Epidemiological analysis of burn patients in East Bulgaria

Epidemiology and mortality in patients hospitalized for burns in Catalonia, Spain

Burn injuries are one of the leading causes of morbidity worldwide. Although the overall incidence of burns and burn-related mortality is declining, these factors have not been analysed in our population for 25 years. The aim of this study has been to determine whether the epidemiological profile of patients hospitalized for burns has changed over the past 25 years. We performed a retrospective cohort study of patients hospitalised between 1 January 2011 and 31 December 2018 with a primary diagnosis of burns. The incidence of burns in our setting was 3.68/105 population. Most patients admitted for burns were men (61%), aged between 35 and 45 years (16.8%), followed by children aged between 0 and 4 years (12.4%). Scalding was the most prevalent mechanism of injury, and the region most frequently affected was the hands. The mean burned total body surface (TBSA) area was 8.3%, and the proportion of severely burned patients was 9.7%. Obesity was the most prevalent comorbidity (39.5%). The median length of stay was 1.8 days. The most frequent in-hospital complications were sepsis (16.6%), acute kidney injury (7.9%), and cardiovascular complications (5.9%). Risk factors for mortality were advanced age, high abbreviated burn severity index score, smoke inhalation, existing cardiovascular disease full-thickness burn, and high percentage of burned TBSA. Overall mortality was 4.3%. Multi-organ failure was the most frequent cause of death, with an incidence of 49.5%. The population has aged over the 25 years since the previous study, and the number of comorbidities has increased. The incidence and severity of burns, and the percentage of burned TBSA have all decreased, with scalding being the most prevalent mechanism of injury. The clinical presentation and evolution of burns differs between children and adults. Risk factors for mortality were advanced age, smoke inhalation, existing cardiovascular disease, full-thickness burn, and high percentage of burned TBSA.

Mortality Rate and Years of Life Lost Due to Burns in Southern Iran During 2004-2019: A Population-Based Study

BACKGROUND

Burns constitute one of the most important etiologies of infection and mortality worldwide, with the most significant number of cases in low- and middle-income countries. This is a cross-sectional study on deaths due to burns in southern Iran.

METHODS

In this study, data on all deaths due to burns in southern Iran between 2004 and 2019 was extracted from the population-based Electronic Death Registry System (EDRS). The Joinpoint Regression method was used to examine the trend of crude mortality rate, standardized mortality rate, and years of life lost (YLL) rate. In order to measure YLL, the number of deaths and life expectancy for different age and gender groups were used, for which the standard life table was considered.

RESULTS

During this study, 2175 deaths due to burns occurred, 50.6% (1106 cases) of which were in men and 38.7% (841 cases) were in the 15-29 age group. The crude and the standardized mortality rate had a decreasing trend during the study years. The total number of YLL was 25260 (0.8 per 1000) in men, 25,785 (0.8 per 1000) in women, and 51,045 (0.8 per 1000) in both genders during the 16 years of the study.

CONCLUSION

Considering the high mortality rate in the 15-29 age group, which consists of the active and productive labor force, necessary actions are needed in order to improve safety equipment and to make the workplace safe.

Epidemiology of hospitalized burns in Romania: A 10-year study on 92,333 patients

BACKGROUND

No epidemiological information is available of the number of burns treated in the past 30 years in Romania. The aim of the present study is to investigate the extent of burn injuries in Romania, as well as to detect and analyze the essential epidemiological characteristics.

METHODS

A comprehensive retrospective study was conducted over a period of 10 years (1.01.2006 to 31.12.2015). Patient-related data were obtained from the Diagnosis-related group (DRG) Center of National School of Public Health, Management and Professional Development, which is the only official national structure that collects and manages data concerning all the hospitalized patients in Romania.

RESULTS

Included in this study were all 92,333 patients with burn injury as the main International Classification of Diseases (ICD-10) code of discharge from Romanian hospitals. The data was analyzed using SPSS V.24, IBM Statistics Package. The annual number of burns decreased gradually from 10,547 in 2006 to 7313 in 2015, reaching statistical significance (p = 0.001). The incidence decreased from 47 cases per 100,000 in 2006 to 36.93 per 100,000 in 2015. The seasonal evolution showed that the number of burns increases in July-August (8.8% and 9.1% of annual burns). The mean length of stay (LoS) was 10.59 days, with the highest value in 2012 (11.00) and the lowest in 2014 (10.30). The median LoS and the mean LoS values during the 10 years period have a plateau-type evolution, with no tendency for improvement. We found a significant correlation (r = 0.708, p = 0.0118) between increased mortality and the year of study.

