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Barčot Z, Kralj R, Kurtanjek M, Petračić I, Tadić K, Žic R, Sović S. The association between improved standard of living and paediatric burns. Burns 2022; 48:683-687. [PMID: 34670716 DOI: 10.1016/j.burns.2021.05.015] [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: 10/11/2020] [Revised: 05/07/2021] [Accepted: 05/25/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION In the "Children's Hospital Zagreb Referral Centre for Paediatric Trauma of the Ministry of Health Republic of Croatia (MHC)" we observed a significant decline in the number of both hospitalised and ambulatory treated paediatric patients with burn injuries in the period from 2011 to 2018. Our hypothesis is that this decline could be either due to the decline of the paediatric population of Croatia or due to the economic growth and the improvement in the standard of living that Croatians have enjoyed in the past decade. MATERIALS AND METHODS In this observational study, we analysed data on the numbers of patients treated due to burn injuries from January 2011 to December 2018 in the Children's Hospital Zagreb Hospital. Indicators of standard of living and population size estimates were obtained from Eurostat and the Croatian Bureau of Statistics. Associations between the proportion of people with poor standard of living and the number of treated patients were analysed with logistic regression models. RESULTS Percentage of the population with low housing standards, percentage of Croatians with low level of education, percentage of children that live in jobless households, and percentage of children at risk of poverty and social exclusion were predictors of the rate of hospital admissions, ambulatory treated patients and total number of treatments. The slight decrease in the rate of treated patients was interrupted with notable decline in 2014 followed by the slight increase in 2015. Over following years, the rate did not change remarkably. CONCLUSION Apart from the decline of the paediatric population of Croatia, it is reasonable to assume that the improvement in the standard of housing, level of education and employment rate as well as the reduction in the risk of poverty and social exclusion in children had a notable contribution to the decline in the rate of paediatric burns in the observed period.
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Affiliation(s)
- Zoran Barčot
- Department of Paediatric Surgery, Children's Hospital Zagreb, Klaićeva 16, 10 000 Zagreb, Croatia.
| | - Rok Kralj
- Department of Paediatric Surgery, Children's Hospital Zagreb, Klaićeva 16, 10 000 Zagreb, Croatia.
| | - Mario Kurtanjek
- Department of Paediatric Surgery, Children's Hospital Zagreb, Klaićeva 16, 10 000 Zagreb, Croatia.
| | - Ivan Petračić
- Department of Paediatric Surgery, Children's Hospital Zagreb, Klaićeva 16, 10 000 Zagreb, Croatia.
| | - Karlo Tadić
- School of Medicine, University of Zagreb, Šalata 3b, Zagreb, Croatia.
| | - Rado Žic
- Department of Plastic, Reconstructive and Aesthetic Surgery, Clinical Hospital Dubrava, Avenija Gojka Šuška 6, 10 000 Zagreb, Croatia.
| | - Slavica Sović
- Department of Medical Statistics, Epidemiology and Medical Informatics, Andrija Štampar School of Public Health School of Medicine University of Zagreb, John Davidson Rockefeller 4, Zagreb, Croatia.
