Evaluating the Effect of Burn Injury Characteristics on Quality Of Life in Pediatric Burn Patients
Kelli N. Patterson1, Tariku J. Beyene1, Katherine Lehman2, Sarah N. VerLee1, Dana Schwartz1, *Renata Fabia1, *Rajan K. Thakkar1
1Nationwide Children's Hospital, Columbus, OH; 2Ohio State University College of Medicine, Columbus, OH
Background: The purpose of this study was to evaluate pediatric burn patients’ and caregivers’ quality of life (QoL), while identifying clinical characteristics most correlated with psychological stress.Methods: Pediatric burn patients at a single, ABA-verified institution who completed a validated screening assessment from November 2019-January 2021 were included. Caregivers of patients aged 0-4 years completed the Infant’s Dermatology QoL Index (IDQOL). Patients >4-16 years old completed the Children’s Dermatology Life Quality Index (CDLQI). Responses to the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT) measured caregivers’ stress. Multivariate regression models were used to evaluate associations between QoL scores and clinical burn characteristics.Findings: The cohort of 244 pediatric burn patients had a median age of 4.0 years, time from injury to survey of 7.6 days, and initial total body surface area (TBSA) burn of 1.0% (range: 0.5-41%). Overall, 27.3% (39/143) of IDQOL and 53.1.% (41/96) of CDLQI scores indicated that patients’ burns caused moderate to extremely large effects on QoL. In caregivers responding to SPRINT, 4.5% (7/159) scored >14, warranting further PTSD evaluation. Increased TBSA and burn depth severity were associated with worsening infant QoL. For IDQOL scores, each additional 1% TBSA burn was associated with a 2.75-point increase (p=0.05), and patients sustaining 2nd degree deep partial thickness burns scored an average of 3.3 points higher compared to those with 2nd degree superficial partial thickness burns (P<0.01). A similar pattern was observed for CDLQI and SPRINT scores. Conclusion: QoL is impacted in a substantial proportion of pediatric burn patients. This study objectively determines that larger TBSA burns and more severe burn depths cause significantly more psychological stress in children. Concurrently, caregivers may also require more extensive psychological evaluation.
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