• Tina L Palmieri, Kate Nelson-Mooney, Richard J Kagan, Teresa K Stubbs, Walter J Meyer, David N Herndon, Michelle I Hinson, Austin F Lee, Nien-Chen Li, Lewis E Kazis, Ronald G Tompkins, and Multi-Center Benchmarking Study Working Group.
• Shriners Hospitals for Children-Northern California, Sacramento, CA, USA.
• J Trauma Acute Care Surg. 2012 Sep 1;73(3 Suppl 2):S197-204.

BackgroundThe purpose of this multicenter study was to evaluate the impact of hand burn injury in preschool children younger than 5 years on health-related quality of life, including both physical and psychosocial function, in the 5 years after burn injury.MethodsThis prospective case series assessed children younger than 5 years admitted to four pediatric burn centers. Each child's family completed the American Burn Association/Shriners Hospitals for Children Burn Outcome Questionnaire (BOQ), a validated and reliable assessment tool, which measures the physical and psychosocial functioning of the child with burn injury ages 0 year to 5 years, at baseline, 3, 6, 12, 18, 24, 36, and 48 months after discharge. Multivariate models controlling for sociodemographic and clinical characteristics were developed, and recovery curves were generated for the time since burn using generalized estimating equations with random effects.ResultsA cohort of 438 patients was followed up prospectively. Mean (SD) patient age was 2.2 (1.2) years, mean (SD) total body surface area (TBSA) was 28% (22.4%), and 19% had inhalation injury. Children with hand burns had lower scores in most of the areas tested, with the most pronounced and significant differences were in fine motor function, gross motor function, and appearance. These findings applied to both small (<20% TBSA) and large (≥20% TBSA) burns. The most profound impact of hand burns was noted in fine and gross motor function during the 4 years of follow-up.ConclusionChildren with hand burns have significantly worse outcomes than do children with burns in other areas.

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