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Kang B, Sul J, Jeon S, Cheon S, Leem J, Jo S. Utilization of Acupuncture and Herbal Ointment Instead of Skin Graft Surgery for the Treatment of Burn Injuries: A Case Series and Literature review. J Burn Care Res 2021; 43:852-862. [PMID: 34718619 DOI: 10.1093/jbcr/irab210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Skin graft surgery is a standard treatment that increases the survival rate of patients with burn injuries; however, it leaves many sequelae. Conventional external preparations for the treatment of burns also have various side effects. In this retrospective case study, we assessed the cases of four patients with topical third-degree burns who did not wish to undergo the skin graft surgeries recommended by medical doctors and were thus treated using traditional medicine alone. A Korean medicine doctor administered integrative traditional medicine treatment to the patients using acupuncture and herbal ointments. Analysis of the patients' treatment photographs, quantitative evaluation indices, and vivid narratives suggested that their skin recovered well without adverse effects. Traditional Korean medicine treatment, including acupuncture and herbal ointment treatment, can be a new alternative therapeutic strategy for the treatment of patients with topical burns who do not want to undergo skin graft surgery or who have higher risks for poor surgical outcomes.
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Affiliation(s)
- Byungsoo Kang
- Graduate School of Korean Medicine, Dongshin University, 67, Dongsindae-gil, Naju-si, Jeollanam-do, Republic of Korea
| | - Jaeuk Sul
- Chung-Yeon Korean Medicine Hospital, 64 Sangmujungang-ro, Seo-gu, Gwangju, Republic of Korea
| | - Sangho Jeon
- Jayeonjaesaeng Korean Medicine Clinic, 434, Bongeunsa-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Seunghun Cheon
- Jayeonjaesaeng Korean Medicine Clinic, 434, Bongeunsa-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Jungtae Leem
- Research Center of Traditional Korean Medicine, Wonkwang University, Iksan-daero, Sin-dong, Iksan, Jeollabuk-do, Republic of Korea
| | - Seongjun Jo
- Jayeonjaesaeng Korean Medicine Clinic, 434, Bongeunsa-ro, Gangnam-gu, Seoul, Republic of Korea
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2
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Demir Yiğit Y, Yiğit E. Flame burns. Dermatol Ther 2021; 34:e15133. [PMID: 34532951 DOI: 10.1111/dth.15133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 09/13/2021] [Indexed: 11/27/2022]
Abstract
Flame burns lead to significant long-term morbidity and functional consequences. This study analyzed the mortality-related factors in patients with flame burns to compare with the existing literature. This retrospective descriptive study was carried out at the General Surgery Clinic, Gazi Yaşargil Training and Research Hospital, Turkey, to include 131 patients admitted and treated with emergency surgery for flame burns between January 2016 and December 2019. Of the patients hospitalized for flame burn, 103 (78.6%) were male and 28 (21.4%) were female (M:F = 3.6) with a mean age of 25.3 ± 20.78 years. The 15-34 years age group was the most affected by flame burns. The most frequently affected body areas were the upper extremities and face (n = 68, 51.9%); conjunctivitis developed in 49 (37.4%) patients. The wound infection rate was 34.3%, and Staphylococcus epidermidis had the highest growth rate in wound culture results (24.4%). Flame burns were most common in winter and autumn. The majority of patients (n = 95, 72.5%) were treated with escharectomy and dressing, while grafting was performed in 36 (27.5%) patients. A total of 3 (2.2%) patients died-one died in a suicide attempt, one due to inhalation burn after flame burn, and another died due to sepsis. The average length of hospital stay was 8.0 ± 3.9 days. Flame burns are much more common in young men, causing deeper and wider burns and requiring greater surgical intervention. This leads to frequent wound infections and longer hospital stays.
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Affiliation(s)
- Yasemin Demir Yiğit
- Department of Pediatrics, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Ebral Yiğit
- Department of General Surgery, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
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3
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Williams FN, Sljivic S, Chrisco L, Nizamani R, Cairns BA, Jones SW. Acuity Is Seasonal in a Tertiary Care Burn Center. J Burn Care Res 2021; 41:359-362. [PMID: 31634406 DOI: 10.1093/jbcr/irz172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Supply and demand dictate resource allocation in large academic institutions. Classic teaching is that burns is a seasonal specialty with winter being the "busiest" time of year. Resident allocation during the winter and summer months, however, is traditionally low due to the holidays and travel peaks. Our objective was to evaluate our acuity-defined as patient complexity-based on seasons, in order to petition for appropriate mid-level provider allocation. We performed a retrospective review of all admissions to an accredited, large academic burn center. All patients admitted between January 1, 2009 and December 31, 2018 were eligible for inclusion. Demographics, length of stay, injury characteristics, and mortality were evaluated. Thirteen thousand four hundred fifty-eight patients were admitted during this study period. Most patients were admitted during the summer. Patients admitted to the intensive care unit were more likely to be admitted in the winter, although this was not statistically significant. Winter admissions had the longest lengths of stay, and the highest incidence of inhalation injury. Female and elderly patients were more likely admitted during the winter. There was a significant difference in mortality between summer and winter seasons. Acuity is seasonal in our large academic burn center and resource allocation should align with the needs of the patients. This data may help large centers petition their institutions for more consistent experienced mid-level providers, specifically during critical seasons.
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Affiliation(s)
- Felicia N Williams
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.,North Carolina Jaycee Burn Center, Chapel Hill
| | - Sanja Sljivic
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.,North Carolina Jaycee Burn Center, Chapel Hill
| | - Lori Chrisco
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.,North Carolina Jaycee Burn Center, Chapel Hill
| | - Rabia Nizamani
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.,North Carolina Jaycee Burn Center, Chapel Hill
| | - Bruce A Cairns
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.,North Carolina Jaycee Burn Center, Chapel Hill
| | - Samuel W Jones
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.,North Carolina Jaycee Burn Center, Chapel Hill
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4
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Support needs of parents of hospitalised children with a burn injury: An integrative review. Burns 2020; 46:771-781. [DOI: 10.1016/j.burns.2019.04.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 02/11/2019] [Accepted: 04/17/2019] [Indexed: 11/18/2022]
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5
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Asena M, Akelma H, Salık F, Karahan ZA. The seasonal and monthly distribution of body limbs affected by burns in paediatric patients in southeast Turkey. Int Wound J 2019; 16:1273-1280. [PMID: 31419055 DOI: 10.1111/iwj.13178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 07/28/2019] [Indexed: 11/27/2022] Open
Abstract
Studies on the frequency of burned limbs according to season and months are limited. The burning of some body limbs, especially in some months, shows that the causes of burns are different, and knowing the reasons is important for providing preventive measures. The aims of this study were to determine the distribution rate of child burns by months and seasons and to contribute to preventive measures by determining the distribution of the burning of body limbs by months. We retrospectively evaluated 419 paediatric patients (0-17 years of age) who were hospitalised in the burn unit between 1 May 2017 and 1 November 2018. The demographic characteristics of the patients were recorded according to age, gender, months, and seasons of the patients admitted; cause of burns; degree of burns; total body surface area; and burning regions. The distribution of burns by months was established as being mainly in May to October. As for the distribution of the patients according to the seasons, it was found that it was most common in summer, 122 (29.1%), and in the autumn season as well, it was 122 (29.1%). While body burns increased in the summer-autumn seasons (P < .023), genital area burns were the lowest in winter and were the highest in summer and autumn seasons. Genital site burns increased statistically in September, October, and November (P < .010). Burn traumas are observed to be more frequent in some seasons and months. The environments where individuals live, forms of life, forms of warming, areas of interest, and sociocultural and economic levels are the causes of this variability.
