Background: Severe burn injuries often lead to lasting physical and psychological consequences. Post-traumatic stress disorder (PTSD) is common among burn survivors and may be influenced by persistent somatic complaints. This study examined whether PTSD is associated with a higher burden of physical symptoms during and after inpatient rehabilitation. Methods: We conducted a subgroup analysis of a multicenter prospective cohort study involving 103 adult burn patients in inpatient rehabilitation. Based on Impact of Event Scale—Revised (IES-R) scores and clinical evaluation, patients were grouped as PTSD (n = 43) or No PTSD (n = 60). Physical symptoms assessed included skin dryness (xerosis), temperature sensitivity (cold/heat), numbness, skin tightness, and increased sweating. Results: Patients with PTSD reported significantly more physical symptoms at follow-up than those without PTSD: xerosis (74% vs. 50%, p = 0.03), cold sensitivity (61% vs. 35%, p = 0.02), heat sensitivity (63% vs. 39%, p = 0.03), numbness (63% vs. 33%, p = 0.006), skin tightness (82% vs. 52%, p = 0.004), and sweating (45% vs. 19%, p = 0.01). PTSD patients also had more severe burns, reflected in higher full-thickness TBSA (2% vs. 0%, p = 0.03) and elevated ABSI scores (median 6 vs. 5, p = 0.04). Conclusion: PTSD is associated with a higher and more persistent burden of physical skin symptoms after severe burns. These findings underscore the importance of early PTSD screening and integrated psychological-somatic rehabilitation to improve long-term recovery and quality of life.

Postoperative delirium is a serious yet underrecognized complication affecting diverse surgical populations, with profound implications for morbidity, mortality, and long-term cognitive function. Its prediction remains imprecise, and screening practices vary widely. We conducted a retrospective analysis of the 2021–2023 data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). The study included 217,783 adult surgical patients with documented delirium assessment. Patients were categorized as delirium, non-delirium, or unscreened, with an additional 2.7 million unscreened patients analyzed to assess selection bias in screening. The primary outcome was the incidence of delirium. Other outcomes included surgical and medical complications, mortality, length of stay, functional decline, discharge destination and conditions, and perioperative lab values. Multivariable regression models were used to identify independent predictors of delirium and its associated outcomes. Delirium screening was performed exclusively in patients aged ≥75 years, accounting for 7.3% of all surgical patients. Screening rates declined with advancing age (44% of patients aged 90+ vs 56% aged 75–79), while the proportion screening positive increased sharply (3.1% at 75–79 years vs 12.8% at ≥90 years). Delirium occurred in 10.6% (n = 23,100) of screened patients. Compared with non-delirium patients, those with delirium were older (mean 81.3 vs 79.9 years, p < 0.0001), more functionally dependent, and had higher ASA class and comorbidity burden. Dementia (37% vs 7.9%, p < 0.0001), recent falls (40% vs 18%, p < 0.0001), and urgent/emergency surgery (55% vs 26%, p < 0.0001) were strongly associated. Each 10-min increase in operative time was seen to independently be associated with 2.3% raised odds of delirium (p < 0.0001). Delirium was independently associated with higher 30-day mortality (OR 3.2, 95% CI 2.9–3.5), reoperation (OR 2.3, 95% CI 2.1–2.5), surgical complications (OR 1.8, 95% CI 1.6–1.9), loss of independence (OR 1.6, 95% CI 1.5–1.7), and reduced odds of home discharge (OR 0.5, 95% CI 0.4–0.5). Postoperative delirium is an independent predictor of adverse surgical outcomes yet remains substantially under-screened, with disparities across patient groups. These findings underscore the need for standardized, routine screening and targeted prevention strategies to improve perioperative care. No funding was received for this study.

Background: Severe burn injuries often lead to lasting physical and psychological con-sequences. Post-traumatic stress disorder (PTSD) is common among burn survivors and may be influenced by persistent somatic complaints. This study examined whether PTSD is associated with a higher burden of physical symptoms during and after inpatient rehabilitation. Methods: We conducted a subgroup analysis of a multicenter prospective cohort study involving 103 adult burn patients in inpatient rehabilitation. Based on Impact of Event Scale-Revised (IES-R) scores and clinical evaluation, patients were grouped as PTSD (n=43) or No PTSD (n=60). Physical symptoms assessed included skin dryness (xerosis), temperature sensitivity (cold/heat), numbness, skin tightness, and increased sweating. Results: Patients with PTSD reported significantly more physical symptoms at follow-up than those without PTSD: xerosis (74% vs. 50%, p=0.03), cold sensitivity (61% vs. 35%, p=0.02), heat sensitivity (63% vs. 39%, p=0.03), numbness (63% vs. 33%, p=0.006), skin tightness (82% vs. 52%, p=0.004), and sweating (45% vs. 19%, p=0.01). PTSD patients also had more severe burns, reflected in higher full-thickness TBSA (2% vs. 0%, p=0.03) and elevated ABSI scores (median 6 vs. 5, p=0.04). Conclusion: PTSD is associated with a higher and more persistent burden of physical skin symptoms after severe burns. These findings highlight the need for early PTSD screening and integrated psychological-somatic rehabilitation to improve long-term recovery and quality of life.