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Association of Total Body Surface Area and Body Part With Mental Health Outcomes in Pediatric Burn Patients
Jazzalyn Zou1, Jaclyn Dempsey2, Rahul Venna3
1School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, Texas. Electronic address: https://twitter.com/utmbsurgery.
Insights
Pediatric burn patients with larger burn areas (TBSA) or older age experienced more mental health issues like anxiety and depression within one year post-injury. These effects diminished by two years, regardless of burn location.
Area of Science:
- Pediatric Burn Care
- Psychological Outcomes in Children
- Trauma Recovery
Background:
- Burn injuries in children significantly impact psychological and emotional well-being.
- Specific risk indicators for negative mental health outcomes in pediatric burn patients require further research.
- Visible and functionally important body part burns may correlate with adverse psychological effects.
Purpose of the Study:
- To investigate the association between the extent of Total Body Surface Area (TBSA) burned and the location of burns with mental health outcomes in pediatric patients.
- To identify risk factors contributing to psychological distress following pediatric burn injuries.
- To assess mental health status at 6 months, 1 year, and 2 years postburn.
Main Methods:
- Retrospective review of 178 pediatric burn patients from the Burns Model System National Database (2010-2023).
- Utilized Patient-Reported Outcomes Measurement Information System (PROMIS) surveys to assess anxiety, depression, peer relationships, pain interference, fatigue, and physical function.
- Analyzed data stratified by TBSA quartiles and affected body parts using chi-squared tests and logistic regression.
Main Results:
- At 1-year postburn, higher TBSA was significantly associated with increased anxiety, fatigue, pain interference, and poorer physical function (P < 0.05).
- No significant correlation was found between the body part burned and mental health outcomes at 1 year.
- By 2 years postburn, the association between TBSA and mental health outcomes was no longer significant. Increased age correlated with higher depression rates and poorer peer relationships (P < 0.05).
Conclusions:
- Greater TBSA burns and older age in children are linked to a higher likelihood of mental health consequences within the first year postburn.
- The location of the burn did not significantly influence mental health outcomes at the 1-year mark.
- Findings underscore the need for targeted interventions to support the psychological recovery of pediatric burn survivors, particularly those with extensive burns or older children.
Introduction:
Burn injuries in children are associated with negative impacts on psychological and emotional well-being, yet specific risk indicators are not well researched. We hypothesize that children with greater total body surface area (TBSA) burned and burns in highly visible and functionally significant body parts are more likely to experience negative mental health outcomes compared to their counterparts.
Materials And Methods:
Database review of 178 pediatric burn patients (median age: 13 ± 2.99) utilizing the Burns Model System National Database, retrospectively collected data between 2010 and 2023. Patient-Reported Outcomes Measurement Information System surveys obtained at 6 mo, 1 y, and 2 y postburn were utilized to assess mental health factors (anxiety, depression, peer relationships, pain interference, fatigue, and physical function). Mental health status was defined using Patient-Reported Outcomes Measurement Information System cut-off points with T-scores. Data were stratified by TBSA quartiles and body part affected (arm, head/neck/face, trunk, perineum, hand, leg, foot). Associations with TBSA and body parts were analyzed with chi-squared calculations using Excel, and demographic data was analyzed using logistic regression using R Studio.
Results:
At 1-y postburn, higher TBSA was associated with increased anxiety (P = 0.005), fatigue (P = 0.04), pain interference (P = 0.02), and poorer physical function (P = 0.003); however, there was no correlation with body part burned. By 2 y postburn, the difference in mental health outcomes by TBSA was no longer significant. Increased age was associated with a higher likelihood of depression (P = 0.002) and poorer peer relationships (P = 0.03).
Conclusions:
Children with greater TBSA burns or older age were associated with a higher likelihood of mental health consequences by 1 y postburn, regardless of which body part was affected. Understanding these relationships is essential for developing targeted interventions to support the psychological recovery of pediatric burn patients.
