J. Zou2, J. Dempsey1, R. Venna2, S. Patel2, B. Syed2, H. Nguyen3, B. Naik-Mathuria2 1University Of Texas Medical Branch, Surgery, Galveston, TX, USA 2University Of Texas Medical Branch, School Of Medicine, Galveston, TX, USA 3University Of Texas Medical Branch, School Of Nursing, Galveston, TX, USA
Introduction: Burn injuries in children are associated with negative impacts on psychological and emotional well-being, yet specific risk indicators are unknown. We hypothesized that children with greater burn total body surface area (TBSA) and burns in highly visible body parts, such as the head, are more likely to experience negative mental health outcomes compared to their counterparts.
Methods: Database review of 178 pediatric burn patients (median age: 13, IQR 10-15) utilizing the Burns Model System (BMS) National Database prospectively collected between 2010-2023. Patient Reported Outcomes Measurement Information Systems (PROMIS) surveys obtained at 6 months, 1 year, and 2 years post-burn were utilized to assess mental health factors (anxiety, depression, peer relationships, pain interference, fatigue). Mental health status was defined using PROMIS cut-off points with T-scores (<55 normal, >55 poor). Data were stratified by TBSA quartiles and body part affected (arm, foot, hand, head, leg, perineum, trunk). Head burns were selected as the comparison group because they represent the most visible area of the body. Associations with TBSA and body part were analyzed using chi-squared calculations and demographic data was analyzed using logistic regression with R Studio.
Results: At 1-year post-burn, higher TBSA was associated with increased anxiety (p=0.005), fatigue (p=0.04), and pain interference (p=0.02) (Figure 1). By 2 years post-burn, this difference was no longer significant. Additionally, no significant differences were found when comparing PROMIS scores for head burns to burns on all other body parts (Figure 2). When analyzing demographics, increased age was found to be positively associated with depression (p=0.002) and negatively associated with good peer relationships (p=0.03).
Conclusion: Children with greater TBSA burns and older age are at the highest risk of developing mental health consequences by one-year post-burn, with no significant impact from the visibility of the burn location. Understanding these relationships is essential for developing targeted interventions to support the psychological recovery of pediatric burn patients.