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Affiliation(s)
- Muhammet Asena
- Department of Child Health and Diseases, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Hakan Akelma
- Department of Anesthesiology and Reanimation, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Fikret Salık
- Department of Anesthesiology and Reanimation, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Zeki A Karahan
- Department of General Surgery and Burn Clinic, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
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6
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Choi JH, Han D, Kang SH, Yoon CH, Cho JR, Kym D. Retrospective study of prognosis and relating factors of cardiac complications associated with electrical injuries at a single centre in Korea. BMJ Open 2019; 9:e028741. [PMID: 31296510 PMCID: PMC6624029 DOI: 10.1136/bmjopen-2018-028741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To date, no research has investigated the association between cardiac complication and electrical injury; hence, we aimed to assess the consequences and relating factors of cardiac complications from electrical injuries in South Korea. DESIGN Retrospective single-centre study. PARTICIPANTS 721 patients who had electrical injury-related admission during 2007-2017. An electronic medical record system was used to extract records of patients admitted for electrical injury treatment. RESULTS Cardiac complications included abnormal parameters of myocardial damage, abnormal regional wall motion detected via echocardiogram, dysrhythmia (eg, bradycardia, atrial flutter/fibrillation) and ventricular tachycardia or fibrillation. Overall, 107 patients (14.8%) experienced cardiac complications. The average admission duration and intensive care unit stay duration were significantly longer in patients with cardiac complications than in those without them (75.0±45.3 vs 56.6±48.0 days and 19.3±24.1 vs 10.4±15.5 days, respectively, p<0.01 for both). Of the total cardiac cases, 72.9% had Troponin I elevation, 3.7% had regional wall motion abnormality, and 5.6% had atrial flutter/fibrillation. Overall, seven patients from the cardiac complication group and three patients from the control group died (p=0.01). All deaths occurred within 32 days, and the most common cause of death was septic shock. Total body surface area (TBSA) was only positively related factor to cardiac complications. CONCLUSION This study is the first in South Korea to reveal that electrical accident patients with cardiac complications experience poorer in-hospital prognosis, and TBSA was the only risk factor of cardiac complications. And initial treatment for infection and inflammations could be important in electrical injury.
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Affiliation(s)
- Jae Hyuk Choi
- Division of Cardiology, Department of Internal Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Donghoon Han
- Division of Cardiology, Department of Internal Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Si-Hyuck Kang
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, Republic of Korea
| | - Chang-Hwan Yoon
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, Republic of Korea
| | - Jung Rae Cho
- Division of Cardiology, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Dohern Kym
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
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7
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Morgan M, Deuis JR, Frøsig-Jørgensen M, Lewis RJ, Cabot PJ, Gray PD, Vetter I. Burn Pain: A Systematic and Critical Review of Epidemiology, Pathophysiology, and Treatment. PAIN MEDICINE 2019; 19:708-734. [PMID: 29036469 DOI: 10.1093/pm/pnx228] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective This review aims to examine the available literature on the epidemiology, pathophysiology, and treatment of burn-induced pain. Methods A search was conducted on the epidemiology of burn injury and treatment of burn pain utilizing the database Medline, and all relevant articles were systemically reviewed. In addition, a critical review was performed on the pathophysiology of burn pain and animal models of burn pain. Results The search on the epidemiology of burn injury yielded a total of 163 publications of interest, 72 of which fit the inclusion/exclusion criteria, with no publications providing epidemiological data on burn injury pain management outcomes. The search on the treatment of burn pain yielded a total of 213 publications, 14 of which fit the inclusion/exclusion criteria, highlighting the limited amount of evidence available on the treatment of burn-induced pain. Conclusions The pathophysiology of burn pain is poorly understood, with limited clinical trials available to assess the effectiveness of analgesics in burn patients. Further studies are needed to identify new pharmacological targets and treatments for the effective management of burn injury pain.
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Affiliation(s)
- Michael Morgan
- Centre for Pain Research, Institute for Molecular Bioscience, The University of Queensland, St Lucia, Queensland, Australia
| | - Jennifer R Deuis
- Centre for Pain Research, Institute for Molecular Bioscience, The University of Queensland, St Lucia, Queensland, Australia
| | - Majbrit Frøsig-Jørgensen
- Centre for Pain Research, Institute for Molecular Bioscience, The University of Queensland, St Lucia, Queensland, Australia
| | - Richard J Lewis
- Centre for Pain Research, Institute for Molecular Bioscience, The University of Queensland, St Lucia, Queensland, Australia
| | - Peter J Cabot
- School of Pharmacy, The University of Queensland, Wooloongabba, Queensland, Australia
| | - Paul D Gray
- Tess Cramond Multidisciplinary Pain Centre, Royal Brisbane & Women's Hospital, Metro North Health, Herston, Queensland, Australia.,School of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Irina Vetter
- Centre for Pain Research, Institute for Molecular Bioscience, The University of Queensland, St Lucia, Queensland, Australia.,School of Pharmacy, The University of Queensland, Wooloongabba, Queensland, Australia
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8
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Sadeghian F, Saeedi Moghaddam S, Saadat S, Niloofar P, Rezaei N, Amirzade-Iranaq MH, Mehdipour P, Abbaszadeh Kasbi A, Ghodsi Z, Mansouri A, Sharif-Alhoseini M, Jazayeri SB, Aryannejad A, Ehyaee V, Naghdi K, Derakhshan P, Moradi-Lakeh M, Mokdad AH, O'Reilly G, Rahimi-Movaghar V. The trend of burn mortality in Iran - A study of fire, heat and hot substance-related fatal injuries from 1990 to 2015. Burns 2018; 45:228-240. [PMID: 30274812 DOI: 10.1016/j.burns.2018.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/30/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Burn injuries are a major cause of preventable mortality worldwide. To implement preventive strategies, a detailed understanding of the rate and trend of fatal burn injuries is needed. The aim of this study was to determine the rate and trend of burn mortality at national and province level in Iran from 1990 to 2015. MATERIALS AND METHODS The data were retrieved from various sources: the Death Registration System, cemetery databases, the Demographic and Health Survey and three national population and housing censuses. ICD-10 codes were converted to Global Burden of Disease (GBD) codes for comparability. After addressing the incompleteness of death data, statistical methods such as spatio-temporal modelling and Gaussian Process Regression (GPR) were applied to estimate the levels and trend of death and cause specific mortality. RESULTS The number of deaths due to burning across Iran was 80,625, with a male to female ratio of 0.88, 0.94 and 1.14 in 1990, 1995 and 2015, respectively. The annual percentage change of age-standardized death rate from 1990 to 2015 was -5.42% and -4.22% in women and men, respectively. The burn-related age-standardized mortality rate decreased considerably from 5.97 in 1990 to 1.74 per 100,000 in 2015. The mortality rate due to burns was highest among those aged more than 85 years, especially in Ilam province. CONCLUSION This study showed a decline in burn mortality in Iran from 1990 to 2015. Continued efforts to reduce the burden of burns are needed to accelerate this progress and prevent injuries.
