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Elrod J, Adathal A, Mohr C, Neuhaus K, Schiestl C, Böttcher-Haberzeth S. As time goes by - Overlooking 40 years of inpatient burn treatment at a national pediatric burn center in Switzerland. Burns 2024; 50:236-243. [PMID: 37690964 DOI: 10.1016/j.burns.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 08/12/2023] [Accepted: 08/18/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Despite extensive prevention programs, burns remain a frequent cause of injury in Switzerland with a known age peak in children. Pediatric burns may cause substantial morbidity, a psyochological burden and therapy related high economic costs. To improve preventive measures, precise knowledge of etiology and treatment of pediatric burns in Switzerland as well as their temporal evolution is indispensable. METHODS The present retrospective analysis included pediatric burn patients admitted for acute treatment to the Pediatric Burn Center of the University Children`s Hospital Zurich over the last four decades. Sociodemographic, injury related, and treatment related data were extracted from medical records. Linear regression analysis was applied to determine temporal changes during the past four decades and chi-square and t-tests were applied wherever applicable. RESULTS A total of 3425 acute burn patients were included in the study between 1977 and 2020, corresponding to a mean of 89 patients/year. Mean age was 3.60 ± 4.12 years, three quarters of all patients were preschool children (0-5 years) and mean total body surface area (TBSA) burned was 8.01% ± 9.57%, however only around one fifth had severe burns (>10% TBSA). Scald burns (65.31%) and flame burns (32.99%) were most commonly seen. Linear regression analysis showed the total number of thermal injuries treated at our center to have increased significantly as of 2004 (p < 0.001). Separate analysis showed the same for small and medium (<10% TBSA) burns (p < 0.001), whereas the number of severe burns did not increase significantly. Length of stay (LOS) was highly associated with %TBSA burned. The percentage of female patients amongst all patients increased over time (p = 0.012). LOS per TBSA burned decreased significantly (p < 0.001). CONCLUSION The present data show pediatric burns to remain a major health burden in Switzerland, especially small and medium burns in preschool children. Prevention programs should focus on this age population as well as on scald and flame burns as most common etiologies. The observed decrease in length of stay suggests a major improvement in overall quality of care in pediatric burns and supports centralization of care.
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Affiliation(s)
- Julia Elrod
- Pediatric Burn Center, Children's Skin Center, Department of Surgery, University Children's Hospital Zurich; University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany
| | - Ashal Adathal
- Pediatric Burn Center, Children's Skin Center, Department of Surgery, University Children's Hospital Zurich; University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Christoph Mohr
- Pediatric Burn Center, Children's Skin Center, Department of Surgery, University Children's Hospital Zurich; University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany
| | - Kathrin Neuhaus
- Pediatric Burn Center, Children's Skin Center, Department of Surgery, University Children's Hospital Zurich; University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| | - Clemens Schiestl
- Pediatric Burn Center, Children's Skin Center, Department of Surgery, University Children's Hospital Zurich; University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| | - Sophie Böttcher-Haberzeth
- Pediatric Burn Center, Children's Skin Center, Department of Surgery, University Children's Hospital Zurich; University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland.
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Chen K, Liu J, Wang X, Chu P, Feng G, Zeng Y, Xu X, Guo Y, Ni X. Epidemiological characteristics of paediatric burn patients in China from 2016 to 2019: a retrospective study. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001796. [PMID: 37156562 PMCID: PMC10174007 DOI: 10.1136/bmjpo-2022-001796] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/25/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Epidemiological characteristics of paediatric burn can help to protect children from burn injuries. Most of the previous studies have been conducted on small scale and single centre in China. This study analysed the epidemiological characteristics of paediatric burn using a large-scale and multicentre database from 23 children's hospitals in China to increase child protection against burn injuries, improve the quality of care and reduce hospitalisation costs. METHODS Excerpted information from medical records of 6741 paediatric burn cases was extracted from the Futang Research Center of Pediatric Development database from 2016 to 2019. The epidemiological characteristics of patients, including gender, age, cause of burn injuries, complication, the timing of hospitalisation (season and month) and hospitalisation length and cost, were collected. RESULTS Male gender (63.23%), aged 1-2 years (69.95%), and hydrothermal scald (80.57%) were significantly dominant among cases. Furthermore, complications were significantly different among groups with different age of patients. Pneumonia was the most common complication (21%). Meanwhile, most paediatric burn occurred in spring (26.73%), and hospitalisation length and cost significantly depended on the cause of the burn injuries and surgical intervention. CONCLUSIONS This large-scale epidemiological study of paediatric burn in China revealed that boys aged 1-2 years with higher activity and lack of self-awareness are more likely to suffer from burn injuries by hydrothermal scald. In addition, complications, especially pneumonia, need attention and early prevention in paediatric burn.
