Quality-of-life loss of people admitted to burn centers, United States Ted Miller • Soma Bhattacharya • William Zamula • Dennis Lezotte • Karen Kowalske • David Herndon • James Fauerbach • Loren Engrav Accepted: 13 November 2012 Ó Springer Science+Business Media Dordrecht 2012 Abstract Purpose To estimate quality-of-life loss per serious burn survivor in a large U.S. cohort. Methods Longitudinal functional assessments of all 1,587 people receiving primary treatment in 5 burn centers between 2000 and 2009 included pre-burn (retrospective), at time of discharge, and 6, 12, and 24 months post-injury. We assessed adults with RAND Short Form (SF) 12 and children with SF-10 or Child Health Questionnaire, the child surveys scored using standard norms-based scoring. A literature review identified 20 quality-adjusted life year utility scorings for SF-12 and 27 scorings for EQ-5d response distributions predicted from SF-12 scores. We computed composite scores for each patient and time per- iod by applying 32 scorings that met quality/non-duplica- tion criteria. Results Mean quality-of-life scores were 0.805 4 weeks pre-burn, 0.562 at discharge, rebounded through 1 year, and stabilized at 0.735 (0.750 for TBSA burned below 25 %, 0.722 for TBSA burned of 25–50 %, and 0.695 for larger burns). As a percentage of initial levels, burns reduced short-term quality of life by 30 %. Long-term loss averaged 11 %, ranging from 9 % for TBSA burned below 25–13 % for TBSA burned above 50 %. Children recov- ered faster and more fully. Conclusion Burns cause substantial losses in quality of life, with long-term losses comparable to traumatic brain injury. Keywords Burn Á QALY Á Systematic review of scorings Á SF-12 Á EQ-5d Introduction Nonfatal burns can cause a lifetime of serious debilities. The accepted measure of associated quality-of-life losses is quality-adjusted life years (QALYs). They are measured in two steps. The first step assesses the losses in physical and role function that result from a medical condition over time. The second scores the functional losses, typically based on how people value them on a scale where 1.0 equals perfect health, and 0.0 equals death. For details about the QALY concept and its limitations, see Whitehead and Ali [1]. Three European studies have assessed quality-of-life loss following burns. Sanchez et al. [2] found quality-of- T. Miller (&) Á S. Bhattacharya Pacific Institute for Research and Evaluation, Calverton, MD, USA e-mail: miller@pire.org W. Zamula U.S. Consumer Product Safety Commission, Bethesda, MD, USA D. Lezotte University of Colorado Health Sciences Center, Lakeland, CO, USA K. Kowalske University of Texas Southwestern Medical Center, Dallas, TX, USA D. Herndon University of Texas Medical Branch and Shriner’s Hospital, Galveston, TX, USA J. Fauerbach Johns Hopkins University, Baltimore, MD, USA L. Engrav Harborview Medical Center, University of Washington, Seattle, WA, USA 123 Qual Life Res DOI 10.1007/s11136-012-0321-5