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Pieptu V, Moscalu R, Mihai A, Moscalu M, Pieptu D, Azoicăi D. Epidemiology of hospitalized burns in Romania: A 10-year study on 92,333 patients. Burns 2022; 48:420-431. [PMID: 34670711 DOI: 10.1016/j.burns.2021.05.020] [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: 11/26/2020] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- V Pieptu
- Department of Plastic and Reconstructive Surgery, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
| | - R Moscalu
- The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
| | - A Mihai
- Department of Plastic and Reconstructive Surgery, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
| | - M Moscalu
- Department of Informatics and Biostatistics, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
| | - D Pieptu
- Department of Plastic and Reconstructive Surgery, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
| | - D Azoicăi
- Department of Epidemiology, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
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Oguntala G, Indramohan V, Jeffery S, Abd-Alhameed R. Triple-layer Tissue Prediction for Cutaneous Skin Burn Injury: Analytical Solution and Parametric Analysis. INTERNATIONAL JOURNAL OF HEAT AND MASS TRANSFER 2021; 173:120907. [DOI: 10.1016/j.ijheatmasstransfer.2021.120907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Aghaei A, Soori H, Ramezankhani A, Mehrabi Y. Factors Related to Pediatric Unintentional Burns: The Comparison of Logistic Regression and Data Mining Algorithms. J Burn Care Res 2020; 40:606-612. [PMID: 31116850 DOI: 10.1093/jbcr/irz066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Abbas Aghaei
- Department of Epidemiology and Biostatistics, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hamid Soori
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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5
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Sarginson JH, Hollén L, Emond A, Mackie I, Young AE. Multicentre observational study describing the systemic response to small-area burns in children. Burns 2020; 47:560-568. [PMID: 32855002 DOI: 10.1016/j.burns.2020.07.020] [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: 01/02/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Burns of less than 10% total body surface area (TBSA) are common injuries in children under five years of age. The inflammatory response to burn injury is well recognised for burns greater than 20% TBSA but has not been described for smaller burns. The aim of this study was to describe the systemic response to burn injury in young children with small-area burns. METHODS The Morbidity In Small Thermal Injury in Children study (MISTIC) was a multicentre prospective observational cohort study that recruited 625 patients under five years of age with burns of less than 10% TBSA over eighteen months across three sites in England. Prospectively collected data included physical observations and laboratory blood tests taken in hospital as part of routine care. Additional information was sourced from temperature recordings taken at home following discharge. RESULTS Elevated temperatures were observed in children with scald or contact burns between 2-10% TBSA, with a peak on day one after burn followed by a fall over days four to seven after burn. No temperature rise was seen in children with burns of <2% TBSA. Higher temperature readings were associated with larger burn size, age under two years and male sex. Heart rate and C-Reactive Protein levels showed a peak on day three after burn. CONCLUSIONS An identifiable systemic inflammatory response to small-area burns in young children is reported. This knowledge can be used to aid in the diagnosis of children with a burn injury who re-present with a pyrexia, and no other symptoms to indicate clinical infection.
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Affiliation(s)
- Julia H Sarginson
- Children's Burns Research Centre, Bristol Royal Hospital for Children, UK.
| | - Linda Hollén
- Children's Burns Research Centre, Bristol Royal Hospital for Children, UK; Centre for Academic Child Health, Bristol Medical School, University of Bristol, UK
| | - Alan Emond
- Children's Burns Research Centre, Bristol Royal Hospital for Children, UK; Centre for Academic Child Health, Bristol Medical School, University of Bristol, UK
| | - Ian Mackie
- Children's Burns Research Centre, Bristol Royal Hospital for Children, UK; South West UK Children's Burns Centre, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, UK; Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Amber E Young
- Children's Burns Research Centre, Bristol Royal Hospital for Children, UK; South West UK Children's Burns Centre, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
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6
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McInnes JA, Cleland HJ, Cameron PA, Darton A, Tracy LM, Wood FM, Singer Y, Gabbe BJ. Epidemiology of burn-related fatalities in Australia and New Zealand, 2009–2015. Burns 2019; 45:1553-1561. [DOI: 10.1016/j.burns.2019.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/03/2019] [Accepted: 07/02/2019] [Indexed: 10/26/2022]
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Davies K, Johnson EL, Hollén L, Jones HM, Lyttle MD, Maguire S, Kemp AM. Incidence of medically attended paediatric burns across the UK. Inj Prev 2019; 26:24-30. [PMID: 30792345 PMCID: PMC7027111 DOI: 10.1136/injuryprev-2018-042881] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 11/25/2022]
Abstract
Objective Childhood burns represent a burden on health services, yet the full extent of the problem is difficult to quantify. We estimated the annual UK incidence from primary care (PC), emergency attendances (EA), hospital admissions (HA) and deaths. Methods The population was children (0–15 years), across England, Wales, Scotland and Northern Ireland (NI), with medically attended burns 2013–2015. Routinely collected data sources included PC attendances from Clinical Practice Research Datalink 2013–2015), EAs from Paediatric Emergency Research in the United Kingdom and Ireland (PERUKI, 2014) and National Health Services Wales Informatics Services, HAs from Hospital Episode Statistics, National Services Scotland and Social Services and Public Safety (2014), and mortality from the Office for National Statistics, National Records of Scotland and NI Statistics and Research Agency 2013–2015. The population denominators were based on Office for National Statistics mid-year population estimates. Results The annual PC burns attendance was 16.1/10 000 persons at risk (95% CI 15.6 to 16.6); EAs were 35.1/10 000 persons at risk (95% CI 34.7 to 35.5) in England and 28.9 (95% CI 27.5 to 30.3) in Wales. HAs ranged from 6.0/10 000 person at risk (95% CI 5.9 to 6.2) in England to 3.1 in Wales and Scotland (95% CI 2.7 to 3.8 and 2.7 to 3.5, respectively) and 2.8 (95% CI 2.4 to 3.4) in NI. In England, Wales and Scotland, 75% of HAs were aged <5 years. Mortality was low with 0.1/1 000 000 persons at risk (95% CI 0.06 to 0.2). Conclusions With an estimated 19 574 PC attendances, 37 703 EAs (England and Wales only), 6639 HAs and 1–6 childhood deaths annually, there is an urgent need to improve UK childhood burns prevention.
