Red Cross Hospital, Burn Centre Beverwijk, Vondellaan 13, Beverwijk, The Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Amsterdam University Medical Centre, Location VU University Medical Centre, de Boelelaan 1117, Amsterdam, The Netherlands.
J Burn Care Res. 2023 Sep 7;44(5):1083-1091. doi: 10.1093/jbcr/irad013.
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.
这项研究通过比较烧伤前后的生长轨迹,评估了烧伤对儿童身高和体重的短期和长期影响。我们邀请了 2013 年在荷兰烧伤中心接受过需要手术治疗或住院治疗的烧伤儿童(≤17 岁,n=175)以及 2009 年至 2018 年期间全身表面积(TBSA)>10%的严重烧伤儿童(n=228)参与研究。通过健康相关主题调查、青少年保健记录和荷兰烧伤资料库 R3 收集数据。对于所有参与者,身高和体重均使用荷兰参考值转换为 Z 分数。线性混合模型嵌套在个体水平上,用于研究烧伤与儿童身高和体重 Z 分数之间的关联。在整个研究期间,儿童的身高和体重 Z 分数均保持在正常范围内。烧伤后第一年,儿童的身高和体重 Z 分数分别下降了-0.21(95%CI-0.41,-0.01)和-0.23(95%CI-0.46,-0.04)。烧伤后第一年之后,烧伤面积与烧伤对参与者身高和体重 Z 分数的总体影响之间的估计值呈正线性关联。这包括 TBSA <4.5%和>14.0%的烧伤参与者中存在适度但具有统计学意义的影响。敏感性分析并未改变我们的发现。总之,儿童的生长轨迹良好,甚至超过了他们的生长潜力。因此,我们的研究结果可以被认为是对患者、家长和临床医生的一种安慰。