CONCLUSIONS

This is the first nationwide epidemiological study concerning hospitalized burns in Romania. It provides insight in demographical characteristics but also uncovers a worrying trend of increasing mortality rates, which requires further investigation. This study cannot make any reference to the severity of burns (surface and depth) or towards major burns events which unfolded during the studied period, due to lack of data. Consequently, it should raise awareness towards policymakers and caregivers that for a durable burns management strategy in Romania, it would be extremely useful to implement a national burn registry.

Burn Injuries in People Who Used Drug, 2009-2017: A Case-Control Study in Shiraz, Southern Iran

BACKGROUND

Burn injury is a critical health issue, which is associated with several morbidities and mortalities. Substance abuse, which is an important public health problem in Iran, can affect burn injury outcomes and etiologies in victims. This study was aimed to evaluate different aspects of burn injuries in people who used drug (PWUD) in two referral centers in the south of Iran.

METHODS

This Case-Control Study was conducted on burn victims referred to Amir-al Momenin Hospital and Ghotb-al-din Hospital from 2009 to 2017. Patients with a history of drug consumption were selected from the database and compared to randomly selected burn victims with no history of drug use. Demographics, burn etiology, underlying disease, total body surface area, hospitalization duration, and also the outcomes were collected and recorded in both groups. Data analysis was done by SPSS software.

RESULTS

A total of 5,912 inpatients were included in this study, which 2,397 of them (40.54%) were female. The mean age of the patients was 26.12 ± 19.18. Drug history was positive in 659 patients (11.15%). Familial issues and mental disorders were significantly higher in the PWUD group compared to the control group (P<0.001). Explosion etiology was significantly higher in the PWUD group (P<0.001). Psychiatric disorders (P<0.001), total body surface area (P=0.023), and hospital stay (P<0.001) were significantly higher in PWUD; however, the mortality rate had no statistically significant differences between the groups (P=0.583).

CONCLUSION

Substance abuse is a risk factor in burn victims, which can affect burn etiology and burn-related morbidities.

Factors Related to Pediatric Unintentional Burns: The Comparison of Logistic Regression and Data Mining Algorithms

Burn injuries are one of the traumas seen in all parts of the world and children are usually one of the vulnerable groups. The aim of this study was to determine the factors related to unintentional burns in children, using data mining algorithms. In this hospital-based case-control study conducted in Kermanshah province, Iran, data were collected over a period of 15 months. Children under the age of 15 years old who were referred to the burn ward of Imam Khomeini Hospital, the only burn referral in Kermanshah province, were included as cases. For the control group, children who were admitted to Dr. Mohammad Kermanshahi Hospital, the only specialist and subspecialist pediatric center in this province, were included. Frequency matching was performed for age and sex. Support vector machine, artificial neural network (ANN), random forest, and logistic regression were employed to determine the factors related to burns in children. The mean age of children with burn injuries was 4.29 ± 3.51 years and 58% of them were boys. The ANN algorithm had better performance than other algorithms. Body mass index (BMI), socioeconomic status, hours without a watchful, mother's age, mother's education, household size, father's job, father's age, having more than one watchful, and petroleum storage were the most important factors related to pediatric burns. The majority of the burn-related variables were related to individuals' social welfare status and their environments. Lessening the effects of these factors could reduce the incidence of pediatric burns.

Trends in burn injuries in Galicia (Spain): An epidemiological study

The treatment of burns is one of the earliest medical activities on record, probably because of the powerful impact of their physical consequences among other sequelae. The aim of the present paper is to perform an epidemiological study of burn patients. The data were obtained by reviewing the medical histories of all those patients admitted or treated in the Outpatients Department of the Burn Unit of our hospital between 2013 and 2017. A sample was gathered of 1401 patients, made up of 716 males (51.11%) and 685 females (48.89%), in a ratio of males to females of 1.05, with a mean age of 40.74 years old. The burns were mainly suffered in a domestic setting (60.96%), mostly as a result of contact with hot liquids. Most of the burns were second degree superficial burns (60.03%), and affected a mean total body surface area (TBSA) of 4.61%. They were most often produced on the hands. It was found that the frequency of burns increased during the summer and during the main mealtimes of the day. These data may be used to make specific plans of prevention, and as a basis for new studies and databases to be made.

Burn Pain: A Systematic and Critical Review of Epidemiology, Pathophysiology, and Treatment

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.

The trend of burn mortality in Iran - A study of fire, heat and hot substance-related fatal injuries from 1990 to 2015

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.

Recent trends in burn epidemiology worldwide: A systematic review

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.