The association of patient and burn characteristics with itching and pain severity

•We performed an observational study to determine predictors of pruritus after burns.•Patients admitted to the burn unit of a tertiary care center, 58% male, 42% female.•53% of enrolled patients report varying levels of itching.•Multivariate analyses revealed age, sex (female), extent of burn injuri...

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Bibliographic Details
Published in:Burns 2019-03, Vol.45 (2), p.348-353
Main Authors: Prasad, Atulya, Thode, Henry C., Sandoval, Steven, Singer, Adam J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Body Surface Area
Burn management
Burns
Burns - complications
Burns - epidemiology
Burns - physiopathology
Child
Facial Injuries - epidemiology
Female
Humans
Itch management
Male
Middle Aged
Multivariate Analysis
Pain
Pain - epidemiology
Pain - etiology
Pain - physiopathology
Pain Measurement
Pruritus
Pruritus - epidemiology
Pruritus - etiology
Pruritus - physiopathology
Sex Factors
Trauma Severity Indices
Young Adult
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Summary:•We performed an observational study to determine predictors of pruritus after burns.•Patients admitted to the burn unit of a tertiary care center, 58% male, 42% female.•53% of enrolled patients report varying levels of itching.•Multivariate analyses revealed age, sex (female), extent of burn injuries, and location (face/neck) to be predictors of itch after burn. Itch after burn injury causes significant distress to patients and can hamper functional recovery. Itching can persist on a time scale ranging from several weeks to even years after injury. In this study, we sought to determine predictors of itching after burn injury. We compared itch and pain severity among patients included in a burn registry at a level 1 trauma center. Both itch and pain severity was based on a 5-point scale. ANOVA, chi-squared, and multivariate analyses were performed to determine predictors of itch and pain severity. Of the 1159 patients enrolled in the registry, 58% were male and 42% female, with a median age (IQR) of 27 (8–47) years. Most patients were diagnosed with 2nd degree superficial (41%) or deep (43%) burns. Upper extremities were the most common location of burn injury (59%), followed by lower extremities (31%), trunk (22%), and face/neck (20%). More than half (53%) of enrolled patients reported itching, ranging from minimal (19%) to severe (7%) itching. Multivariate analyses revealed age, sex (female), extent of burn injuries, and location (face/neck) to be predictors of itch after burn. Predictors of pain after burn were slightly different: age, extent of burn, and depth of burn. Pain and itch after burn injuries are predicted by slightly different variables, presumably secondary to different underlying mechanisms. We conclude that age, sex (female), extent of burn injuries (total body surface area %), and injuries to the face/neck predict itching of greater severity. Patients with burn injuries that match these parameters would require greater care and closer follow up to reduce itching after healing.
ISSN:0305-4179
1879-1409
DOI:10.1016/j.burns.2018.06.011