Epidemiological and Clinical Characteristics of Pediatric Burns: 6-Year Study Reveals Critical Data from Central China
Aug 23, 2024
2024/8/22
This study delves into pediatric burns, a critical public health issue, examining data from 5,569 burn cases from 2013 to 2019 at the Burn Research Center of the First People’s Hospital of Zhengzhou City. By analyzing the epidemiology and clinical characteristics of these cases, the paper provides valuable insights into risk factors and treatment outcomes for burn patients in central China.
1. The study found that scald burns were the leading cause of injuries, accounting for 90.63%, followed by flames (5.12%) and electrical burns (1.17%).
2. The most commonly affected body parts were the limbs (38.3%), with burn severity determined using the Burn Index (BI) and Abbreviated Burn Severity Index (ABSI) systems.
3. The study identified significant seasonal peaks, with January, May, and August seeing the highest burn rates, especially in rural areas where the incidence was notably higher (rural/urban ratio of 1.61:1).
4. Surgical intervention for burns has increased dramatically, from 3.8% in 2013 to 37.8% in 2019, reflecting the rise in full-thickness burns and the need for more aggressive treatment approaches.
5. The mortality rate was exceptionally low at 0.1%, with seven deaths reported. However, severe complications like shock (7.6%) and pneumonia (19.2%) remained prevalent.
Cited from: Epidemiological and Clinical Characteristics of 5,569 Pediatric Burns in Central China From 2013 to 2019
Author: C Lee, K Mahendraraj, A Houng, M Marano, S Petrone, R Lee
DOI: https://doi.org/10.3389/fpubh.2022.751615
Introduction
Burns in children are a major health concern worldwide, causing both physical and emotional damage. This study focuses on pediatric burns in Central China, drawing on 5,569 cases from the Burn Research Center. It aims to analyze the clinical characteristics, causes, and outcomes of these burns, with a focus on scalds, which are the most common cause of burns in children. The study spans 2013 to 2019 and includes critical data on factors such as length of stay, cost, and surgical interventions.
Method
The study retrospectively examined data from 5,569 pediatric burn patients treated at the Burn Research Center from 2013 to 2019. Data was collected from medical records, including demographic information (age, gender, etc.), burn characteristics (e.g., %TBSA, burn depth, and cause), and treatment outcomes. Statistical methods such as chi-squared tests and regression analysis were used to identify risk factors related to length of stay (LOS) and hospitalization costs. Descriptive statistics, including mean, standard deviation (SD), and interquartile range (IQR), were calculated to summarize the data. Comparisons between different groups of patients were made using appropriate statistical tests such as ANOVA for continuous variables and chi-squared for categorical variables.
Result
1. High Incidence of Scald Burns
The study revealed that scald burns were the dominant type of injury, accounting for 90.63% of the cases analyzed. This extremely high percentage is indicative of the widespread exposure children have to hot liquids such as water, milk, and soup, particularly in households without adequate child safety measures. The second most common cause, flame burns, was far behind at 5.12%, while electrical burns, although only 1.17% of cases, were associated with a higher rate of disability and complications.
To reach these conclusions, the researchers compiled and analyzed hospital records for each burn patient, categorizing the injuries by cause. The high frequency of scald injuries, especially among children under five years old, was attributed to domestic environments where toddlers are left unsupervised in kitchens or bathrooms. Seasonal peaks in scald incidents were observed during the summer and winter months, coinciding with vacation periods when children are more likely to be home.
Statistically, the gender ratio showed that boys were more commonly affected by burns, with a boy-to-girl ratio of approximately 1.4:1. This is consistent with previous epidemiological studies on pediatric injuries, where boys tend to be more active and prone to accidents. These findings highlight the need for targeted prevention strategies aimed at reducing scald burns in young children, especially in rural areas, where burn incidents are more prevalent.
2. Geographic and Seasonal Patterns
The study identified clear geographic disparities in burn incidence, with rural areas experiencing significantly more cases than urban areas. Specifically, 61.7% of pediatric burns occurred in rural areas, compared to 38.3% in urban settings, resulting in a rural/urban ratio of 1.61:1. This pattern reflects the socioeconomic and infrastructural differences between rural and urban regions. Rural households often lack adequate burn prevention measures, such as safe kitchen practices and water temperature controls, which are more commonly found in urban homes.
Seasonally, the study noted spikes in burn cases during January, May, and August. These months correspond to colder winter periods (January) when children are indoors and exposed to space heaters and hot liquids, as well as summer vacation months (May and August) when children are more likely to be home and unsupervised. Winter months saw a rise in flame-related injuries due to household heating methods like stoves, while summer months saw an increase in scald burns from hot water and cooking-related accidents.
The statistical analysis revealed significant associations between rural living, specific months, and higher burn risk. This geographic and seasonal data strongly suggests that public health interventions should be tailored to specific populations and times of the year, focusing on educating rural communities about burn prevention during peak months.
3. Increase in Surgical Interventions
One of the most striking findings of the study was the sharp increase in surgical interventions for pediatric burns over the six-year period. In 2013, only 3.8% of pediatric burn patients required surgery, but by 2019, this figure had risen dramatically to 37.8%. This rise is likely due to the increasing proportion of patients presenting with full-thickness burns, which necessitate more invasive treatment methods such as debridement and skin grafting.
Full-thickness burns, which affect all layers of the skin, are particularly challenging to treat and are associated with higher rates of complications, longer hospital stays, and increased healthcare costs. The study found that patients with larger burn areas, as measured by total body surface area (%TBSA), and those with deeper burns were more likely to require surgery. These patients also had a longer median length of stay (LOS) in the hospital, which was 15 days, compared to non-surgical cases.
The data also indicated that surgeries were more common in boys than in girls, with the youngest children (ages 0-1) being the most likely to undergo surgical treatment. Furthermore, rural patients were more likely to require surgical interventions than their urban counterparts, reflecting the delay in accessing care and the severity of injuries sustained. These findings underscore the importance of improving access to early treatment, especially in rural areas, to prevent the progression of burn injuries and reduce the need for surgery.
Conclusion
This six-year study provides a comprehensive look at pediatric burns in Central China, highlighting key trends such as the prevalence of scald burns, the rural/urban divide, and the increase in surgical interventions for severe cases. Future prevention strategies should focus on scald prevention, rural populations, and ensuring access to advanced burn care.