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Affiliation(s)
- Farideh Sadeghian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Saadat
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parastoo Niloofar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Amirzade-Iranaq
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Universal Network of Interdisciplinary Research in Oral and Maxillofacial Surgery (UNIROMS), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Parinaz Mehdipour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Anita Mansouri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Behzad Jazayeri
- Department of Surgery, Kaiser Permanente, Fontana, CA, USA; Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, USA
| | - Armin Aryannejad
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Vida Ehyaee
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Khatereh Naghdi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Derakhshan
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, WA, USA
| | - Gerard O'Reilly
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Park JM, Park YS, Park I, Kim MJ, Kim KH, Park J, Shin DW. Characteristics of burn injuries among children aged under six years in South Korea: Data from the Emergency Department-Based Injury In-Depth Surveillance, 2011-2016. PLoS One 2018; 13:e0198195. [PMID: 29883475 PMCID: PMC5993236 DOI: 10.1371/journal.pone.0198195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 05/15/2018] [Indexed: 11/19/2022] Open
Abstract
Studies show that young children are vulnerable to burn injuries. We aimed to investigate the characteristics of thermal injuries in this population. We included children below 6 years of age who visited the emergency department (ED) after thermal injuries who were registered in the Korean Emergency Department-based Injury In-Depth Surveillance (2011-2016) database. Demographic characteristics, injury-related factors, and factors associated with ED treatment were gathered from the data. Then, we divided all children into two groups according to the ED discharge status: discharge versus admission (including cases transferred to other hospitals). The characteristics of the two groups were compared, and factors associated with admission were investigated. During the study period, 11,667 children with thermal injuries visited the ED. The number of boys was higher than the number of girls, and children aged 1 year accounted for the largest proportion. Most cases occurred in spring and indoors; the home was found to be the most common place. The most common type of burn was scald burns (69%), followed by contact burns (25.9%), and the most commonly burnt body area was the upper limbs (43.7%), followed by the lower limbs (16.8%). Most children (95.8%) were discharged home. The odds for hospital admission were lower for 2-3 and 4-5 year olds than for 0-1 year olds. The odds for hospital admission for contact burns were lower and those for electrical burns were higher than odds for hospital admission for scald burns. In summary, those aged 0-1 showed the largest incidence of thermal injuries and the most common burn mechanism was scald burns. Upper limbs were the most commonly affected body area, but their odds for requiring admission was lowest. Our results could be used as baseline data for prospective interventional studies investigating ways to reduce the incidence of childhood thermal injuries.
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Affiliation(s)
- Joon Min Park
- Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Yoo Seok Park
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Incheol Park
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Min Joung Kim
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
- * E-mail:
| | - Kyung Hwan Kim
- Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Junseok Park
- Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Dong Wun Shin
- Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
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10
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Tian H, Wang L, Xie W, Shen C, Guo G, Liu J, Han C, Ren L, Liang Y, Tang Y, Wang Y, Yin M, Zhang J, Huang Y. Epidemiologic and clinical characteristics of severe burn patients: results of a retrospective multicenter study in China, 2011-2015. BURNS & TRAUMA 2018; 6:14. [PMID: 29850643 PMCID: PMC5964711 DOI: 10.1186/s41038-018-0118-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 04/26/2018] [Indexed: 12/26/2022]
Abstract
Background Severe burns injury is a serious pathology, leading to teratogenicity and significant mortality, and it also has a long-term social impact. The aim of this article is to describe the hospitalized population with severe burns injuries in eight burn centers in China between 2011 and 2015 and to suggest future preventive strategies. Methods This 5-year retrospective review included all patients with severe burns in a database at eight institutions. The data collected included gender, age, month distribution, etiology, location, presence of inhalation injury, total burn surface area, depth of the burn, the length of hospitalization, and mortality. SPSS 19.0 software was used to analyze the data. Results A total of 1126 patients were included: 803 (71.3%) male patients and 323 (28.7%) female patients. Scalds were the most common cause of burns (476, 42.27%), followed by fire (457, 40.59%). The extremities were the most frequently affected areas, followed by the trunk. The median length of hospitalization was 30 (15, 52) days. The overall mortality rate was 14.21%. Conclusions Although medical centers have devoted intensive resources to improving the survival rates of burn patients, expenditures for prevention and education programs are minimal. Our findings suggest that more attention should be paid to the importance of prevention and the reduction of injury severity. This study may contribute to the establishment of a nationwide burn database and the elaboration of strategies to prevent severe burns injury.
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Affiliation(s)
- Hao Tian
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street no.29, Shapingba District, Chongqing, People's Republic of China
| | - Liangxi Wang
- Institute of Burn and Plastic Surgery, the 97th Hospital of PLA, Xuzhou, , Jiangsu People's Republic of China
| | - Weiguo Xie
- 3Department of Burns, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, Hubei People's Republic of China
| | - Chuanan Shen
- 4The Department of Burns and Plastic Surgery, First Affiliated Hospital of People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Guanghua Guo
- 5The Department of Burns and Plastic Surgery, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006 People's Republic of China
| | - Jiaqi Liu
- Institute of Burn Research Center of PLA, Xijin Hospital, Forth Military Medical University, Xi'an, Shaanxi 710032 People's Republic of China
| | - Chunmao Han
- 7Department of Burns and Wound Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hang Zhou, Zhejiang, 310009 People's Republic of China
| | - Licheng Ren
- 8Department of Burn Reconstruction Surgery, Xiangya Hospital, Central South University, Changsha, Hunan People's Republic of China
| | - Yi Liang
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street no.29, Shapingba District, Chongqing, People's Republic of China
| | - Yong Tang
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street no.29, Shapingba District, Chongqing, People's Republic of China
| | - Yuan Wang
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street no.29, Shapingba District, Chongqing, People's Republic of China
| | - Meifang Yin
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street no.29, Shapingba District, Chongqing, People's Republic of China
| | - Jiaping Zhang
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street no.29, Shapingba District, Chongqing, People's Republic of China
| | - Yuesheng Huang
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street no.29, Shapingba District, Chongqing, People's Republic of China
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11
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Retrospective analysis on thermal injuries in children—Demographic, etiological and clinical data of German and Austrian pediatric hospitals 2006–2015—Approaching the new German burn registry. Burns 2018. [DOI: 10.1016/j.burns.2017.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Choi J, Park S, Kim HC, D. P. Epidemiologic Analysis of Burns in Military Hospital. JOURNAL OF TRAUMA AND INJURY 2017. [DOI: 10.20408/jti.2017.30.4.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jangkyu Choi
- Department of Surgery, Burn Center, Armed Forces Capital Hospital, Seongnam, Korea
| | - Sejin Park
- Department of Surgery, Burn Center, Armed Forces Capital Hospital, Seongnam, Korea
| | - Hyun Chul Kim
- Department of Surgery, Burn Center, Armed Forces Capital Hospital, Seongnam, Korea
| | - Ph. D.
- Department of Surgery, Burn Center, Armed Forces Capital Hospital, Seongnam, Korea
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The accuracy of burn diagnosis codes in health administrative data: A validation study. Burns 2017; 43:258-264. [PMID: 28069344 DOI: 10.1016/j.burns.2016.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 11/02/2016] [Accepted: 11/07/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Health administrative databases may provide rich sources of data for the study of outcomes following burn. We aimed to determine the accuracy of International Classification of Diseases diagnoses codes for burn in a population-based administrative database. METHODS Data from a regional burn center's clinical registry of patients admitted between 2006-2013 were linked to administrative databases. Burn total body surface area (TBSA), depth, mechanism, and inhalation injury were compared between the registry and administrative records. The sensitivity, specificity, and positive and negative predictive values were determined, and coding agreement was assessed with the kappa statistic. RESULTS 1215 burn center patients were linked to administrative records. TBSA codes were highly sensitive and specific for ≥10 and ≥20% TBSA (89/93% sensitive and 95/97% specific), with excellent agreement (κ, 0.85/κ, 0.88). Codes were weakly sensitive (68%) in identifying ≥10% TBSA full-thickness burn, though highly specific (86%) with moderate agreement (κ, 0.46). Codes for inhalation injury had limited sensitivity (43%) but high specificity (99%) with moderate agreement (κ, 0.54). Burn mechanism had excellent coding agreement (κ, 0.84). CONCLUSIONS Administrative data diagnosis codes accurately identify burn by burn size and mechanism, while identification of inhalation injury or full-thickness burns is less sensitive but highly specific.
