Pain and Pruritus Increase Long-Term Psychosocial Morbidity in Pediatric Burn Survivors

While pain and pruritus are well-established sequelae of burn injury, their downstream impact on pediatric burn survivors is poorly characterized. This project addresses this gap by evaluating associations of pain and pruritus with functional and psychosocial symptoms at 12 months post-injury in pediatric burn survivors.

Using a multicenter longitudinal database (injured between 2014 and 2024), this retrospective review identified pediatric burn survivors aged 8-17 years who completed a self-reported survey assessing pain and pruritus at 12-months post-injury. Patient-Reported Outcomes Measurement Information System (PROMIS) domains included pain intensity, pruritus, physical function, anxiety, depression, and fatigue. General linear models (GLM) were fitted at the 12-month follow-up to evaluate independent associations between pain and pruritus scores and demographic, functional, and psychosocial variables.

The study included 67 pediatric burn survivors with a mean age of 11.8 ± 2.9 years. In multivariate regression models at 12 months post-injury, demographic and burn characteristics were not significant predictors of pain or pruritus. Both higher pain and itch were significantly associated with greater anxiety (p = 0.0109; p < 0.0001), depression (p = 0.0021; p = 0.0006), and fatigue (p = 0.0053; p = 0.0096); higher itch was additionally associated with worse physical function (p = 0.0396).

This review shows that even one year after injury, pain and pruritus remain strongly associated with psychosocial distress, with pruritus additionally linked to impaired physical function. These findings highlight that pain and itch are interrelated drivers of impaired quality of life in children.