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Affiliation(s)
- Kun Chen
- Department of Burn & Plastic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Jing Liu
- Department of Burn & Plastic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Xinyu Wang
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Ping Chu
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Disaeases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Guoshuang Feng
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Yueping Zeng
- Medical Record Management Office, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Xin Xu
- Infromation Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Yongli Guo
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Disaeases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Xin Ni
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Disaeases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
- Department of Otolaryngology Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children' s Health, Beijing, People's Republic of China
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Nakarmi KK, Pathak BD. Prevalence of Acute Pediatric Burns in a Tertiary Care Hospital. JNMA J Nepal Med Assoc 2020; 58:862-865. [PMID: 34506422 PMCID: PMC7775026 DOI: 10.31729/jnma.5233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Burn injury is an important cause of mortality and morbidity in children worldwide. Mortality is higher in developing countries than in developed ones. Most of them occur in predictable domestic settings and can be prevented. The objective of this study was to find out the prevalence of acute pediatric burns in a hospital setting. METHODS A descriptive cross-sectional study was conducted by reviewing the secondary data of burn cases admitted during the years 2016 AD to 2018 AD in a tertiary care hospital after taking ethical clearance from the Institutional Review Committee (IRC No. 016-2019). The sample size was calculated and systematic random sampling was done. Data analysis was done using Statistical Package for the Social Sciences, version 23. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS The prevalence of acute pediatric burns at the hospital was found to be 101 (29.71%) (24.85-34.57 at 95% Confidence Interval). The majority of them were males 54 (53.47%) and toddlers 39 (38.61%). Scalding 54 (53.47%) was the main etiology. Most of the burn injuries occurred inside the house 76 (75.25%) and on November 11 (10.9%). The mortality rate was 11 (10.89%). CONCLUSIONS The prevalence of acute pediatric burns in a hospital setting was lower than most other countries but mortality was higher. The majority of the burn injuries occurred inside the house. Therefore, special focus should be done on prevention at the household level. Adequate medical services for emergency management of childhood burns should be available in different parts of the country.
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Affiliation(s)
- Kiran Kishor Nakarmi
- Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Kathmandu, Nepal
| | - Bishnu Deep Pathak
- Nepalese Army Institute of Health Sciences, Bhandarkhal, Kathmandu, Nepal
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Richards H, Kokocinska M, Lewis D. A five year review of paediatric burns and social deprivation: Is there a link? Burns 2017. [DOI: 10.1016/j.burns.2017.01.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Smolle C, Cambiaso-Daniel J, Forbes AA, Wurzer P, Hundeshagen G, Branski LK, Huss F, Kamolz LP. Recent trends in burn epidemiology worldwide: A systematic review. Burns 2017; 43:249-257. [PMID: 27600982 PMCID: PMC5616188 DOI: 10.1016/j.burns.2016.08.013] [Citation(s) in RCA: 340] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/20/2016] [Accepted: 08/12/2016] [Indexed: 11/30/2022]
Abstract
Burns have been more prevalent among low socioeconomic populations and in less developed regions. Incredible advances in burn care and social development over the recent decades, however, should have placed the incidence and severity of burns in a downwards trend. The aim of this review was to give an overview on current trends in burn epidemiology across the world. Also the socioeconomic development in countries that have published epidemiological data used in this study has been taken into account when comparing the results. There was a worldwide downwards trend of burn incidence, burn severity, length of hospital stay, and mortality rate. These findings were particularly pronounced in very highly developed countries. Data from highly and medium developed countries were more heterogeneous. No studies could be obtained from low and middle income countries. Comparisons between the different studies were compromised by the fact that studies emerged from specialized facilities on one hand and general hospitals on the other. Analyzed studies were also frequently focusing on limited patient populations such as "children" or "elderly". Our findings indicate the need for an international burn database with a minimal data-set in order to obtain objective and comparable results in respect of burn epidemiology.
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Affiliation(s)
- Christian Smolle
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria.