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Affiliation(s)
- Katie Davies
- Division of Population Medicine, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK
| | - Emma Louise Johnson
- Division of Population Medicine, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK
| | - Linda Hollén
- Division of Population Medicine, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK.,Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK.,The Scar Free Foundation Centre for Children's Burn Research, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Hywel M Jones
- Division of Population Medicine, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK
| | - Mark D Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK.,Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.,Paediatric Emergency Research, Ireland, UK
| | - Sabine Maguire
- Division of Population Medicine, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK.,The Scar Free Foundation Centre for Children's Burn Research, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Alison Mary Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK .,The Scar Free Foundation Centre for Children's Burn Research, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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8
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Santos JV, Viana J, Oliveira A, Ramalho A, Sousa-Teixeira J, Duke J, Amarante J, Freitas A. Hospitalisations with burns in children younger than five years in Portugal, 2011-2015. Burns 2019; 45:1223-1230. [PMID: 30686698 DOI: 10.1016/j.burns.2019.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/21/2018] [Accepted: 01/01/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Paediatric population still represents a high burden of hospitalisations among burns inpatients. Children under five years old have a distinct aetiology distribution comparing to other age groups, representing in Portugal a fifth of all hospitalisations with burns. We aimed to describe the demographic and clinical burden of burns requiring hospitalization, as well as hospitalization charges, among this age group in Portugal. METHODS We performed a retrospective study including inpatients younger than five years-old and discharged between 2011 and 2015 in a public Portuguese hospital with a main or secondary diagnosis of burns (ICD-9-CM: 940.xx-949.xx). Clinical and demographics characteristics were assessed, as well as hospital reimbursement charges. RESULTS A total of 1217 hospitalisations with burns were found, with a hospitalization rate of 54.6 hospitalisations/100,000 inhabitants/year, higher among boys. Ninety percent of them were due to hot liquid or objects. There were three in-hospital deaths. There was a median length of stay of 9days and a mean hospitalization reimbursed charge of 3073 Euros (4918 I$). Non-rural: rural hospitalization rate ratio was of 0.42:1. Évora and Bragança were the districts with higher hospitalization rate with 116 and 107, respectively. DISCUSSION This Portuguese nation-wide study on hospitalisations with burns highlights that 90% of all burns were due to hot liquid or object and a major impact of patients younger than 2years old in this age group. Urban vs rural difference in hospitalization rate should also be considered for further health inequalities' studies. As conclusion, ongoing attention needs to be dedicated to paediatric burn prevention and safety cost-effective strategies, particularly in relation to scalds, to further reduce the incidence of burn hospitalisations in children and the associated hospital costs.
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Affiliation(s)
- João Vasco Santos
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Portugal; Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Portugal.
