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Acute pediatric burn injuries often result in chronic sequelae that affect physical, psychological, and social outcomes. To date, no review has comprehensively reported on the impact of burn injuries across all three domains in school-aged children. The aim of this systematic review was to identify published literature that focuses on the impact of burn injuries on physical, psychological, or social functioning, and report upon the nature of study characteristics and their outcomes. We included literature published after 1980, focusing on burn outcomes in children aged 5 to 18 years. Each eligible study was systematically reviewed and primary outcomes were classified into outcome domains based on existing frameworks. Fifty-eight studies met inclusion criteria, and reported on physical (n = 24), psychological (n = 47), and social (n = 29) domains. The majority of the studies had sample sizes of

Introduction Acute burn injuries often result in chronic sequelae that affect functional and psychosocial outcomes. Few prior reviews on pediatric populations report on outcomes across multiple domains. The aim of this systematic review was to identify study characteristics and design of published burn literature that focus on the impact of burns on physical and psychosocial outcomes. Methods We included literature published after 1980, focusing on multifunctional burn outcomes in children aged 5–18 years. PubMed and Web of Science were searched with keywords covering broad and domain specific terms (e.g., “pediatric burns”, “outcomes”, “psychosocial recovery”) along with a manual reference check. After screening 751 potential abstracts, each eligible study was systematically reviewed using the McMaster Critical Review Form and assigned a score by two coordinators. Dyad discussions resolved inconsistencies. Extracted data elements included study designs, participant types, measurements, outcomes, clinical and demographic information, and main findings of each study. Results Sixty-two studies met inclusion criteria, and outcomes were classified into physical (n=31), psychological (n=53), and social (n=38) domains. The majority of studies were cross-sectional designs (n=33) and received a complete critical review score on all applicable categories (n=42). Study population ranged from six to 678 patients. Half of the studies did not have a comparison group. Patient- and parent-report measures were used in 43 and 41 studies respectively, with 25 studies using both types of measures. Across 62 studies, 85 different measures used, with only nine used in more than three studies. Parents and children generally reported better functioning in social and physical domains compared to age-matched groups, and worse psychological outcomes compared to non-burned population. Physical disabilities were associated with psychosocial functioning in 16 studies. Physical and social functioning improved where follow-up data was reported in six studies. Examples of selected factors that significantly impacted physical and psychosocial outcomes across domains included burn size, pain and itch, visible scars, body image satisfaction, athletic competence, peer relations, and adjustment skills. Conclusions This review demonstrated important associations with physical health and psychosocial status as outcomes. Additionally, there is a need for a standardized burn-specific measurement tool. These findings are relevant to burn clinicians and researchers to understand pathways and outcomes that affect quality of life in pediatrics post-burns.

Introduction Burn injuries can have major long-term effects on the health and quality of life for children and adolescents. This study narratively reviewed the health outcomes literature focusing on the impact of burn injury for children aged 5–18. Methods Literature targeting pediatric outcomes was reviewed to identify the effects of burns on children aged 5–18 (n=16). Inclusion criteria included studies that focused on the impact of burns on health and quality of life and were age-appropriate for this population. Articles were identified via PubMed, Web of Science, and manual reference checks. Data collected included the outcomes and health domains assessed in each article and the findings of the effects of the burn injury on those specific outcomes. The Preschool LIBRE Conceptual Model served as a ‘domains framework’ to guide the identification of outcomes and health domains. Results Long-term burn-specific outcomes and broad health domains identified were physical functioning (n=9), psychological functioning (n=12), social functioning (n=4), symptoms (n=8), and family (n=7). Some studies exclusively focused on one domain whereas others assessed two domains or more. Subdomains such as upper extremity functioning and functional independence were addressed in the physical functioning domain. Psychological functioning outcomes included subdomains such as emotional health and behavioral problems. Social functioning outcomes evaluated subdomains such as problems with peers and social participation. The symptoms domain addressed post-burn pain and itch. Family outcomes subdomains such as parental satisfaction with appearance and general family functioning were identified. Conclusions Burn-specific outcomes and health domains assessing the effects of burns on children aged 5–18 were identified among 16 studies. There is a need for a comprehensive assessment tool that more precisely measures the impact of burn injury across these domains. This work will inform the development of the School-Aged Life Impact Burn Recovery Evaluation (LIBRE) Computer Adaptive Test (CAT) Profile – a new outcome metric for children and adolescents with burns. Applicability of Research to Practice This review is relevant to researchers and clinicians assessing health outcomes and measuring burn recovery in children aged 5–18.