The Impact of Adverse Childhood Experiences on Burn Outcomes in Adult Burn Patients

Mikenzy Fassel; Brian Grieve; Sameen Hosseini; Resmiye Oral; Colette Galet; Colleen Ryan; Lewis Kazis; Ni Pengsheng; Lucy A Wibbenmeyer

doi:10.1093/jbcr/irz014

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The Impact of Adverse Childhood Experiences on Burn Outcomes in Adult Burn Patients

Journal article

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The Impact of Adverse Childhood Experiences on Burn Outcomes in Adult Burn Patients

Mikenzy Fassel, Brian Grieve, Sameen Hosseini, Resmiye Oral, Colette Galet, Colleen Ryan, Lewis Kazis, Ni Pengsheng and Lucy A Wibbenmeyer

Journal of burn care & research, Vol.40(3), pp.294-301

03/12/2019

DOI: 10.1093/jbcr/irz014

PMCID: PMC8344292

PMID: 30873544

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Abstract

Adverse childhood experiences (ACEs), including child maltreatment and household dysfunction, define adverse events that occur before 18 years of age. National and state data show that between 12.5 and 14.5% of the adult population report ≥4 ACEs (HIGH-ACE), respectively. HIGH-ACEs are associated with more chronic health problems. To date, the interaction between ACEs and burn injuries has not been studied. Herein, we sought to define the ACE exposure in our burn patients and its impact on early outcomes. Inpatient and outpatient adult burn survivors (≥18 years of age) were enrolled. Subjects completed surveys assessing adverse experiences (ACEs-18), needs, strengths, and resiliency at consent, and pain, depression, post-traumatic stress disorder (PTSD), and social participation surveys at 2 weeks to 3 months postinjury. Demographics, burn, and hospital course data were also collected. Chi-square and student’s t -tests were used for descriptive analysis and to compare the groups (HIGH-ACE vs LOW-ACE). The HIGH-ACE group ( n = 24; 45.3%) reported more depressive symptoms ( P < .04) than the LOW-ACE group ( n = 29, 54.7%). HIGH-ACE patients were less resilient when facing stressful events ( P ≤ .02) and more likely to screen positive for probable PTSD ( P = .01) and to score lower on the Life Impact Burn Recovery Evaluation Profile (LIBRE Profile), which assesses for social participation, in the domain of Family and Friends ( P = .015). Our exploratory study suggests that ACE screening may help detect burn patients at risk for a more complicated recovery, thereby promoting personalized assistance in recovery.

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Title: Subtitle: The Impact of Adverse Childhood Experiences on Burn Outcomes in Adult Burn Patients
Creators: Mikenzy Fassel - University of Iowa
Brian Grieve - Roy J. and Lucille A. Carver College of Medicine
Sameen Hosseini - University of Iowa Hospitals and Clinics
Resmiye Oral - University of Iowa
Colette Galet - University of Iowa
Colleen Ryan - Shriners Hospitals for Children - Boston
Lewis Kazis - Boston University
Ni Pengsheng - Boston University
Lucy A Wibbenmeyer - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Journal of burn care & research, Vol.40(3), pp.294-301
DOI: 10.1093/jbcr/irz014
PMID: 30873544
PMCID: PMC8344292
NLM abbreviation: J Burn Care Res
ISSN: 1559-047X
eISSN: 1559-0488
Publisher: Oxford University Press
Grant note: ; #90DP0055 / ;
Language: English
Date published: 03/12/2019
Academic Unit: Stead Family Department of Pediatrics; Surgery; Injury Prevention Research Center
Record Identifier: 9984322799302771

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