Unemployed Burn Survivors Experience Significantly Worse Long-Term Psychosocial and Functional Outcomes: A Burn Model System Study.

BACKGROUND

The impact of preinjury employment status on patient-reported outcomes after injury is not well described. This study compared psychosocial and functional domains between adults who were employed or unemployed before sustaining a burn injury to examine the association of employment status with long-term outcomes.

METHODS

Adult participants enrolled in the Burn Model System national, multicenter database between 2013 and 2023 were included. Associations between preburn employment status and long-term outcome scores were analyzed using mixed-effects models while adjusting for sex, age, total body surface area burn size, presence of the COVID-19 pandemic, and time after injury.

RESULTS

A total of 814 participants were included, 635 of whom were employed and 179 of whom were unemployed before the 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), posttraumatic stress disorder 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.

CONCLUSION

Employment status may be an important social factor to consider when identifying adult burn survivors who may benefit from greater psychological, vocational, and social resources to optimize long-term recovery and quality of life.