Health Related Quality of Life in Children After Burn Injuries: A Systematic Review

Background Through improved survival of burns, more children have to deal with consequences of burns. Health-related quality of life (HRQL) measurement is important to qualify the perceived burden of burns in children. No systematic study of this outcome in children exist. Therefore, our objective was to review study designs, instruments, methodological quality, outcomes and predictors of HRQL in children after burns. Methods A systematic literature search was conducted in CINAHL, Embase, Google Scholar, Medline, The Cochrane library and Web of science (PROSPERO ID=CRD42016048065). Studies examining HRQL in pediatric burn patients were included. The risk of bias was assessed using the Quality in Prognostic Studies (QUIPS) tool. Results Twenty-seven studies using twelve HRQL instruments were included. The Burns Outcome Questionnaire 0-4 and 5-18 years old were most often applied. All longitudinal studies showed improvement of HRQL over time. However, problems were reported on the longer term on the domains '(parental) concern' and 'appearance'. Parental proxy scores were in general comparable to children’s self-ratings. Severity of burns, facial burns, hand burns, comorbidity and short time since burn predicted an impaired HRQL. The risk of bias of the studies was in general moderate. Conclusions HRQL in children after burns increases over time. Domains and patient groups that require special attention are identified. However, due to lack of comparability of studies, the available information could not be used optimally. To further improve our understanding of HRQL, consensus on design, data-analysis and data presentation is needed. Level of evidence Systematic review, level III Email addresses:spronki@maasstadziekenhuis.nl, legematec@maasstadziekenhuis.nl, s.polinder@erasmusmc.nl, baarm@maasstadziekenhuis.nl *Corresponding author: Inge Spronk, Association of Dutch Burn centers, Maasstad Hospital, PO Box 9100, 3007 AC Rotterdam, the Netherlands, Tel. 00 31 10 291 2739, Email: spronki@maasstadziekenhuis.nl. Conflict of Interest: None declared. Funding source: All phases of this study were supported by The Dutch Burn Foundation (grant number: 15.102 to MvB). The funding source had no role in any part of the study. © 2018 Lippincott Williams & Wilkins, Inc.

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