Unemployed burn survivors experience significantly worse long-term psychosocial and functional outcomes: a Burn Model System study.

Abstract

The impact of pre-injury employment status on patient-reported outcomes post-injury is not well-described. This study compares psychosocial and functional domains between adults who were employed and unemployed pre-burn injury to examine the association with long-term outcomes. Adult participants enrolled in the Burn Model System national, multicenter database between 2013-2023 were included. Associations between pre-burn employment status and long-term outcome scores were analyzed using mixed-effects models while adjusting for sex, age, TBSA burn size, presence of the COVID-19 pandemic, and time after injury. A total of 814 participants were included, of which 635 were employed and 179 were unemployed pre-burn injury. The unemployed group reported significantly worse Pain Interference T-scores ([3.02, 6.04], p<0.001), Anxiety T-scores ([1.38, 4.56], p<0.001), Depression T-scores ([1.45, 4.59], p<0.001), Fatigue T-scores ([1.29, 4.79], p=0.001), Ability to Participate in Social Roles T-scores ([-5.91, -2.69], p<0.001), Physical Function T-scores ([-6.47, -3.59], p<0.001), Community Integration Questionnaire total scores ([-1.50, -0.80], p<0.001), PTSD total scores ([0.80, 5.62], p<0.01), and Satisfaction with Life total scores ([-4.12, -1.80], p<0.001) after adjusting for sex, age, burn size, presence of the COVID-19 pandemic, and time after injury. Employment status may be an important social factor when identifying adult burn survivors who may benefit from greater psychological, vocational, and social resources to optimize long-term recovery and quality of life.