title: Impact of hand burns on health-related quality of life in children younger than 5 years.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  This 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.
  
  
  RESULTS
  A 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.
  
  
  CONCLUSIONS
  Children with hand burns have significantly worse outcomes than do children with burns in other areas.
authors.affiliation: Shriners Hospitals for Children-Northern California, Sacramento, CA, USA.
authors.forename: Tina L
authors.initials: TL
authors.lastname: Palmieri
authors.forename: Kate
authors.initials: K
authors.lastname: Nelson-Mooney
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kagan
authors.forename: Teresa K
authors.initials: TK
authors.lastname: Stubbs
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Meyer
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.forename: Michelle I
authors.initials: MI
authors.lastname: Hinson
authors.forename: Austin F
authors.initials: AF
authors.lastname: Lee
authors.forename: Nien-Chen
authors.initials: NC
authors.lastname: Li
authors.forename: Lewis E
authors.initials: LE
authors.lastname: Kazis
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Tompkins
mesh_terms: D002056:Burns / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D006230:Hand Injuries / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires