Physical and Psychosocial Outcome Comparisons in Similar Groups of Pediatric Burn Patients in the United States and Mexico: A National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System Study

Pediatric massive burn survivors experience significant impairment in long-term physical function and psychosocial distress. Pediatric patients from the United States and Mexico with major burns likely receive similar care during the initial hospitalization given that many U.S. burn centers treat children with injuries from Mexico. However, follow-up care may differ, possibly affecting physical and psychosocial outcomes. This retrospective cohort study investigated differences in psychological and physical outcomes between pediatric burn patients residing in the United States and those residing in Mexico. Analysis included 100 patients, aged 8-17 years, residents of the United States or Mexico, who were hospitalized for burn injuries between 2015 and 2023 and enrolled in the Burn Model System database. Patient-Reported Outcomes Measures Information System measures of physical and psychological functioning were analyzed. Using univariate analyses, there was a significant difference in severity of burns, with the patients from Mexico having a greater total surface area of burn and an increased likelihood of amputation. Differences in the mechanism of burn, length of hospital stay, and ventilator days were not statistically significant when controlled for TBSA. Linear regression analyses examining the association between physical outcomes and country of residence (controlling for age, sex, TBSA, etiology of burn, and amputation) showed a significant difference in physical function outcomes at 6 months (P = .012) but no difference in fatigue, pain interference, or pain intensity. Analysis of psychosocial outcomes showed no significant difference in anger, depression, anxiety, or peer relationships at 6 months.