PURPOSE: Burn injuries affect over half a million Americans annually. As acute outcomes improve, long-term sequelae such as chronic sensory disturbances have become increasingly important determinants of quality of life (QoL). Paresthesia, which are abnormal non-painful sensations such as tingling or numbness, are common after burn injury and affect up to 82% of patients. Despite the high prevalence in burn patients, paresthesia is understudied compared to pain. This study isolates the independent effect of paresthesia on QoL and mental health in burn survivors, accounting for pain intensity. METHODS: Data were obtained from the Burn Model System (BMS) National Database, a multicenter longitudinal cohort of burn patients in the United States. Paresthesia was identified through patient responses to the question: "Do you feel numbness, pins and needles, or burning sensations in your burn scar?" QoL was assessed using the PROMIS-29 profile at 12 months post-injury, generating T-scores for Anxiety, Depression, Fatigue, Sleep Disturbance, Physical Function, and Social Roles (mean = 50, SD = 10). Multivariable linear regression evaluated the association between paresthesia and PROMIS domains, adjusting for age, total body surface area (TBSA) burned, inhalation injury, and pain intensity. Pain was categorized as low (50) or high (≥50) based on PROMIS pain interference T-scores. Patients were also stratified into four groups (low/high pain × with/without paresthesia), and outcomes were compared using ANOVA and Tukey-Kramer post hoc tests. RESULTS: A total of 669 patients (mean age = 47.9 ± 16.6 years; 68% male; mean TBSA = 17%) completed the 12-month follow-up. Paresthesia was independently associated with higher PROMIS T-scores for Fatigue (β = 1.88, p = 0.014), Anxiety (β = 2.05, p = 0.006), Sleep Disturbance (β = 2.01, p = 0.008), and Depression (β = 1.93, p = 0.010), indicating worse outcomes. Paresthesia was not associated with a change in Physical Function or Social Roles (p 0.05). Patients who regained sensation showed improved Physical Function (β = 2.57, p = 0.017). Stratified analysis revealed that among high-pain patients, those with paresthesia reported significantly higher Anxiety (55.5 vs. 49.3, p 0.001), Depression (54.4 vs. 50.0, p = 0.003), Fatigue (55.4 vs. 51.8, p = 0.026), Sleep Disturbance (55.2 vs. 51.4, p = 0.011), and Social Role Functioning (46.6 vs. 50.0, p = 0.028). No significant differences were observed between low-pain patients with or without paresthesia (p 0.1 across all domains). CONCLUSION: Paresthesia is a frequent and clinically meaningful complication of burn injury, independently associated with poorer mental health and fatigue at one-year post-injury. Its detrimental effects are amplified in patients with high pain, suggesting a compounding interaction between paresthesia and pain in shaping long-term QoL. These findings highlight the need for clinicians to assess and treat paresthesia alongside pain in burn rehabilitation to optimize functional and psychological recovery. *Source: https://ps-rc.org/meeting/Program/2026/EP102.cgi*