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15
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Santos JV, Oliveira A, Costa-Pereira A, Amarante J, Freitas A. Burden of burns in Portugal, 2000–2013: A clinical and economic analysis of 26,447 hospitalisations. Burns 2016; 42:891-900. [DOI: 10.1016/j.burns.2016.01.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/09/2016] [Accepted: 01/13/2016] [Indexed: 11/15/2022]
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Abstract
Purpose Our objective was to determine the risk factors for inpatient admission of pediatric burn patients. Materials & methods This cross-sectional study uses data from the Healthcare Cost and Utilization Project Kids' Inpatient Database (HCUP KID) for the years of 2003, 2006, 2009, and 2012 to estimate the risk factors for inpatient admission for pediatric patients who sustained a burn injury. Patients who sustained a burn between the ages of 1 and 18 years were included. Results A total of 43,453 patients met inclusion criteria. Of those, 42.3% were Caucasian, 20.1% were African American, and 19.3% were Hispanic. Males comprised 63.5% of the studied population. The month of July was associated with a 31.8% increased chance (p=.011) of being admitted to hospital for a pediatric burn. It was found that patients being admitted had a 32.2% increased chance (p=.002) of a fluid and electrolyte abnormality and a 61.0% increased chance (p=.027) of drug abuse. Conclusions Pediatric burn patients are more likely to be admitted to the hospital having a fluid and electrolyte abnormality, having a drug abuse status, and/or during the month of July.
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Affiliation(s)
- Alvin To
- Saint Louis University School of Medicine
| | - Yana Puckett
- Surgery, Texas Tech University Health Sciences Center
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Etiology, incidence and gender-specific patterns of severe burns in a German Burn Center – Insights of 25 years. Burns 2016; 42:687-96. [DOI: 10.1016/j.burns.2015.10.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/24/2015] [Accepted: 10/28/2015] [Indexed: 11/20/2022]
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Kim JB, Cho YS, Jang KU, Joo SY, Choi JS, Seo CH. Effects of sustained release growth hormone treatment during the rehabilitation of adult severe burn survivors. Growth Horm IGF Res 2016; 27:1-6. [PMID: 26843473 DOI: 10.1016/j.ghir.2015.12.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 12/17/2015] [Accepted: 12/31/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The catabolic phase following burn injuries increases caloric imbalance and results in substantial weight loss because of hypermetabolism; energy expenditures as high as twice the normal limit have been documented during the first 3 weeks. Furthermore, the wound size and healing duration seem to be related to the length of stay in the intensive care unit, which results in the loss of muscle mass, the so-called sarcopenia; weakness; and physical frailty. Possible therapeutic strategies include exercises, use of anabolic steroids, or replacement with human growth hormone (hGH). To determine the clinical effects of hGH on sarcopenia after burn injuries, we compared patients who received subcutaneous hGH injections during rehabilitation with control patients who received placebo treatment. METHODS A total of 33 patients with third degree burn injuries covering a total body surface area of >20% were randomly divided into a test group (n=18), which received 2-mg injections of sustained release hGH (SR-hGH) weekly for 3 months during rehabilitation, and a control group (n=15), which followed the same rehabilitation protocol with placebo injections. Muscular strength, cardiopulmonary function, body composition, and body weight were measured at baseline and 1 and 3 months after SR-hGH or placebo administration. RESULTS The mean age of patients was 37.67 ± 7.64 years in the SR-hGH group and 37.22 ± 8.19 years in the control group, while the interval between injury and SR-hGH or placebo injection was 123.7 ± 53.6 and 126.6 ± 43.5 days, respectively. The oxygen consumption at the lactate threshold, maximum oxygen consumption, lean body mass, knee extensor peak torque, and insulin-like growth factor 1 (IGF-1) and adiponectin levels were significantly higher in the SR-hGH group than in the control group at 3 months. There were no differences in the body weight, systolic and diastolic blood pressure (BP), bone mineral content, percentage body fat, and burn scar characteristics between groups. CONCLUSION Our results suggest that SR-hGH treatment during the rehabilitation of adult burn survivors positively affects physical fitness levels, muscle power, and metabolic processes, although further confirmation through research of metabolic pathways in burn survivors is required.
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Affiliation(s)
- June-Bum Kim
- Department of Pediatrics, Hallym University, College of Medicine, 94-200 Yeongdeungpo-Dong Yeongdeungpo-Ku, Seoul 150-030, South Korea.
| | - Yun Soo Cho
- Department of Rehabilitation Medicine, Hallym University, College of Medicine, 94-200 Yeongdeungpo-Dong Yeongdeungpo-Ku, Seoul 150-030, South Korea.
| | - Ki Un Jang
- Department of Rehabilitation Medicine, Hallym University, College of Medicine, 94-200 Yeongdeungpo-Dong Yeongdeungpo-Ku, Seoul 150-030, South Korea.
| | - So Young Joo
- Department of Rehabilitation Medicine, Hallym University, College of Medicine, 94-200 Yeongdeungpo-Dong Yeongdeungpo-Ku, Seoul 150-030, South Korea.
| | - Ji Soo Choi
- Department of Rehabilitation Medicine, Hallym University, College of Medicine, 94-200 Yeongdeungpo-Dong Yeongdeungpo-Ku, Seoul 150-030, South Korea.
| | - Cheong Hoon Seo
- Department of Rehabilitation Medicine, Hallym University, College of Medicine, 94-200 Yeongdeungpo-Dong Yeongdeungpo-Ku, Seoul 150-030, South Korea.
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Epidemiologic characteristics of death by burn injury from 2000 to 2009 in Colombia, South America: a population-based study. BURNS & TRAUMA 2016; 4:8. [PMID: 27574678 PMCID: PMC4963989 DOI: 10.1186/s41038-016-0033-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/09/2016] [Indexed: 11/16/2022]
Abstract
Background Burns are one of the most severe traumas that an individual can suffer. The World Health Organization (WHO) affirms that injuries related to burns are a global public health problem mainly in low- and middle-income countries. The first step towards reducing any preventable injury is based on accurate information. In Colombia, the basic epidemiological characteristics of burn injuries are unknown. The objectives were establishing the causes, high-risk populations, mortality rate, and tendencies of burn deaths. Methods Observational, analytical, population-based study based on official death certificate occurred between 2000 and 2009. All codes of the International Classification of Diseases-10th Revision (ICD-10) related to burns were included. The mortality rates were standardized using the WHO world average age weights 2000–2025. To determine the tendency, an average annual percent change (AACP) was calculated. Results A total of 5448 deaths due to burns were identified; 78.4 % were men. The crude and adjusted burn mortality rate was 1.270 and 1.302 per 100,000, respectively. The AACP was −5.25 %. Electrical injury caused the greatest number of deaths (49.5 %), followed by fire and lightning injuries. A total of 1197 (22.1 %) children were under 15 years old. The causes of deaths were different among age groups. 59.4 % deaths occurred outside health institutions. Conclusions This study is a first step in identifying the main causes of death and groups with higher mortality rates. Electricity is the main cause of deaths due to burn injury. Further research is required in order to generate awareness among government and community for reducing the number of injuries and burn deaths in our country.
