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Family Income and Recovery Outcomes in Pediatric Burn Survivors: A Burn Model System National Database Study
Sarah Wang1, Trevor A Pickering2, Shelley Wiechman3
1Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States.
Insights
Family income did not significantly impact pediatric burn survivors' return to school or psychosocial outcomes. This suggests factors beyond socioeconomic status, like social support, are crucial for recovery in pediatric burn patients.
Area of Science:
- Pediatric burn care
- Socioeconomic factors in health
- Psychosocial outcomes in children
Background:
- Children from lower income families experience disproportionately higher burn injury rates.
- These children may face greater psychosocial challenges post-injury.
- Understanding the impact of family income on recovery is critical for effective pediatric burn care.
Purpose of the Study:
- To investigate the relationship between family income and functional recovery in pediatric burn patients.
- To assess whether socioeconomic status influences return to school and psychosocial outcomes 12 months post-burn.
- To identify factors affecting recovery trajectories in pediatric burn survivors across different income levels.
Main Methods:
- Retrospective analysis of a multi-center longitudinal database (2015-2024) of pediatric burn patients (<18 years).
- Patients categorized into three income cohorts: <$50k, $50k-$100k, and >$100k.
- Collected data on return to school, psychosocial outcomes (PROMIS scales, Post-Traumatic Growth, Body Image, Pain Intensity), and injury severity (%TBSA, inhalation injury).
Main Results:
- Children with family income <$50k had significantly higher %TBSA burned and a greater incidence of inhalation injury.
- No significant differences were found in return to school or any measured psychosocial outcomes at 12 months post-injury, after adjusting for %TBSA burned.
- The study included 204 pediatric burn survivors across income groups.
Conclusions:
- Lower family income did not impede functional recovery or psychosocial outcomes in pediatric burn survivors.
- Factors other than socioeconomic status, such as social support, may play a more significant role in recovery.
- Addressing systemic inequalities is necessary to reduce the disproportionate burden of burn injuries in lower-income children.
Abstract:
Children from lower income families are often disproportionately affected by burns, potentially experiencing greater psychosocial challenges. This study examines whether family income influences the ability of pediatric patients with burn injuries to return to baseline function. A retrospective study of pediatric patients (<18 years) from a multicenter longitudinal database between 2015 and 2024 was conducted. There were 3 cohorts of patients based on income level: <$50 k, $50 k-$100 k, and > $100 k. Return to school and psychosocial outcomes (Patient-Reported Outcomes Measurement Information System [PROMIS] Depression, PROMIS Anger, PROMIS Peer Relationships, PROMIS Anxiety, PROMIS Pain Interference, PROMIS Family Relationships, Posttraumatic Growth, Body Image, and Pain Intensity) were collected at 12 months after injury by individuals ages 8-17. The final sample consisted of 204 individuals: 115 with income < $50 k, 55 with income $50 k-$100 k, and 34 with income > $100 k. On average, the %TBSA burned was significantly higher (P < .001) and there was a greater incidence of inhalation injury (P = .03) in children with a family income of < 50 k. There were no significant differences in any psychosocial outcomes or return to school (P = .40) after adjusting for %TBSA burned. These findings show that lower socioeconomic status does not necessarily impede recovery in pediatric burn survivors, and other factors such as social support may have greater impact on recovery. However, there is a need to address systemic inequalities that contribute to the disproportionate injury burden faced by children from lower income families.
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