Background
Methods
Search strategy and inclusion criteria
Selection of studies and data extraction
Risk of bias
Data analysis
Results
Search results
Study characteristics
Study | Country | Study populationa | Mean %TBSA burned (SD) | HRQL instrument(s)b | Assessment time point(s) |
---|---|---|---|---|---|
Ahuja et al. 2016 [27] | India | n = 60 (M, 40%). Age, 18–65 years (median, 28 years) | Median, 30% | BSHS-RBA | Median, 10 months |
Anzarut et al. 2005 [53] | Canada | n = 47 (M, 96%). Mean age 28 years | 64% (2) | BSHS-A, SF-36 | ≥ 2 years after discharge |
Blalock et al. 1994 [54] | USA | n = 254 (M, 74%). Mean age 39 years | 19% (15) | BSHS | Mean, 8–9 months |
Corry et al. 2010 [55] | USA | n = 171 (M, 70%). Age, 8–86 years (mean, 42 years) | 15% (13); range, 1–74% | SF-36 | Discharge, 1, 6, 12, and 24 monthsc |
Cromes et al. 2002 [56] | USA | n = 110 (M, 84%). Mean age 38 years | 24% | BSHS | 2d, 6d, and 12d months |
Edgar et al. 2013 [17] | Australia | n = 1051, (M, 80%). Age, 15–89 years (mean, 37 years) | 8% (11); range, 0–75% | BSHS-B, SF-36 | 1, 3, 6, 12, and 24 monthsc |
Ekeblad et al. 2015 [29] | Sweden | n = 107 (M, 75%). Age, 19–89 years (mean 43 years) | 23%; range 1–80% | BSHS-B, EQ-5D, SF-36 | 12 months |
Finlay et al. 2014 [57] | Australia | n = 927 (M, 73%). Age, 16–83 years (mean, 32 years) | 7% (10) | BSHS-B | Discharge, 1, 3d, 6, 12, and 24 months |
Finlay et al. 2015 [58] | Australia | n = 224 (M, 83%). Age, 16–84 years (median 36 years) | Median, 4%; range 1–60% | BSHS-B | NA |
Kildal et al. 2001 [59] | Sweden | n = 248 (M, 80%). Mean age 37 years | 23% (16) | BSHS-B | Mean, 9.3 years (SD 4.8 years) |
Kildal et al. 2004 [60] | Sweden | n = 166 (M, 80%). Mean age 50 years | 25% (16) | BSHS-B | Mean, 11.4 years; range, 3 – 19 years |
Kildal et al. 2005 [61] | Sweden | n = 161 (M, 79%). Age, 17–79 years (mean, 48 years) | 24% (16); range, 1–85% | BSHS-B | Mean, 9.2 years; range 1–18 years |
Knight et al. 2017 [62] | Australia | n = 41 (M, 81%). Age, 19–81 years (mean, 45 years) | 8% | BSHS-B | 12–24 months |
Leblebici et al. 2006 [63] | Turkey | n = 22 (M, 64%). Mean age 25 years | 28% (17) | SF-36 | Mean, 21 months |
Low et al. 2012 [64] | Sweden | n = 85 (M, 75%). Age, 19–89 years (mean, 45 years) | 24% (20); range, 1–80% | BSHS-B | 12 months |
Moi et al. 2007 [65] | Norway | n = 95 (M, 82%). Mean age 44 years | 19% (14) | BSHS-A | Mean, 47 months (SD 24 months) |
Moi and Nilsen 2012 [9] | Norway | n = 95 (M, 82%). Mean age 44 years | 19% (14) | BSHS-A, SF-36, QOLS | Mean, 47 months (SD 24 months) |
Novelli et al. 2009 [66] | Italy | n = 30 (M, 60%). Mean age 42 years | 32% (13) | SIP | Discharge, 3 monthsd |
Orwelius et al. 2013 [28] | Sweden | n = 156 (M, 74%). Age, 16–90 years (mean, 46 years) | 24% (19); range, 0–80% | SF-36 | 12d and 24 months |
Oster et al. 2011 [18] | Sweden | n = 89 (M, 77%). Mean age 43 years | 25% (20) | EQ-5D | Admission, 3, 6, 12 months, and 2 to 7d years |
Oster et al. 2013 [30] | Sweden | n = 67 (M, 78%). Mean age 43 years | 25% (20) | BSHS-B | 6 and 12 months and 2 to 7d years |
Palmu et al. 2015 [67] | Finland | n = 92 (M, 70%). Mean age 46 years | 10% | 15D, EQ-5D, RAND-36 | 6 months |
Renneberg et al. 2014 [68] | Germany | n = 265 (M, 72%). Age, 16–73 years (mean, 39 years) | 14% (14); range, 1–76% | BSHS-B, SF-12 | Admission, 6, 12, 24, and 36 monthsc |
Ricci et al. 2014 [69] | Brazil | n = 73 (M, 69%). Mean age 38 years | 14% (12) | BSHS-R | 5 to 7 months |