| | - João Viana
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Portugal
| | - Andreia Oliveira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal
| | - André Ramalho
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Portugal; FGV Management (Getúlio Vargas Foundation), São Paulo, Brazil
| | - Joana Sousa-Teixeira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal
| | - Janine Duke
- Burn Injury Research Unit, Faculty of Health and Medical Sciences, The University of Western Australia, Australia
| | - José Amarante
- Department of Surgery, Faculty of Medicine, University of Porto, Portugal
| | - Alberto Freitas
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Portugal
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Duke JM, Randall SM, Vetrichevvel TP, McGarry S, Boyd JH, Rea S, Wood FM. Long-term mental health outcomes after unintentional burns sustained during childhood: a retrospective cohort study. BURNS & TRAUMA 2018; 6:32. [PMID: 30460320 PMCID: PMC6233288 DOI: 10.1186/s41038-018-0134-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 10/17/2018] [Indexed: 01/29/2023]
Abstract
Background Burns are a devastating injury that can cause physical and psychological issues. Limited data exist on long-term mental health (MH) after unintentional burns sustained during childhood. This study assessed long-term MH admissions after paediatric burns. Methods This retrospective cohort study included all children (< 18 years) hospitalised for a first burn (n = 11,967) in Western Australia, 1980-2012, and a frequency matched uninjured comparison cohort (n = 46,548). Linked hospital, MH and death data were examined. Multivariable negative binomial regression modelling was used to generate incidence rate ratios (IRR) and 95% confidence intervals (CI). Results The burn cohort had a significantly higher adjusted rate of post-burn MH admissions compared to the uninjured cohort (IRR, 95% CI: 2.55, 2.07-3.15). Post-burn MH admission rates were twice as high for those younger than 5 years at index burn (IRR, 95% CI 2.06, 1.54-2.74), three times higher for those 5-9 years and 15-18 years (IRR, 95% CI: 3.21, 1.92-5.37 and 3.37, 2.13-5.33, respectively) and almost five times higher for those aged 10-14 (IRR, 95% CI: 4.90, 3.10-7.76), when compared with respective ages of uninjured children. The burn cohort had higher admission rates for mood and anxiety disorders (IRR, 95% CI: 2.79, 2.20-3.53), psychotic disorders (IRR, 95% CI: 2.82, 1.97-4.03) and mental and behavioural conditions relating to drug and alcohol abuse (IRR, 95% CI: 4.25, 3.39-5.32). Conclusions Ongoing MH support is indicated for paediatric burn patients for a prolonged period after discharge to potentially prevent psychiatric morbidity and associated academic, social and psychological issues.
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Affiliation(s)
- Janine M Duke
- 1Burn Injury Research Unit, Faculty Health and Medical Sciences, The University of Western Australia, M318 35 Stirling Highway, Crawley, Perth, Western Australia 6009 Australia
| | - Sean M Randall
- 2Centre for Data Linkage, Curtin University, Perth, Western Australia Australia
| | | | - Sarah McGarry
- 4School of Occupational Therapy Social work and Speech Pathology, Curtin University, Perth, Western Australia Australia
| | - James H Boyd
- 2Centre for Data Linkage, Curtin University, Perth, Western Australia Australia
| | - Suzanne Rea
- 1Burn Injury Research Unit, Faculty Health and Medical Sciences, The University of Western Australia, M318 35 Stirling Highway, Crawley, Perth, Western Australia 6009 Australia.,5Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Western Australia Australia
| | - Fiona M Wood
- 1Burn Injury Research Unit, Faculty Health and Medical Sciences, The University of Western Australia, M318 35 Stirling Highway, Crawley, Perth, Western Australia 6009 Australia.,5Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Western Australia Australia
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10
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Toft-Petersen AP, Ferrando-Vivas P, Harrison DA, Dunn K, Rowan KM. The organisation of critical care for burn patients in the UK: epidemiology and comparison of mortality prediction models. Anaesthesia 2018; 73:1131-1140. [PMID: 29762869 DOI: 10.1111/anae.14319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2018] [Indexed: 12/23/2022]
Abstract
In the UK, a network of specialist centres has been set up to provide critical care for burn patients. However, some burn patients are admitted to general intensive care units. Little is known about the casemix of these patients and how it compares with patients in specialist burn centres. It is not known whether burn-specific or generic risk prediction models perform better when applied to patients managed in intensive care units. We examined admissions for burns in the Case Mix Programme Database from April 2010 to March 2016. The casemix, activity and outcome in general and specialist burn intensive care units were compared and the fit of two burn-specific risk prediction models (revised Baux and Belgian Outcome in Burn Injury models) and one generic model (Intensive Care National Audit and Research Centre model) were compared. Patients in burn intensive care units had more extensive injuries compared with patients in general intensive care units (median (IQR [range]) burn surface area 16 (7-32 [0-98])% vs. 8 (1-18 [0-100])%, respectively) but in-hospital mortality was similar (22.8% vs. 19.0%, respectively). The discrimination and calibration of the generic Intensive Care National Audit and Research Centre model was superior to the revised Baux and Belgian Outcome in Burn Injury burn-specific models for patients managed on both specialist burn and general intensive care units.