| | - Janos Cambiaso-Daniel
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria
| | - Abigail A Forbes
- School of Medicine, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0724, USA
| | - Paul Wurzer
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria; Department of Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0724, USA; Shriners Hospitals for Children, 815 Market St., Galveston, TX 77550-2725, USA
| | - Gabriel Hundeshagen
- Department of Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0724, USA; Shriners Hospitals for Children, 815 Market St., Galveston, TX 77550-2725, USA
| | - Ludwik K Branski
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria; Department of Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0724, USA; Shriners Hospitals for Children, 815 Market St., Galveston, TX 77550-2725, USA
| | - Fredrik Huss
- Burn Center, Department of Plastic- and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden; Department of Surgical Sciences, Plastic Surgery, Uppsala University, 751 85 Uppsala, Sweden
| | - Lars-Peter Kamolz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria
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Abstract
Background This study aimed to assess the epidemiological characteristics of pediatric burns in Beijing City. Methods This was a retrospective study of pediatric patients (n = 400) admitted to four burn centers in Beijing City between June 2010 and May 2011. Burn severity was determined according to total body surface area (TBSA) percentage and degree. Patients were followed up for one year. Multivariate analyses were carried out to determine the factors (burn etiology, time and place of injury, living conditions, hospital type, first-aid treatment methods, and parent/guardian knowledge of burns, educational level, occupation) affecting burn properties (severity and pigmentation/scar). Results 191/400 (47.8 %) patients were aged 2-3 years, and scalding was the leading etiology (355/400, 88.8 %). Burn incidence peaked in May (14.8 %), at 10:00-12:00 and 17:00-20:00. Most burn events occurred indoors (272/400, 68.0 %), especially in the kitchen (180/400, 45.0 %). Roughly half of them involved head and neck; 188 (47.0 %) patients had mild burns, 140 (35.0 %) moderate, 44 (11.0 %) extensive, and 28 (7.0 %) critical burns; 184 (46.0 %) patients were treated only with cold-water rinsing or compress; 120 (30.0 %) received no first aid. Only 32 (8.0 %) patients visited a specialized institution. 164 patients underwent surgery. Hospitalization lasted for 14.8 ± 8.1 days. Independent risk factors for burn severity were occurrence month, living conditions, occupation of the mother, and first aid. 288 (72.0 %) patients developed pigmentation and scar within a year while no independent risk factors was observed. Conclusions Pediatric burns often occurred indoors, especially in the kitchen, and a substantial proportion receives no first aid. Electronic supplementary material The online version of this article (doi:10.1186/s12887-016-0686-7) contains supplementary material, which is available to authorized users.
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Epidemiologic characteristics, knowledge and risk factors of unintentional burns in rural children in Zunyi, Southwest China. Sci Rep 2016; 6:35445. [PMID: 27748426 PMCID: PMC5066217 DOI: 10.1038/srep35445] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/29/2016] [Indexed: 11/27/2022] Open
Abstract
We investigated the knowledge level and risk factors for pediatric unintentional burns in rural Southwest China with an aim to provide basic evidence for the prevention strategies. A stratified sampling method was used to recruit 1842 rural children from 9 schools. Self-reported burns during the past 12 months and relevant risk factors were collected by questionnaires. The burn incidence of all surveyed children was 12.7% (95% confidence interval [95% CI] 11.2–14.2%). We found that burn incidence had a trend to increase with the increasing school grade level and a trend to decrease with increasing knowledge scores on burns. The top two causes of burns were hot liquids (36.3%) and hot object (29.5%). More than 30% of children had little knowledge about preventive measures and how to give first-aid after burns. The main risk factors for burns included female gender, left-behind children by parents who were working in cities, and poor mother school education level. As the incidence of pediatric unintentional burns was high in rural southwest China, schools, families, and local public health agencies should put efforts into health education targeting burn prevention and first-aid measures after burns, particularly in “left-behind” children and those with mothers with poor education.
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Wang KA, Sun Y, Wu GS, Wang YR, Xia ZF. Epidemiology and outcome analysis of hand burns: A 5-year retrospective review of 378 cases in a burn center in Eastern China. Burns 2015; 41:1550-5. [DOI: 10.1016/j.burns.2015.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 04/18/2015] [Accepted: 04/20/2015] [Indexed: 10/23/2022]
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Chen XJ, Sun WJ, Wang J, Han DZ, Gao GZ, Yan DX, Zhao XC, Yao XW, Wang L, Wang GS. Epidemiology of bedside stove burns in a retrospective cohort of 5089 pediatric patients. Burns 2014; 40:1761-9. [DOI: 10.1016/j.burns.2014.03.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 03/14/2014] [Accepted: 03/25/2014] [Indexed: 11/27/2022]
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Zhou B, Zhou X, Ouyang LZ, Huang XY, Zhang PH, Zhang MH, Ren LC, Liang PF. An epidemiological analysis of paediatric burns in urban and rural areas in south central China. Burns 2014; 40:150-6. [DOI: 10.1016/j.burns.2013.04.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 03/27/2013] [Accepted: 04/30/2013] [Indexed: 10/26/2022]
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Zhu L, Zhang Y, Liu L, Jiang J, Liu Y, Shi F, Yi D. Hospitalized Pediatric Burns in North China: A 10-year epidemiologic review. Burns 2013; 39:1004-11. [DOI: 10.1016/j.burns.2012.12.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 11/13/2012] [Accepted: 12/15/2012] [Indexed: 11/16/2022]
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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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