Victoria G Rontoyanni1, Andrzej Kudlicki2, Alen Palackic3, Nicole Gibran4, Barclay Stewart5, Jeffrey C Schneider6, Colleen M Ryan7, Andrew J Murton8, Steven E Wolf9, Karen Kowalske10, Oscar E Suman11. 1. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: virodoyi@utmb.edu. 2. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: askudlic@utmb.edu. 3. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. Electronic address: alpalack@utmb.edu. 4. UW Medicine Regional Burn Center, Department of Surgery, University of Washington, Seattle, WA, USA. Electronic address: nicoleg@uw.edu. 5. UW Medicine Regional Burn Center, Department of Surgery, University of Washington, Seattle, WA, USA; Harborview Injury Prevention & Research Center, Seattle, WA, USA. Electronic address: barclays@uw.edu. 6. Spaulding Rehabilitation Hospital, Spaulding Research Institute, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA. Electronic address: jcschneider@partners.org. 7. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Shriners Hospital for Children-Boston, Boston, MA, USA. Electronic address: cryan@mgh.harvard.edu. 8. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: ajmurton@utmb.edu. 9. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: swolf@utmb.edu. 10. Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address: karen.kowalske@UTSouthwestern.edu. 11. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: oesuman@utmb.edu.
Abstract
OBJECTIVE: Increased body weight has been associated with reduced muscle wasting in the early catabolic phase after a severe burn. Yet, overweight and obese non-burn children often exhibit impaired musculoskeletal function, which may lead to poor physical function (PF). We aimed to determine the association between body mass index (BMI) at discharge and self-reported PF and caregiver proxy-reported PF during recovery of burned children. MATERIALS AND METHODS: This is a retrospective multisite longitudinal study in paediatric burn patients ((8-17 y old at time of burn). PF outcome measures were self-reported mobility, proxy-reported mobility, and upper extremity PF evaluated using PROMIS measures at 6-, 12-, and 24-months after injury. Primary exposure variable was BMI-for-age at discharge. RESULTS: A total of 118 paediatric patients, aged 11.7 ± 3.3 y, with burns covering 37.6 ± 18.8% of their total body surface area (TBSA) and BMI-for-age of 23.1 ± 5.4 kg/m2 at discharge were analyzed. BMI at discharge was not significantly associated with self-reported mobility scores 6 months after burn (beta coefficient =-0.23, p = 0.31), had a positive effect on mobility at 12 months (beta = 0.46, p = 0.05), and no effect at 24 months after injury (beta=-0.10, p = 0.60), when adjusted for burn size. BMI did not have a significant effect on proxy-reported mobility or upper extremity PF. CONCLUSION: A greater BMI at discharge was associated with improved self-reported PF at 12 months after burn but not at 6 months or 24 months, which suggests a faster recovery of PF in paediatric patients of larger body weight. Our data suggests that a larger body weight does not compromise the recovery of PF after burn.
OBJECTIVE: Increased body weight has been associated with reduced muscle wasting in the early catabolic phase after a severe burn. Yet, overweight and obese non-burn children often exhibit impaired musculoskeletal function, which may lead to poor physical function (PF). We aimed to determine the association between body mass index (BMI) at discharge and self-reported PF and caregiver proxy-reported PF during recovery of burned children. MATERIALS AND METHODS: This is a retrospective multisite longitudinal study in paediatric burn patients ((8-17 y old at time of burn). PF outcome measures were self-reported mobility, proxy-reported mobility, and upper extremity PF evaluated using PROMIS measures at 6-, 12-, and 24-months after injury. Primary exposure variable was BMI-for-age at discharge. RESULTS: A total of 118 paediatric patients, aged 11.7 ± 3.3 y, with burns covering 37.6 ± 18.8% of their total body surface area (TBSA) and BMI-for-age of 23.1 ± 5.4 kg/m2 at discharge were analyzed. BMI at discharge was not significantly associated with self-reported mobility scores 6 months after burn (beta coefficient =-0.23, p = 0.31), had a positive effect on mobility at 12 months (beta = 0.46, p = 0.05), and no effect at 24 months after injury (beta=-0.10, p = 0.60), when adjusted for burn size. BMI did not have a significant effect on proxy-reported mobility or upper extremity PF. CONCLUSION: A greater BMI at discharge was associated with improved self-reported PF at 12 months after burn but not at 6 months or 24 months, which suggests a faster recovery of PF in paediatric patients of larger body weight. Our data suggests that a larger body weight does not compromise the recovery of PF after burn.
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