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Segu S, Tataria R. Paediatric suicidal burns: A growing concern. Burns 2016; 42:825-9. [PMID: 26803366 DOI: 10.1016/j.burns.2015.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/20/2015] [Accepted: 12/27/2015] [Indexed: 10/22/2022]
Abstract
An alarming rise in rates of paediatric population committing self-immolation acts is a growing social and medical problem. In recent times there seems to be a rising concern in paediatric population. A study was conducted at a government tertiary care burn centre over 5 years in paediatric age group of <18 years who had committed self-immolation. Demographic data, aetiology, burn severity, associated illnesses, treatment and outcomes of the patients were collected with preventive strategies. Of total 89 patients, 12 patients were below 12 years (children) and 77 between 12-18 years (adolescent) with female preponderance. Majority belonged to lower middle and upper lower class families. Most had deep partial thickness burns. Psychiatric and personality disorder were found in 24.03% and 31.46% patients respectively. Kerosene was the main agent chosen to inflict injury. The average length of hospital stay was 19.8 days. The crude mortality rate observed was 38.2%. With cultural and socio-economic changes children and adolescents are exposed to increased levels of stress and peer pressure leaving them vulnerable. A multidisciplinary care involving medical, psychological and social support is required. Identifying children at risk and proper counselling and support can form an important strategy at prevention rather than cure.
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Affiliation(s)
- Smitha Segu
- Department of Plastic Surgery and Burns, Bangalore Medical College and Research Institute, Victoria Hospital, Bengaluru, Karnataka, India
| | - Rachana Tataria
- Department of Plastic Surgery and Burns, Bangalore Medical College and Research Institute, Victoria Hospital, Bengaluru, Karnataka, India.
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Oh H, Boo S. Burns in South Korea: An analysis of nationwide data from the Health Insurance Review and Assessment Service. Burns 2016; 42:675-81. [PMID: 26787128 DOI: 10.1016/j.burns.2015.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 10/01/2015] [Accepted: 10/02/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of the study was to identify and describe the incidence of burn injuries in patients seen and treated in South Korea. Characteristics of inpatients and outpatients with burns were analyzed according to gender, age, burn site, and burn severity. METHODS This retrospective study examined the characteristics of a stratified sample of burn patients seen and treated in South Korea during the calendar year 2011. The sample was drawn from the national patient database Health Insurance Review and Assessment (HIRA). RESULTS Approximately 1.71% of the total patients in the Patient Sample of HIRA for 2011 were burn-injured patients. The numbers of patients treated for burns were 913/10(5) males (n=8009) and 1454/10(5) females (n=11,881). Nearly all of these patients (94.1%) were covered by national health insurance and the majority of these patients (80.6%) were treated as outpatients. Nearly half of the burn injuries were of the upper extremities (43.5%), and most of these injuries (71.5%) were rated as second-degree burns. CONCLUSION A review of the national data on patients seen and treated for burns in 2011 revealed that people in South Korea may experience higher numbers and more severe cases of burns and burn-related injuries than found in other countries. General burn prevention programs as well as gender- and age-specific prevention strategies are needed to reduce the risk of burns in this population.
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Steinvall I, Elmasry M, Fredrikson M, Sjoberg F. Standardised mortality ratio based on the sum of age and percentage total body surface area burned is an adequate quality indicator in burn care: An exploratory review. Burns 2015; 42:28-40. [PMID: 26700877 DOI: 10.1016/j.burns.2015.10.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 10/28/2015] [Accepted: 10/29/2015] [Indexed: 11/27/2022]
Abstract
Standardised Mortality Ratio (SMR) based on generic mortality predicting models is an established quality indicator in critical care. Burn-specific mortality models are preferred for the comparison among patients with burns as their predictive value is better. The aim was to assess whether the sum of age (years) and percentage total body surface area burned (which constitutes the Baux score) is acceptable in comparison to other more complex models, and to find out if data collected from a separate burn centre are sufficient for SMR based quality assessment. The predictive value of nine burn-specific models was tested by comparing values from the area under the receiver-operating characteristic curve (AUC) and a non-inferiority analysis using 1% as the limit (delta). SMR was analysed by comparing data from seven reference sources, including the North American National Burn Repository (NBR), with the observed mortality (years 1993-2012, n=1613, 80 deaths). The AUC values ranged between 0.934 and 0.976. The AUC 0.970 (95% CI 0.96-0.98) for the Baux score was non-inferior to the other models. SMR was 0.52 (95% CI 0.28-0.88) for the most recent five-year period compared with NBR based data. The analysis suggests that SMR based on the Baux score is eligible as an indicator of quality for setting standards of mortality in burn care. More advanced modelling only marginally improves the predictive value. The SMR can detect mortality differences in data from a single centre.
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Affiliation(s)
- Ingrid Steinvall
- The Burn Centre, Department of Plastic Surgery, Hand Surgery, and Burns, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
| | - Moustafa Elmasry
- The Burn Centre, Department of Plastic Surgery, Hand Surgery, and Burns, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; The Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt
| | - Mats Fredrikson
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Folke Sjoberg
- The Burn Centre, Department of Plastic Surgery, Hand Surgery, and Burns, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Anaesthesiology and Intensive Care, Linköping University, Linköping, Sweden
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Marino M, Kimble R, Stockton K. Paediatric burns patients: Reasons for admission at a tertiary centre. Burns 2015; 41:708-13. [DOI: 10.1016/j.burns.2014.12.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 12/19/2014] [Indexed: 11/25/2022]
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Childhood burns in Sulaimaniyah province, Iraqi Kurdistan: A prospective study of admissions and outpatients. Burns 2015; 41:394-400. [DOI: 10.1016/j.burns.2014.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/16/2014] [Accepted: 07/08/2014] [Indexed: 11/15/2022]
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Chen SH, Chen YC, Chen TJ, Ma H. Epidemiology of burns in Taiwan: A nationwide report including inpatients and outpatients. Burns 2014; 40:1397-405. [DOI: 10.1016/j.burns.2014.01.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 01/03/2014] [Accepted: 01/20/2014] [Indexed: 11/24/2022]
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Laitakari E, Koljonen V, Pyörälä S, Rintala R. Outpatient treated burns in infants younger than 1 year in Helsinki during 2005–2009. Burns 2014; 40:489-94. [DOI: 10.1016/j.burns.2013.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/02/2013] [Accepted: 08/02/2013] [Indexed: 10/26/2022]
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Kumar S, Ali W, Verma AK, Pandey A, Rathore S. Epidemiology and mortality of burns in the Lucknow Region, India—A 5 year study. Burns 2013; 39:1599-605. [DOI: 10.1016/j.burns.2013.04.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 04/05/2013] [Accepted: 04/07/2013] [Indexed: 10/26/2022]
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Epidemiology and outcome of burns: Early experience at the country's first national burns Centre. Burns 2013; 39:358-62. [PMID: 22867734 DOI: 10.1016/j.burns.2012.07.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 07/02/2012] [Accepted: 07/12/2012] [Indexed: 11/16/2022]
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Hultman CS, Tong WT, Surrusco M, Roden KS, Kiser M, Cairns BA. To everything there is a season: impact of seasonal change on admissions, acuity of injury, length of stay, throughput, and charges at an accredited, regional burn center. Ann Plast Surg 2012; 69:30-4. [PMID: 22627496 DOI: 10.1097/sap.0b013e31823f3df0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Although previous studies have investigated the impact of weather and temporal factors on incidence of trauma admissions, there is a paucity of data describing the effect of seasonal change on burn injury. The purpose of this study was to examine the impact of the changing seasons on admissions to and resource utilization at an accredited burn center, with the goal of optimizing patient throughput and matching supply with demand. METHODS We performed a retrospective review of all burn admissions to an accredited, regional burn center, from Summer 2009 through Spring 2010. Patients were segregated into the seasonal cohorts of Summer, Fall, Winter, and Spring, based on admission date. Patient demographics included age, gender, mechanism of injury, and total body surface area (TBSA) injured. Main outcome measures included length of intensive care unit (ICU) stay, length of stay (LOS), and hospital charges, which served as a proxy for resource utilization (nursing, wound, and critical care; access to operating room (OR); inpatient rehabilitation). Groups were compared by T tests, with statistical significance assigned to P values <0.05. RESULTS Seven hundred thirty patients were admitted to the burn center during this annual period, with a mean age of 31.6 years and a TBSA of 8.9%. Although Spring had the greatest the number of admissions at 219 (30%), patients from Summer and Winter had the largest burns, longest length of ICU and hospital stays, and highest hospital charges (P < 0.05). Furthermore, variability of these parameters, as measured by standard deviation, was greatest during Summer and Winter, serving to reduce throughput via uneven demand on resources. Highest throughput occurred during the Spring, which had the highest admission-to-LOS ratio. No differences were observed in age, gender, and incidence of electrical injuries, across the 4 seasons. CONCLUSIONS Summer and winter were the peak seasons of resource utilization at our burn center, in terms of length and variability of ICU and hospital stays, as well as total hospital charges. Such seasonal change may be related to acuity of burn injury but not number of burn admissions. To improve operational efficiency and maximize patient throughput, resource allocation should be structured to anticipate seasonal changes, so that supply of services matches demand.