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Affiliation(s)
- A P Toft-Petersen
- Departments of Clinical Medicine and Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.,Intensive Care National Audit and Research Centre (ICNARC), London, UK
| | - P Ferrando-Vivas
- Intensive Care National Audit and Research Centre (ICNARC), London, UK
| | - D A Harrison
- Intensive Care National Audit and Research Centre (ICNARC), London, UK
| | - K Dunn
- Adult Burn Service, University Hospital of South Manchester, Manchester, UK
| | - K M Rowan
- Intensive Care National Audit and Research Centre (ICNARC), London, UK
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11
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Abstract
BACKGROUND Burns are a major public health concern, affecting mostly low- and middle-income countries. However, there is a lack of epidemiological studies on burns in these countries, particularly in Latin American countries. Our aim was to analyze nationwide demographic, epidemiological and economic characteristics of hospitalized burn patients in Brazil. METHODS A retrospective study was conducted including inpatients admitted with a diagnosis of burns (ICD-10:T20-T31) from all hospitals in Brazil from 2000 to 2014. We calculated hospitalization and in-hospital mortality rates. Length of stay (LoS), charges and premature mortality were also assessed. RESULTS A total of 412,541 burn hospitalizations were found, with a hospitalization rate of 14.56 hospitalizations/100,000 inhabitants/year. This rate is decreasing since 2003, mostly due to the reduction among children and elderly. Children below 5 years old accounted for 24% of all admissions. In-hospital mortality rate was 8.1% and median LoS was 5 days. Mean hospitalization charge was 856 international dollars. Substantial regional discrepancies were found in several indicators. CONCLUSION In this first Latin American nationwide study of burn patients, a decreasing trend of hospitalization rate and a low charge contrasted with a high in-hospital mortality rate. This latter indicator, associated with a low LoS, may raise concerns regarding the quality of healthcare. Important discrepancies were found between regions, which may indicate important differences in regard to healthcare access and risk of burns. Targeting effective prevention, improving healthcare quality and providing more widespread and accurate burn registry are recommended.
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A 10 year epidemiological study of paediatric burns at the Welsh Centre for burns and plastic surgery. Burns 2016; 43:632-637. [PMID: 27816410 DOI: 10.1016/j.burns.2016.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 10/02/2016] [Accepted: 10/04/2016] [Indexed: 11/22/2022]
Abstract
Paediatric burns make up a significant proportion of burn injured patients seen within the hospital setting and worldwide account for a significant proportion of unintentional deaths. Currently there is limited data on severe paediatric burns requiring intensive care support. Our study aimed primarily to describe the epidemiology of severe burns admitted to the intensive care unit at our centre receiving fluid resuscitation over a 10 year period. A secondary aim was to describe the referrals patterns in general over the same time period. A retrospective analysis was performed for paediatric patients referred to our centre receiving fluid resuscitation and intensive care support from 2003 to 2013. We also analysed the patterns of referrals, admissions and need for surgical intervention over the same time period retrospectively. Children less than 5 years old made up 65% of admissions to intensive care and scald injuries (56%) were the commonest aetiology. Both total length of stay (25 days in 2003 to 10 days in 2013) and intensive care length of stay (7.2 days in 2003 to 3 days in 2013) decreased during the study and less patients underwent operative intervention. Referrals to our centre increased from 261 in 2003 to 366 in 2013, however admission rates declined from 145 to 85 during that time period. Currently there is limited data on severe burns within the paediatric population. Our study provides epidemiological data in this area, an important step for developing future prevention strategies.
