The Effect of Burns on Children's Growth Trajectory: A Nationwide Cohort Study

Abstract

This study evaluates the short- and long-term effect of burns on children's height and weight, by comparing their pre and postburn growth trajectory. We invited children (≤17 years old), who sustained a burn requiring surgical treatment or admission at one of the Dutch burn centers in 2013 (n = 175). As well as children who sustained a severe burn, covering >10% of the total body surface area (TBSA), throughout 2009-2018 (n = 228). Data was collected from a survey on health-related topics, Youth Health Care records, and the Dutch Burn Repository R3. For all participants, height and weight were converted to Z-scores using Dutch reference values. Linear mixed modeling, nested on the individual level, was used to examine the associations between burns and children's height and weight Z-scores. Children's height and weight Z-scores remained within the normal range throughout the study period. During the first-year postburn, children's height and weight Z-scores decreased by -0.21 (95% CI -0.41, -0.01) and -0.23 (95% CI -0.46, -0.04), respectively. Beyond the first-year postburn, estimates were consistent with a positive linear association between burn size and the overall effect of burns on participants' height and weight Z-scores. This included a modest, but statistically significant, effect among participants with a burn covering ≤4.5% and >14.0% of the TBSA. Sensitivity analyses did not alter our findings. In conclusion, children were on track or even surpassed their growth potential. Our findings could therefore be considered reassuring to patients, parents, and clinicians.