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Affiliation(s)
- C Scott Hultman
- Division of Plastic Surgery, University of North Carolina Health Care System, Chapel Hill, NC 27516-7195, USA.
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Othman N, Kendrick D. Risk factors for burns at home in Kurdish preschool children: a case-control study. Inj Prev 2012; 19:184-90. [DOI: 10.1136/injuryprev-2012-040412] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Engrav LH, Heimbach DM, Rivara FP, Kerr KF, Osler T, Pham TN, Sharar SR, Esselman PC, Bulger EM, Carrougher GJ, Honari S, Gibran NS. Harborview burns--1974 to 2009. PLoS One 2012; 7:e40086. [PMID: 22792216 PMCID: PMC3390332 DOI: 10.1371/journal.pone.0040086] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 05/31/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Burn demographics, prevention and care have changed considerably since the 1970s. The objectives were to 1) identify new and confirm previously described changes, 2) make comparisons to the American Burn Association National Burn Repository, 3) determine when the administration of fluids in excess of the Baxter formula began and to identify potential causes, and 4) model mortality over time, during a 36-year period (1974-2009) at the Harborview Burn Center in Seattle, WA, USA. METHODS AND FINDINGS 14,266 consecutive admissions were analyzed in five-year periods and many parameters compared to the National Burn Repository. Fluid resuscitation was compared in five-year periods from 1974 to 2009. Mortality was modeled with the rBaux model. Many changes are highlighted at the end of the manuscript including 1) the large increase in numbers of total and short-stay admissions, 2) the decline in numbers of large burn injuries, 3) that unadjusted case fatality declined to the mid-1980s but has changed little during the past two decades, 4) that race/ethnicity and payer status disparity exists, and 5) that the trajectory to death changed with fewer deaths occurring after seven days post-injury. Administration of fluids in excess of the Baxter formula during resuscitation of uncomplicated injuries was evident at least by the early 1990s and has continued to the present; the cause is likely multifactorial but pre-hospital fluids, prophylactic tracheal intubation and opioids may be involved. CONCLUSIONS 1) The dramatic changes include the rise in short-stay admissions; as a result, the model of burn care practiced since the 1970s is still required but is no longer sufficient. 2) Fluid administration in excess of the Baxter formula with uncomplicated injuries began at least two decades ago. 3) Unadjusted case fatality declined to ∼6% in the mid-1980s and changed little since then. The rBaux mortality model is quite accurate.
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Affiliation(s)
- Loren H Engrav
- Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, Washington, United States of America.
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Urban compared with rural and remote burn hospitalisations in Western Australia. Burns 2012; 38:591-8. [DOI: 10.1016/j.burns.2011.10.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 10/26/2011] [Accepted: 10/27/2011] [Indexed: 11/23/2022]
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Houshyarikhah H, Shayestehfard M, Javaherizadeh H, Cheraghian B, Latifzadeh S, Madari Z. Pediatric burns in Khuzestan Province, Iran. J Egypt Public Health Assoc 2012; 87:34-37. [PMID: 22415334 DOI: 10.1097/01.epx.0000408546.10870.8f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Burn injuries are the most frequently occurring injuries among pediatric populations worldwide, and they are significant pediatric injuries in Iran. AIM This study was conducted to analyze the pattern of pediatric burns in Khuzestan province in the south-west of Iran from April 2006 to March 2007. PATIENTS AND METHODS The location of the study was Taleghani Hospital, a sole center for burn patients in Khuzestan province. The number of patients with burns admitted to the center in 1 year (from April 2006 to March 2007) was 211. Data were obtained by reviewing the medical records of patients hospitalized at the center. RESULTS Of the patients, 85 (40.3%) were female and 126 (59.7%) were male. Of the 85 female patients, 50 were from urban areas and 35 were from rural areas. Of the 126 male patients, 68 (54%) were from urban areas and 58 (46%) were from rural areas. The mean ± SE age of the children ranging between 0 and 11 years was 3.20 ± 0.188. Scalding was the predominant cause of burns and caused 86.7% of the burns. The age of the patients with scald injuries (2.95 ± 2.56 years) was significantly lower than that of patients with flame injuries (4.28 ± 3.3 years) (P=0.007). Correlation analysis showed that younger children and urban residents are more vulnerable to scald injuries. The mean body surface area of burns was 20.5 ± 10.26 cm in all patients. CONCLUSION AND RECOMMENDATIONS Scalding was the most common cause of burns. Age <4 years and residency in urban areas were the major factors increasing the risk of burn accidents in children in Khuzestan. An appropriate burn prevention program, with focus on education, is needed to prevent this injury.
