Malnutrition among pediatric burn patients: A consequence of delayed admissions.

Early definitive burn treatment is assumed to improve prognosis, in part because open wounds rapidly stimulate muscle catabolism and systemic inflammation. This study describes the incidence and management of injury associated malnutrition among pediatric burn patients transferred for definitive care 21-166 days following burn injury. Medical records of patients admitted to our hospital between January 2003 and January 2009, at least 3 weeks after burn injury, were retrospectively reviewed. Only children with an initial total body surface area (TBSA) burn of ≥20% were included in this study (n=36). Patients were classified as acutely well nourished or malnourished by the medical team. All patients were admitted with chronic open wounds (31±16% TBSA). Sixty-one percent (n=22) of patients were diagnosed with malnutrition. These patients had a significantly longer delay to transfer (26-166 days) than well nourished patients who transferred at 21-138 days (p<0.05). Average protein (2.8±0.18g/kg), and kilocalorie (1.6±0.1% basal metabolic rate) provision did not differ between groups. Incidence of infection was not different between well nourished and malnourished patients. Malnutrition occurs frequently among pediatric burn patients with delayed admissions. Adequate surgical care, infection control, and nutrition are required for wound healing.