Roh et al. 2012 [70] | South Korea | n = 113 (M, 71%). Mean age 38 years | 14% (12) | BSHS-B | 1 month |
Tahir et al. 2011 [71] | Pakistan | n = 99 (M, 68%). Age, 19–57 years (median, 30 years) | 19%, range; 5–38% | SF-36 | Admission, 5 and 6d months |
Van Loey et al. 2012 [20] | The Netherlands and Belgium | n = 244 (M, 73%). Mean age 39 years | 12% (11); range 1–65% | EQ-5D | 3 weeks, 3, 9, and 18 monthsc |
Wasiak et al. 2014 [72] | Australia | n = 99 (M, 75%). Mean age 42 years | 19% | BSHS-B, SF-36 | Preburn and 12d months |
Willebrand et al. 2006 [73] | Sweden | n = 86 (M, 73%). Age, 15–85 years (mean, 43 years) | 17% (14) | BSHS-B | Mean, 3.6 years (SD 1.2 years) |
Willebrand and Ekselius 2011 [74] | Sweden | n = 94 (M, 76%). Age, 19–90 years (mean, 44 years) | 23% (20) | BSHS-B, SF-36 | 6d, 12d, and 24d months |
Xie et al. 2012 [75] | China | n = 20 (M, 70%). Mean age 43 years | 84% (10) | BSHS-B, SF-36 | ≥ 2 years after discharge |
Zhang et al. 2014 [33] | China | n = 208 (M, 77%). Mean age 42 years | 42% (27) | BSHS-B | ≥ 2 years after discharge |
Risk of bias
Study | Study Participation | Study attrition | Prognostic factor measurement | Outcome measurement | Study confounding | Statistical analysis and reporting | Total score |
---|---|---|---|---|---|---|---|
Ahuja et al. 2016 [27] | Low | Low | Moderate | Low | Moderate | Low | 8 |
Anzarut et al. 2005 [53] | Moderate | Moderate | Moderate | Moderate | High | Moderate | 13 |
Blalock et al. 1994 [54] | Moderate | High | Moderate | Low | High | Low | 11 |
Corry et al. 2010 [55] | Moderate | High | Low | Low | Moderate | Low | 10 |
Cromes et al. 2002 [56] | Moderate | High | Moderate | Low | High | Moderate | 13 |
Edgar et al. 2013 [17] | Low | Low | Moderate | Low | Moderate | Low | 8 |
Ekeblad et al. 2015 [29] | Low | Moderate | High | Low | High | Low | 11 |
Finlay et al. 2014 [57] | Low | Moderate | Low | Low | Moderate | Low | 8 |
Finlay et al. 2015 [58] | Low | Moderate | Low | Low | Moderate | Low | 8 |
Kildal et al. 2001 [59] | Low | Moderate | Moderate | Low | Moderate | Low | 9 |
Kildal et al. 2004 [60] | Low | Moderate | Moderate | Low | Moderate | Low | 9 |
Kildal et al. 2005 [61] | Low | High | Moderate | Low | Moderate | Low | 10 |
Knight et al. 2017 [62] | Moderate | High | Low | Low | Low | Low | 9 |
Leblebici et al. 2006 [63] | Moderate | High | Moderate | Low | Low | Low | 10 |
Low et al. 2012 [64] | Low | Moderate | Low | Low | Moderate | Low | 8 |
Moi et al. 2007 [65] | Low | Moderate | Low | Low | Moderate | Low | 8 |
Moi and Nilsen 2012 [9] | Low | Moderate | Moderate | Low | Moderate | Low | 9 |
Novelli et al. 2009 [66] | High | High | Moderate | Low | High | Moderate | 14 |
Orwelius et al. 2013 [28] | Low | Moderate | Low | Low | Low | Low | 7 |
Oster et al. 2011 [18] | Low | Moderate | Moderate | Low | Moderate | Low | 9 |
Oster et al. 2013 [30] | Low | Moderate | Moderate | Low | Moderate | Low | 9 |
Palmu et al. 2015 [67] | Low | Moderate | Low | Low | Moderate | Moderate | 9 |
Renneberg et al. 2014 [68] | Moderate | High | Low | Low | Low | Low | 9 |
Ricci et al. 2014 [69] | Moderate | High | Moderate | Low | Moderate | Low | 11 |
Roh et al. 2012 [70] | Moderate | High | Low | Low | Low | Low | 9 |
Tahir et al. 2011 [71] | Low | High | Moderate | Low | High | Moderate | 12 |
Van Loey et al. 2012 [20] | Low | High | Low | Low | Moderate | Low | 9 |
Wasiak et al. 2014 [72] | Low | High | Low | Low | Moderate | Low | 9 |
Willebrand et al. 2006 [73] | Low | High | Moderate | Low | Moderate | Low | 10 |
