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From Injury to Independence: Investigating the Impact of Hand Burn Severity on Functional Outcomes in Children and
Ingrid Parry1, Cameron Ward2, Jeffrey Fine3
1Shriners Children's Northern California, Sacramento, CA 95817, USA.
Insights
The Hand Burn Severity (HABS) score helps predict long-term upper extremity function in children with hand burns. Higher HABS scores correlate with poorer outcomes, especially early after injury, aiding in early intervention planning.
Area of Science:
- Pediatric burn care
- Orthopedic surgery
- Rehabilitation medicine
Background:
- Hand burns frequently occur in children, potentially leading to lasting functional deficits.
- The Hand Burn Severity (HABS) score assesses burn severity but its link to pediatric functional outcomes requires further definition.
- Understanding this relationship is crucial for effective pediatric burn management.
Purpose of the Study:
- To investigate the association between the Hand Burn Severity (HABS) score, measured at injury, and longitudinal upper extremity functional outcomes in pediatric patients.
- To determine if HABS is a reliable predictor of functional recovery after hand burns in children.
- To inform clinical decision-making for children with hand burns.
Main Methods:
- A 24-month prospective longitudinal study included 119 children (aged 2-18 years) with 165 hand burns.
- Burn severity was assessed using the HABS score at enrollment.
- Upper extremity function was evaluated using the Burn Outcomes Questionnaire (BOQ) and the PROMIS-UE8 at multiple time points.
Main Results:
- Higher HABS scores were significantly linked to lower BOQ upper extremity function scores at 2 and 6 months post-burn.
- Higher HABS scores were independently associated with lower patient-reported PROMIS-UE8 scores throughout the 2-year follow-up.
- These associations highlight the predictive value of HABS for functional outcomes.
Conclusions:
- The Hand Burn Severity (HABS) score at the time of injury is associated with poorer upper extremity outcomes in children.
- The HABS score is particularly predictive in the early post-burn period.
- HABS can identify children who may benefit from intensified monitoring or early rehabilitation strategies.
Background:
Hand burns are common in children and can result in long-term functional impairment. The Hand Burn Severity (HABS) score is an anatomy-specific measure of hand burn severity, but its relationship to functional outcomes in pediatric patients has not been well defined. The purpose of this study was to determine whether HABS, measured at the time of injury, is associated with longitudinal upper extremity functional outcomes in children.
Methods:
We conducted a 24-month prospective longitudinal study of children aged 2-18 years with hand burns. Burn severity was determined using HABS at enrollment, and outcomes were measured using the Burn Outcomes Questionnaire (BOQ) and the eight-item Patient-Reported Outcomes Measurement Information System-Upper Extremity (PROMIS-UE8). Repeated-measures linear regression models evaluated associations between HABS and outcomes over time, adjusting for age, dominant- and bilateral-hand involvement, and surgery.
Results:
A total of 119 children with 165 hand burns were enrolled. Higher HABS scores, indicating more severe injury, were significantly associated with lower BOQ upper extremity function domain scores, indicating poorer health, at 2- and 6-months post burn, but not at later time points. Higher HABS scores were independently associated with lower patient-reported PROMIS-UE8 scores, indicating poorer health, across the 2-year follow-up period.
Conclusions:
These findings indicate that higher HABS scores at the time of injury are associated with poorer upper extremity outcomes, particularly in the early post-burn period, suggesting that HABS may help identify children who could benefit from closer monitoring or early rehabilitation planning.
