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Burns. 2018 Aug;44(5):1167-1178. doi: 10.1016/j.burns.2018.04.011. Epub 2018 May 8.

Perioperative Research into Memory (PRiMe): Cognitive impairment following a severe burn injury and critical care admission, part 1.

Author information

1
Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK. Electronic address: edward.watson@imperial.ac.uk.
2
Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Psychology Department, Westminster University, London, UK.
3
Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
4
Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Department of Anaesthesia, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, UK.
5
Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK.
6
Psychology Department, Westminster University, London, UK; Department of Psychology, City, University of London, UK.

Abstract

INTRODUCTION:

An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns.

METHODS:

A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks.

RESULTS:

15 patients (11M, 4F; 41±14 years; TBSA 38.4%±18.5) and comparators (11M, 4F; 40±13 years) were recruited. Burns patients reported worse QoL (Neuro-QoL Short Form v2, patient 30.1±8.2, control 38.7±3.2, p=0.0004) and cognitive function (patient composite z-score 0.01, IQR -0.11 to 0.33, control 0.13, IQR 0.47-0.73, p=0.02). Compared to estimated premorbid FSIQ, patients dropped an equivalent of 8 IQ points (p=0.002). Cognitive function negatively correlated with burn severity (rBaux score, p=0.04). QoL strongly correlated with depressive symptoms (Rho=-0.67, p=0.009) but not cognitive function.

CONCLUSIONS:

Severe burns injuries are associated with a significant, global, cognitive deficit. Patients also report worse QoL, depression and post-traumatic stress. Perceived QoL from cognitive impairment was more closely associated with depression than cognitive impairment.

KEYWORDS:

Cognitive impairment; Critical illness; Mental health; Quality of Life; Severe burns

PMID:
29752016
DOI:
10.1016/j.burns.2018.04.011
[Indexed for MEDLINE]

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