245 An Investigation of Pain Responses Among Burn Injured Children
Bibliographic record
Abstract
The purpose of this study is to investigate whether children who were burned in infancy experience greater pain after a medical procedure than those burned later in childhood. According to research carried out by Wollgarten-Hadamek et al. (2009; 2011), children who have received treatment for a severe burn injury in infancy may have altered pain responses in later childhood. Thus, our group is specifically interested in determining if these findings are valid among burn patients treated at our pediatric burn center. A retrospective cohort study was conducted at our institution. Children admitted between 2014 and 2018 were divided into two groups: 1) burn sustained during infancy (< 2 years) and 2) burn sustained during post-infancy (> 2–18 years). Pain scores following laser treatment of the resulting burn scar were compared between the two groups. The pain management model for acute burn care at our institution includes using a closed dressing technique coupled with sedation/anesthesia for dressing changes +/- the use of narcotics followed by acetaminophen and ibuprofen. Contributing factors examined in the analysis included site of injury (critical areas: face, hands, feet, perineum, major joints) and total body surface area (TBSA) of the original burn. Patients without pain scores or those that had laser therapy combined with another medical procedure were excluded. Ninety-nine patients met the inclusion criteria. The mean age at injury and TBSA was 1.1 years (SD, 0.66) and 10.7% (SD, 9.01) in the younger group and 7.9 years (SD, 4.1) and 10.9% (SD, 9.74) in the older group. The incidence of pain in the younger and older groups was 28.6% (95% CI, 0.15–0.42) and 28.0% (95% CI, 0.16–0.40) respectively. There was no significant difference in the odds of reporting pain between the two age groups with respect to: 1) site of injury (OR=0.57 (95% CI, 0.12- 2.68) versus OR=1.02 (95% CI, 0.30–3.47)) and 2) burn size (OR=0.85 (95% CI, 0.21–3.4) versus OR=0.38, (95% CI, 0.11–1.27)). In this retrospective cohort study, children burned in infancy did not experience increased pain compared to children burned later in life. Although larger-scale prospective studies are needed to confirm these findings, the results of this study further our understanding of pain responses following a burn injury. The findings obtained from this study contribute to the limited body of literature regarding pain in pediatric burn patients and suggest that early age at injury may not lead to hyperalgesia later in life. Ultimately, the results of this study and future subsequent studies could be used to help design an optimal pain management protocol for burn-injured children.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".