Long-Term Outcomes in Burned OEF/OIF Veterans (LOBO)
Polly Hitchcock Noel PhD MA BA
South Texas Health Care System, San Antonio, TX
San Antonio, TX
Funding Period: August 2007 - December 2013

BACKGROUND/RATIONALE:
While HSR&D studies are exploring PTSD, polytrauma, and blast-related injury outcomes in OEF/OIF veterans, none specifically focus on burn injuries or compare recovery outcomes after burn vs. non-burn combat injuries.

OBJECTIVE(S):
Using DoD and VA trauma, clinical, and administrative databases and partnering with two DoD shorter-term studies, we are assessing functional outcomes at discharge, 1, 2, 3, and 4 years in three survivor cohorts: OEF/OIF survivors of combat burns, OEF/OIF survivors of non-burn combat trauma, and survivors of civilian burns. We expect those with combat burns will have worse long-term function compared to those with non-burn trauma or civilian burns.

METHODS:
This prospective study will use the Disablement Process Model as a guide, and USAISR/BAMC (US Army Institute of Surgical Research/Brooke Army Medical Center) databases and patient surveys to compare rates of functional recovery among survivors of combat burns, combat non-burn trauma, and civilian burns discharged from the USAISR Burn Center or BAMC, with follow-up at 1, 2, 3, and 4 years. The 4 primary outcomes will be activities of daily living, instrumental activities of daily living, work status, and community integration.

FINDINGS/RESULTS:
Nonburn combat injury cohort: 85 patients are enrolled; 96% are male; mean age is 27.9 (SD 6.1) years; 76% are Caucasian, 16% are Hispanic, and 4% are African-American. Psychiatric morbidity is significant: baseline mean PCL-M (PTSD Checklist-Military) score is 32.3, and 1-year follow-up mean score is 35.8; baseline mean CES-D (Center for Epidemiological Studies-Depression scale) score is 10.6, and 1-year follow-up mean score is 8.9.

IMPACT:
Little is known about the comparative long-term functional outcomes of veterans with burn and non-burn combat trauma. Findings from this VA-DoD collaborative study will inform clinicians and policy makers about these combat-injured veterans' needs and the best ways to optimize health care for these wounded warriors.

PUBLICATIONS:

Conference Presentations

1. Lawrence VA. Long-term outcomes in burned OEF/OIF veterans. Strategies, insights, lessons learned, and possibilities for improving collaboration (invited speaker). VA/DoD Collaborations Interest Group. Presented at: VA HSR&D National Meeting; 2009 Feb 11; Baltimore, MD.

DRA: Health Systems, Acute and Combat-Related Injury, Military and Environmental Exposures
DRE: Epidemiology, Treatment - Observational
Keywords: Functional Status, Operation Enduring Freedom, Operation Iraqi Freedom, Outcomes - Patient, Pain, Rehabilitation, Reintegration Post-Deployment
MeSH Terms: none