíminn fram að fyrsta
tilviki. 25% hlutfallsleg áhættuminnkun varð hjá sjúklingum sem fengu
meðferð með JARDIANCE
fyrir þennan endapunkt (áhættuhlutfall (HR) = 0,75; 95% CI: 0,65 - 0.86;
p<0.001) heildarminnkun áhættu 5,2% (frá 24,7% til 19.4%).3
¶ Lækkun á eGFR var fyrirframtilgreindur aukaendapunktur í EMPEROR
Reduced®rannsókninni.3
eGFR: JARDIANCE: 61,8 ml/mín./1,73m2; lyfleysa 62,2 ml/mín./1,73m2.3
IS
/P
C-
DK
-1
00
93
1 0
1.0
7.2
1
Ein 10 mg tafla einu sinni á sólarhring2
Engin skammtastilling og má taka óháð máltíðum.2
Jardiance 10 mg og 25 mg filmuhúðaðar töflur
Heiti virkra efna
Empagliflozin 10 mg eða 25 mg.
Ábendingar
Jardiance er ætlað til meðferðar hjá fullorðnum með sykursýki af tegund 2
sem ekki hefur náðst nægileg stjórn á, til viðbótar við sérhæft mataræði og
hreyfingu: sem einlyfjameðferð þegar talið er óheppilegt að gefa metformín
vegna óþols; til viðbótar við önnur lyf til meðferðar við sykursýki.
Upplýsingar um niðurstöður rannsókna með tilliti til samsetninga, áhrifa
á blóðsykurstjórnun og hjarta- og æðatilvik og rannsóknarþýðin má
sjá í SmPC. Jardiance er ætlað fullorðnum til meðferðar við langvinnri
hjartabilun með einkennum og skertu útfallsbroti.
Frábendingar
Ofnæmi fyrir virka efninu eða einhverju hjálparefnanna.
Markaðsleyfishafi
Boehringer Ingelheim International GmbH.
Nálgast má upplýsingar um lyfið, fylgiseðil þess og gildandi samantekt
á eiginleikum lyfs á vef Lyfjastofnunar, www.serlyfjaskra.is.
Pantone litir:
Hjarta: Rautt: 200C
Letur: Grátt: 424C
CMYK litir:
Hjarta: Cyan: 10, Magenta: 100, Yellow: 100, Svart: 20
Letur: Cyan: 10, Magenta: 10, Yellow: 10, Svart: 60
Boehringer Ingelheim á Íslandi — Vistor hf.
sími 535 7000 · vistor@vistor.is
Hörgatúni 2 · 210 Garðabæ
Lovísa Baldursdóttir1,2
Sigríður Zoëga1,2
Gunnar Auðólfsson3
Vigdís Friðriksdóttir1
Sigurður Ýmir Sigurjónsson4
Brynja Ingadóttir1,2
1Landspitali - National University Hospital of Iceland, 2Faculty of Nursing, School
of Health Sciences, University of Iceland, 3Department of plastic surgery, National
University Hospital of Iceland 4Hrafnista, old people´s home.
Correspondence: Lovísa Baldursdóttir, lovisaba@landspitali.is
Key words: burn injury, health-quality of life, burn survivor, burn
specific health scale