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Affiliation(s)
- Hojjat Houshyarikhah
- Abadan Faculty of Nursing, Ahvaz Jundishapur University of Medical Sciences, Abadan, Iran
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Duke J, Wood F, Semmens J, Edgar D, Spilsbury K, Rea S. An assessment of burn injury hospitalisations of adolescents and young adults in Western Australia, 1983–2008. Burns 2012; 38:128-35. [DOI: 10.1016/j.burns.2011.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 02/07/2011] [Accepted: 02/24/2011] [Indexed: 10/15/2022]
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A 26-Year Population-Based Study of Burn Injury Hospital Admissions in Western Australia. J Burn Care Res 2011; 32:379-86. [DOI: 10.1097/bcr.0b013e318219d16c] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Duke J, Wood F, Semmens J, Edgar DW, Spilsbury K, Hendrie D, Rea S. A study of burn hospitalizations for children younger than 5 years of age: 1983-2008. Pediatrics 2011; 127:e971-7. [PMID: 21382945 DOI: 10.1542/peds.2010-3136] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Burn injury is a leading cause of emergency department visits and hospitalizations for young children. We aimed to use statewide linked health administrative data to evaluate the incidence, temporal trends, and cause of burn injuries for children younger than 5 years hospitalized for burn injuries in Western Australia for the period 1983-2008. METHODS Epidemiologic analysis of linked hospital morbidity and death data of children younger than 5 years hospitalized with an index burn injury in Western Australia for the period 1983-2008. Poisson regression analyses were used to estimate temporal trends in hospital admissions and the external cause of the burn injury. RESULTS From 1983 to 2008, there were 5398 hospitalizations for an index burn injury and 3 burn-related deaths. Hospital admission rates declined by an average annual rate of 2.3% (incidence rate ratio: 0.977 [95% confidence interval: 0.974-0.981]). More than half of the admissions were for scald burns. Hospitalizations declined for injury caused by scald, flame, contact, and electrical burns; however, the number of hospital admissions increased for chemical burns during the study period. CONCLUSIONS The burn-injury hospitalizations reported in this study were preventable. Most burns occurred in the home and resulted from exposure to a household hazard. Further effort needs to be devoted to burn prevention and safety strategies, particularly in relation to scalds, to further reduce the incidence of burn injury in young children.
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Affiliation(s)
- Janine Duke
- Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth 6845, Western Australia.
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Brusselaers N, Monstrey S, Vogelaers D, Hoste E, Blot S. Severe burn injury in Europe: a systematic review of the incidence, etiology, morbidity, and mortality. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2010; 14:R188. [PMID: 20958968 PMCID: PMC3219295 DOI: 10.1186/cc9300] [Citation(s) in RCA: 369] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 04/21/2010] [Accepted: 10/19/2010] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Burn injury is a serious pathology, potentially leading to severe morbidity and significant mortality, but it also has a considerable health-economic impact. The aim of this study was to describe the European hospitalized population with severe burn injury, including the incidence, etiology, risk factors, mortality, and causes of death. METHODS The systematic literature search (1985 to 2009) involved PubMed, the Web of Science, and the search engine Google. The reference lists and the Science Citation Index were used for hand searching (snowballing). Only studies dealing with epidemiologic issues (for example, incidence and outcome) as their major topic, on hospitalized populations with severe burn injury (in secondary and tertiary care) in Europe were included. Language restrictions were set on English, French, and Dutch. RESULTS The search led to 76 eligible studies, including more than 186,500 patients in total. The annual incidence of severe burns was 0.2 to 2.9/10,000 inhabitants with a decreasing trend in time. Almost 50% of patients were younger than 16 years, and ~60% were male patients. Flames, scalds, and contact burns were the most prevalent causes in the total population, but in children, scalds clearly dominated. Mortality was usually between 1.4% and 18% and is decreasing in time. Major risk factors for death were older age and a higher total percentage of burned surface area, as well as chronic diseases. (Multi) organ failure and sepsis were the most frequently reported causes of death. The main causes of early death (< 48 hours) were burn shock and inhalation injury. CONCLUSIONS Despite the lack of a large-scale European registration of burn injury, more epidemiologic information is available about the hospitalized population with severe burn injury than is generally presumed. National and international registration systems nevertheless remain necessary to allow better targeting of prevention campaigns and further improvement of cost-effectiveness in total burn care.
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Affiliation(s)
- Nele Brusselaers
- Department of General Internal Medicine, Infectious Diseases and Psychosomatic Medicine, Ghent University Hospital, De Pintelaan 185, Ghent 9000, Belgium.
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Sadeghi-Bazargani H, Mohammadi R, Svanstrom L, Ekman R, Arshi S, Hekmat S, Malekpour N, Mashoufi M. Epidemiology of minor and moderate burns in rural Ardabil, Iran. Burns 2010; 36:933-7. [DOI: 10.1016/j.burns.2009.10.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 10/05/2009] [Accepted: 10/22/2009] [Indexed: 11/28/2022]
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Taghavi M, Rasouli MR, Boddouhi N, Zarei MR, Khaji A, Abdollahi M. Epidemiology of outpatient burns in Tehran: an analysis of 4813 cases. Burns 2010; 36:109-13. [PMID: 19818561 DOI: 10.1016/j.burns.2009.02.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Revised: 02/05/2009] [Accepted: 02/16/2009] [Indexed: 02/08/2023]
Abstract
This study aims to demonstrate the epidemiologic characteristics of outpatient burn injuries in Tehran. This cross-sectional study was performed over a 1-year period in a referral burn centre in Tehran and included all outpatient burns. The required data were recorded by two trained physicians. Of the 4813 studied patients, including 293 infants, 2901 patients (60%) were male (P<0.001). The mean age of the adult patients was 31.3+/-18.3 years, while for infants it was 10.68+/-2.27 months. In all age groups and both genders, scalding was the most common aetiology. Majority of the burns were non-intentional (n=4808) and 70.5% of the injuries occurred at home. Housewives consisted of 24% of the burn patients. With respect to the site of burn, multiple injuries were the most frequent (53%) followed by upper extremities (37%). Most of the burns (96%) were partial thickness. Significant association was present between the aetiology and depth of burn (P<0.001). The mean affected total body surface area (TBSA) was 3.16+/-2.92% and there was significant association between burnt TBSA and the mechanism of injury (P<0.001). In conclusion, it seems that women aged 21-30 years and children younger than 10 years are at greater risk of these injuries and therefore should be the target for preventive strategies.
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Affiliation(s)
- Morteza Taghavi
- Division of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Dissanaike S, Rahimi M. Epidemiology of burn injuries: highlighting cultural and socio-demographic aspects. Int Rev Psychiatry 2009; 21:505-11. [PMID: 19919203 DOI: 10.3109/09540260903340865] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Burns are devastating injuries that disproportionately affect people in developing countries, including children. In addition to a high mortality rate, survivors are burdened with life-long physical and emotional scars. The etiology and nature of burn injuries varies significantly by country, and this chapter explores the predominant causes and patterns of burn injury in both the developing and industrialized worlds. Gender differences play a significant role in the risk of burn injuries, across a spectrum with a predominance of women injured in fires from cooking and heating fuels in the developing world and industrial accidents primarily affecting men in developed nations. Children are particularly vulnerable to burn injuries, accounting for almost 50% of all burn patients in some studies. A majority of pediatric burns are scald injuries usually affecting very young children below the age of 5 years, and we discuss the behavioral patterns underlying this finding. Finally, the elderly form a rapidly increasing proportion of the population in many countries, and are often burdened with comorbidities that are likely to pose significant challenges in burn care.
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Affiliation(s)
- Sharmila Dissanaike
- Division of Trauma and Burn Care, Department of Surgery, and Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA.
