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

December 18, 2019

Authors: Al-Hindawi A, Clancy OH, Edginton TL, Farag M, Mandalia S, Mehmet ART, Nenadlová K, Nilsen A, Nordin NA, Vizcaychipi MP, Watson EJR, Williams LM

Journal: Burns : journal of the International Society for Burn Injuries

DOI: 10.1016/j.burns.2018.04.011

Year Published: 2018

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.

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