1. Acute and long-term clinical, neuropsychological and return-to-work sequelae following electrical injury: a retrospective cohort study
- Author
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Sarah Rehou, Stephanie A. Mason, Nada Radulovic, Marc G. Jeschke, and Matthew Godleski
- Subjects
Adult ,Male ,Rehabilitation hospital ,Canada ,medicine.medical_specialty ,medicine.medical_treatment ,Psychological intervention ,Anxiety ,rehabilitation ,Stress Disorders, Post-Traumatic ,burns ,03 medical and health sciences ,Return to Work ,0302 clinical medicine ,Sleep Initiation and Maintenance Disorders ,medicine ,Accidents, Occupational ,Humans ,10. No inequality ,Adverse effect ,Retrospective Studies ,Depressive Disorder, Major ,Rehabilitation ,business.industry ,Research ,Neuropsychology ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,3. Good health ,Electric Injuries ,Hospitalization ,Emergency medicine ,Cohort ,electrical injuries ,Female ,Surgery ,business ,Rhabdomyolysis ,030217 neurology & neurosurgery - Abstract
ObjectiveTo determine acute and long-term clinical, neuropsychological, and return-to-work (RTW) effects of electrical injuries (EIs). This study aims to further contrast sequelae between low-voltage and high-voltage injuries (LVIs and HVIs). We hypothesise that all EIs will result in substantial adverse effects during both phases of management, with HVIs contributing to greater rates of sequelae.DesignRetrospective cohort study evaluating EI admissions between 1998 and 2015.SettingProvincial burn centre and rehabilitation hospital specialising in EI management.ParticipantsAll EI admissions were reviewed for acute clinical outcomes (n=207). For long-term outcomes, rehabilitation patients, who were referred from the burn centre (n=63) or other burn units across the province (n=65), were screened for inclusion. Six patients were excluded due to pre-existing psychiatric conditions. This cohort (n=122) was assessed for long-term outcomes. Median time to first and last follow-up were 201 (68–766) and 980 (391–1409) days, respectively.Outcome measuresAcute and long-term clinical, neuropsychological and RTW sequelae.ResultsAcute clinical complications included infections (14%) and amputations (13%). HVIs resulted in greater rates of these complications, including compartment syndrome (16% vs 4%, p=0.007) and rhabdomyolysis (12% vs 0%, pConclusionsThis is the first investigation to determine acute and long-term patient outcomes post-EI as a continuum. Findings highlight substantial rates of neuropsychological and social sequelae, regardless of voltage. Specialised and individualised early interventions, including screening for mental health concerns, are imperative to improvingoutcomes of EI patients.
- Published
- 2019
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