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Torabian S, Saba MS. Epidemiology of paediatric burn injuries in Hamadan, Iran. Burns 2009; 35:1147-51. [DOI: 10.1016/j.burns.2009.06.194] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 06/04/2009] [Accepted: 06/04/2009] [Indexed: 11/28/2022]
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Pelvic Fracture and Risk Factors for Mortality: A Population-Based Study in Taiwan. Eur J Trauma Emerg Surg 2009; 36:131-7. [PMID: 26815687 DOI: 10.1007/s00068-009-9094-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Accepted: 06/30/2009] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To study the incidence, demographics, distribution of fracture sites, associated injuries, and risk factors for the outcomes of pelvic fracture on a population basis. METHODS An annual claim dataset from 2001 to 2003 was retrieved from the Bureau of National Health Insurance (BNHI) trauma database with any International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) coded as pelvic fracture. Statistical analyses were conducted to discover the association between variables such as age, gender, month of injury, injury mechanisms, associated injuries, and outcome. RESULTS Pelvic fracture was diagnosed in 10,109 patients (4,693 males, 46.4%) and 384 patients (3.8%) died. The incidence was 14.97/100,000 person-years. The mean length of stay was 9.3 days (females, 8.8 days; males, 9.9 days; p < 0.01) and the average cost per patient was US$1,475. Both were affected by age, gender, and hospital accreditation level and ownership. There were more female cases in the age groups over 44 years old. Head injury (excluding concussion), associated chest and abdominal injuries, open pelvic fracture, and the transfusion of more than four units of blood significantly increased the risk of mortality. CONCLUSIONS The incidence rate of pelvic fracture was higher in females over 44 years of age, but the average medical resource use was higher in males. Associated injuries were stronger positive factors for the risk of mortality than gender, fracture sites, injury mechanisms, and the characteristics of the treating hospitals.
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Changing trends of an endemic trauma. Burns 2009; 35:650-6. [DOI: 10.1016/j.burns.2009.01.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Revised: 12/28/2008] [Accepted: 01/08/2009] [Indexed: 11/21/2022]
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The epidemiology of burn injuries in an Australian setting, 2000-2006. Burns 2009; 35:1124-32. [PMID: 19482430 DOI: 10.1016/j.burns.2009.04.016] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Revised: 04/09/2009] [Accepted: 04/09/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To describe presentation characteristics of burn leading to death or hospital treatment (i.e. inpatient admissions and emergency department [ED] presentations) across the state of Victoria, Australia, for the years 2000-2006 inclusive. METHODS Data were provided by the Victorian Injury Surveillance Unit (VISU) from three different datasets pertaining to burn deaths, hospital inpatient admissions and non-admitted ED presentations. Population estimates were derived from census data provided by Australian Bureau of Statistics. RESULTS During the 7-year period, 178 people died and 36,430 were treated for non-fatal burn injury, comprising 7543 hospital admissions and 28,887 non-admitted ED presentations. Males, children aged less than 5 years of age, and the elderly (> or =65 years of age) were at the highest risk of injury. Contact with heat and hot substances represented the major aetiological factor contributing to thermal injuries accounting for 64% of all hospital admissions and 90% of ED presentations. Temporal trends indicate no change in the population rate of burn deaths or hospital admissions during the study period. CONCLUSIONS ED presentations and hospital admissions and deaths have remained the same over this study period, but rates of burn remain high in males, children and the elderly. This could be due to variations in the implementation of government prevention and control programs and the divergence in efficient treatments and clinical practices amongst hospital care providers. Therefore, educational efforts for prevention should be the keystone to minimise the incidence of burns.
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Mashreky S, Rahman A, Chowdhury S, Giashuddin S, SvanstrÖm L, Linnan M, Shafinaz S, Uhaa I, Rahman F. Epidemiology of childhood burn: Yield of largest community based injury survey in Bangladesh. Burns 2008; 34:856-62. [DOI: 10.1016/j.burns.2007.09.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022]
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Greenwood JE, Tee R, Jackson WL. INCREASING NUMBERS OF ADMISSIONS TO THE ADULT BURNS SERVICE AT THE ROYAL ADELAIDE HOSPITAL 2001?2004. ANZ J Surg 2007; 77:358-63. [PMID: 17497976 DOI: 10.1111/j.1445-2197.2007.04060.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The purpose of the study was to illustrate the increasing trend in the number of adult burns patients admitted to the Royal Adelaide Hospital and attempt to explain it and to describe the burn patients admitted to the Royal Adelaide Hospital in terms of age, sex, origin, cause and burn size, particularly since the increasing trend began, in an effort to identify a particular group or burn cause, which may make up a large proportion of the increasing numbers. METHODS A retrospective review of 1548 acute burn-injured patients using information from the burns unit database between 1996 and 2004 was carried out. RESULTS Of 1841 total admissions, 1548 were admitted for acute burn injury. There has been an increase in the number of admissions since 2001 amounting to approximately 20% per annum. The cumulative rise in total admissions 2000-2004 is 107% where the increase in acute burn admission in the same period is 82%. There appears to be no difference whether the patient is from a rural or a metropolitan area. Burns of <10% total body surface area constitute most of the increase and are mainly flame and scald injuries. Chemical and contact burns are proportionately increasing. CONCLUSION The increase in acute admissions is mainly due to the increasing presentation of smaller burns to the unit. The statewide rural burn education programme and media exposure following the 2002 Bali bombings may have contributed to the increase in acute admissions.
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Affiliation(s)
- John E Greenwood
- Burns Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
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Jang YC, Lee JW, Han KW, Han TH. Burns in epilepsy: seven years of experience from the Hallym Burn Center in Korea. J Burn Care Res 2007; 27:877-81. [PMID: 17091086 DOI: 10.1097/01.bcr.0000245649.38644.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this retrospective epidemiological study was to identify the characteristics of burn injuries of seizure disorder patients in Korea, with the goal of developing programs to prevent or reduce the frequency and morbidity of such injuries. We reviewed the medical records of 34 acutely burned, epileptic-seizure patients who were admitted to a single regional burn center unit during the 7 years between January 1997 and April 2003, all of whom had been burned during an epileptic seizure. The most commonly associated seizure type was generalized tonic-clonic, followed by absence and complex partial. Females predominated in all age groups. There were more seizures in the morning hours between 3 and 10 am. The mean age was 43 +/- 16 years. Seizures occurred at home, while the patient was conducting daily household chores. Scalding was the most common injury, leaving small-but-deep wounds that required a mean hospital stay of 37 +/- 27 days. Typically, upper limbs and trunk were affected. To implement a successful burns injury-prevention program, patients with epilepsy should be better recognized as a high-risk group. Specific passive as well as active recommendations are suggested based on the epidemiologic features of seizure disorder patients in Korea.
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Affiliation(s)
- Young Chul Jang
- Department of Plastic and Reconstructive Surgery, Hallym Burn Center, Hangang Sacred Heart Hospital, Seoul, Korea
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Akerlund E, Huss FRM, Sjöberg F. Burns in Sweden: An analysis of 24538 cases during the period 1987–2004. Burns 2007; 33:31-6. [PMID: 17223486 DOI: 10.1016/j.burns.2006.10.002] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Accepted: 10/03/2006] [Indexed: 10/23/2022]
Abstract
Burn care is always progressing, but there is little epidemiological information giving a clear picture of the current number of treated burns in Sweden. This study was conducted to provide an update of patients admitted to hospital with burns in Sweden. Data were obtained for all patients who were admitted to hospitals with a primary or secondary diagnosis of burns (ICD-9/10 codes) from 1 January 1987 to 31 December 2004; 24,538 patients were found. Most of the patients were male (69%), giving a male:female ratio of 2.23:1. Children in the age-group 0-4 years old predominated, and accounted for 27% of the study material. The median length of stay was 3 days. Throughout the period 740 patients (3%) died of their burns. Significant reductions in mortality, incidence, and length of stay were seen during the study, which correlates well with other studies. However, most of the reductions were in the younger age-groups. Men accounted for the improved mortality, as female mortality did not change significantly. We think that the improvement in results among patients admitted to hospital after burns is a combination of preventive measures, improved treatment protocols, and an expanding strategy by which burned patients are treated as outpatients.
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Affiliation(s)
- Emma Akerlund
- Department of Plastic Surgery, Hand Surgery, and Burns, University Hospital of Linköping, Linköping, Sweden
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