Willebrand and Ekselius 2011 [74] | Low | Moderate | Moderate | Low | Moderate | Low | 9 |
Xie et al. 2012 [75] | Moderate | Moderate | Low | Low | Low | Low | 8 |
Zhang et al. 2014 [33] | Low | Moderate | Moderate | Low | Moderate | Moderate | 10 |
Predictors of HRQL
QUIPS score | 8 | 8 | 8 | 8 | 8 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 10 | 10 | 10 | 12 | 13 | 13 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Edgar 2013 (SF-36)1 | Edgar 2013 (BSHS-B)1 | Finlay 2015 (BSHS-B)1 | Low 2012 (BSHS-B)4 | Xie 2012 (SF-36) | Renneberg 2014 (SF-12) | Van Loey 2012 (EQ-5D) | Kildal 2004 (BSHS-B)2 | Wasiak 2014 (SF-36)3 | Wasiak 2014 (BSHS-B)3 | Moi 2012(QOLS) | Palmu 2015(RAND-36) | Oster 2011(EQ-5D index)4 | Oster 2011(EQ-5D VAS)4 | Oster 2013(BSHS-B)4 | Knight 2016(BSHS-B) | Zhang 2014(BSHS-B) | Kildal 2005(BSHS-B)2 | Willebrand 2006(BSHS-B) | Tahir 2011(SF-36) | Cromes 2002(BSHS) | Anzarut 2005(SF-36) | |
Demographic factors | ||||||||||||||||||||||
Increasing age | – | + | 0 | +/− | + | 0 | -- | ? | -- | -- | 0 | ? | 0 | 0 | 0 | 0 | 0 | ? | – | 0 | – | |
Male gender | + | ++ | ++ | + | 0 | + | ++ | ? | + | ++ | 0 | ? | 0 | 0 | 0 | ++ | ++ | ? | + | 0 | 0 | |
Married | 0 | 0 | 0 | |||||||||||||||||||
Living alone | 0 | 0 | 0 | 0 | ||||||||||||||||||
Low level of education | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||||||||
Rehabilitation | 0 | 0 | ||||||||||||||||||||
Environmental factors | ||||||||||||||||||||||
Low socioeconomic status | 0 | 0 | ||||||||||||||||||||
Work related injury | 0 | 0 | ||||||||||||||||||||
Preburn working status | 0 | 0 | ++ | 0 | ||||||||||||||||||
Working status postburn | + | 0 | ++ | ++ | + | 0 | ||||||||||||||||
Burn-specific factors | ||||||||||||||||||||||
High %TBSA burned | -- | -- | 0 | – | 0 | 0 | 0 | 0 | 0 | ? | 0 | 0 | 0 | 0 | -- | – | 0 | 0 | ||||
Full-thickness injury | 0 | – | 0 | -- | 0 | 0 | 0 | 0 | 0 | 0 | – | |||||||||||
Longer length of hospital stay | – | + | 0 | 0 | 0 | 0 | -- | 0 | -- | -- | 0 | -- | 0 | |||||||||
Surgery | + | ++ | -- | 0 | ||||||||||||||||||
Number of surgeries | -- | 0 | 0 | 0 | -- | |||||||||||||||||
Burn area | ? | 0 | ? | -- | ||||||||||||||||||
Hand burns | 0 | – | 0 | 0 | + | -- | 0 | |||||||||||||||
Hands needing grafting | 0 | 0 | ||||||||||||||||||||
Facial burns | 0 | 0 | 0 | 0 | 0 | |||||||||||||||||
Face needing grafting | + | 0 | ||||||||||||||||||||
Upper limb burn | ++ | 0 | ||||||||||||||||||||
Mechanical ventilation | 0 | 0 | 0 | -- | 0 | |||||||||||||||||
Tracheostomy required | 0 | 0 | 0 | |||||||||||||||||||
Pain | 0 | -- | 0 | -- | 0 | |||||||||||||||||
Etiology | 0 | 0 | 0 | |||||||||||||||||||
Longer time since burn | 0 | ++ | 0 | ? | 0 | 0 | 0 | 0 | ? | 0 | 0 | |||||||||||
Psychological factors | ||||||||||||||||||||||
Any preburn psychiatric disorder | 0 | 0 | 0 | 0 | 0 | -- | ||||||||||||||||
Any postburn psychiatric disorder | 0 | 0 | 0 | 0 | ||||||||||||||||||
Post-traumatic stress disorder or symptoms | -- | ? | 0 | -- | – | |||||||||||||||||
Preburn depression | – | ? | 0 | 0 | ||||||||||||||||||
Postburn depression or depressive symptoms | – | -- | -- | 0 | 0 | – | ||||||||||||||||
Preburn substance use disorder | – | ? | 0 | 0 | 0 | |||||||||||||||||
Postburn substance use disorder | ? | 0 | -- | |||||||||||||||||||
Preburn anxiety disorder | – | 0 | 0 | 0 | ||||||||||||||||||
Avoidant coping | – | – | – | |||||||||||||||||||
Emotional or social support | 0 | + | + | |||||||||||||||||||
Neuroticism | – | -- | – | |||||||||||||||||||
Body image | 0 | 0 |