Abstract | February 25, 2021
Relationship of Pre-existing Impaired Functional Mobility to Burn Outcomes
Learning Objectives
- Examine the occurrence of pre-existing functional mobility impairment in the adult burn-injured population.
- Discuss the impact of pre-existing functional mobility impairment on the treatment course and outcomes in burn-injured adults.
Background: It is well-established that burn severity is determined by size of surface area affected, temperature of source and duration of exposure. Patients with impaired mobility, regardless of etiology, are less capable of avoiding and escaping traumatic injuries. Additionally, patients with impaired mobility frequently suffer from other co-morbid conditions and have specialized needs which can complicate their acute illness/injury, prolong their hospital length of stay, and impact recovery.
Methods: This was an IRB- Exempted retrospective electronic medical records review of all adult patients, aged 18 years and older with pre-existing mobility impairment, admitted as inpatients to the Orlando Regional Medical Center for treatment of burn-related injuries from January 1, 2009 to December 31, 2019
Results: The 10 year review of 1648 adult burn admissions meeting the initial criteria of inpatient admission and burn injury, 178 were found to have documentation supporting pre-existing functional mobility impairment (11%). Rolling walker use (33%) was most common, followed by cane (28%). Contrary to the initial hypothesis, patients actually had overall lengths of stays consistent with all burn populations at 0.81 days per % total body surface area, with average length of stay being 6.7 days. The demographic data was also consistent with national burn registry data as primarily male, caucasian population, though older, with mean age of 61.1 years. Regression analysis identified relationships between burn size and discharge disposition. Additionally, statistically significant relationships were identified between BMI and the pre-existing co-morbid illness Diabetes and Chronic Obstructive Pulmonary Disease.
Conclusions/Implications: There is a paucity of literature describing the needs of this unique burn population. Burn-injured patients with pre-existing impaired mobility suffer from similar mechanisms of injury, although the source for the thermal burns is more likely to originate from smoking on home oxygen. By identifying attributes unique to this population, we hope to develop specialized prevention education and treatment protocols.
Length of Stay Interpretation: Data shows that there is weak, but significant correlation between TBSA and LOS.
Y = mx + b
Y = 0.81082x + 6.70456
The data follows this line and can be interpreted as, for every one-unit increase in TBSA (X), the LOS (Y) increases by 0.81 days with the average LOS for 0% TBSA being 6.7 days.
Disability descriptive statistics
| Disability | Frequency | Percent |
| Use of cane | 49 | 27.84% |
| Use of rolling walker | 58 | 32.95% |
| Wheelchair | 34 | 19.32% |
| Motorized scooter | 9 | 5.11% |
| Assistance with ADLs NOS | 26 | 14.77% |
Hospital Discharge Disposition
| Disposition | Frequency | Percent |
| Home | 57 | 32.39% |
| Home w/ HH | 39 | 22.16% |
| SNF | 30 | 17.05% |
| Shelter | 0 | 0% |
| LTAC | 6 | 3.41% |
| Transfer back to referral | 14 | 7.95% |
| Psychiatric inpatient | 2 | 1.14% |
| Inpatient rehab | 10 | 5.68% |
| Hospice or expired in hospital | 18 | 10.23% |
Descriptive of most common mechanism of injury
| Mechanism | Frequency | Percent |
| Scald | 52 | 29.55% |
| Flame/flash | 90 | 51.14% |
| Electrical | 2 | 1.14% |
| Chemical | 0 | 0% |
| Contact | 17 | 9.66% |
| flame and scald | 1 | 0.57% |
| smoke inhalation only | 11 | 6.25% |
| inhalation and flame | 3 | 1.7% |
Treatment
| Surgery | Frequency | Percent |
| Autograft | 69 | 39.20% |
| Xenograft | 3 | 1.70% |
| Conservative | 85 | 48.29% |
| Autograft and xenograft | 13 | 7.39% |
| Other | 6 | 3.41% |
References and Resources
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