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13
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Baker R, Tata LJ, Kendrick D, Burch T, Kennedy M, Orton E. Differing patterns in thermal injury incidence and hospitalisations among 0-4 year old children from England. Burns 2016; 42:1609-1616. [PMID: 27268109 PMCID: PMC5062947 DOI: 10.1016/j.burns.2016.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 05/06/2016] [Accepted: 05/12/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe patterns in thermal injury incidence and hospitalisations by age, gender, calendar year and socioeconomic status among 0-4 year olds in England for the period 1998-2013. PARTICIPANTS 708,050 children with linked primary care and hospitalisation data from the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES), respectively. ANALYSIS Incidence rates of all thermal injuries (identified in CPRD and/or HES), hospitalised thermal injuries, and serious thermal injuries (hospitalised for ≥72h). Adjusted incidence rate ratios (IRR) and 95% confidence intervals (95%CI), estimated using Poisson regression. RESULTS Incidence rates of all thermal injuries, hospitalised thermal injuries, and serious thermal injuries were 59.5 per 10,000 person-years (95%CI 58.4-60.6), 11.3 (10.8-11.8) and 2.15 (1.95-2.37), respectively. Socioeconomic gradients, between the most and least deprived quintiles, were steepest for serious thermal injuries (IRR 3.17, 95%CI 2.53-3.96). Incidence of all thermal injuries (IRR 0.64, 95%CI 0.58-0.70) and serious thermal injuries (IRR 0.44, 95%CI 0.33-0.59) reduced between 1998/9 and 2012/13. Incidence rates of hospitalised thermal injuries did not significantly change over time. CONCLUSION Incidence of all thermal injuries and those hospitalised for ≥72h reduced over time. Steep socioeconomic gradients support continued targeting of preventative interventions to those living in the most deprived areas.
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Affiliation(s)
- Ruth Baker
- Division of Primary Care, The University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, United Kingdom.
| | - Laila J Tata
- Division of Epidemiology and Public Health, The University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom.
| | - Denise Kendrick
- Division of Primary Care, The University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, United Kingdom.
| | - Tiffany Burch
- Division of Epidemiology and Public Health, The University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom.
| | - Mary Kennedy
- Nottingham Burns Unit, Nottingham University Hospitals, NHS Trust, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom.
| | - Elizabeth Orton
- Division of Primary Care, The University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, United Kingdom.
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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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Baker R, Orton E, Tata LJ, Kendrick D. Epidemiology of poisonings, fractures and burns among 0-24 year olds in England using linked health and mortality data. Eur J Public Health 2016; 26:940-946. [PMID: 27247115 DOI: 10.1093/eurpub/ckw064] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Understanding patterns of injury in England is challenging due to a lack of national injury surveillance data. Through recent linkage of a large primary care research database to hospitalization and mortality data, we describe the epidemiology of poisonings, fractures and burns over a 14-year period. METHODS We used linked English primary care, hospitalisation and mortality data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics between 1998 and 2011 to establish a cohort of 2,106,420 0-24 year olds. Incidence rates, per 10 000 person-years (PY) were estimated by age, sex, calendar year and socioeconomic status. Using Poisson regression we estimated incidence rate ratios, adjusting for age and sex. RESULTS Age patterns of injury incidence varied by injury type, with peaks at age 2 (74.3/10 000 PY) and 18 (74.7/10 000 PY) for poisonings, age 13 for fractures (305.1/10 000 PY) and age 1 for burns (116.8/10 000 PY). Over time, fracture incidence increased, whereas poisoning incidence increased only among 15-24 year olds and burns incidence reduced. Poisoning and burns incidence increased with deprivation, with the steepest socioeconomic gradient for poisonings among 20-24 year olds (IRR 2.63, 95% confidence interval 2.24-3.09). CONCLUSION Differing patterns according to age and injury type reflect differences in underlying injury mechanisms, highlighting the importance of developing tailored preventative interventions across the life course. Inequalities in injury occurrences support the targeting of preventative interventions to children and young people living in the most deprived areas.
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Affiliation(s)
- Ruth Baker
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Elizabeth Orton
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Laila J Tata
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Denise Kendrick
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
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Duke JM, Boyd JH, Randall SM, Wood FM. Long term mortality in a population-based cohort of adolescents, and young and middle-aged adults with burn injury in Western Australia: A 33-year study. ACCIDENT; ANALYSIS AND PREVENTION 2015; 85:118-124. [PMID: 26432064 DOI: 10.1016/j.aap.2015.09.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 06/03/2015] [Accepted: 09/13/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Advances in the treatment and management of burn patients over the past decades have resulted in a decline of in-hospital mortality rates. Current estimates of burn-related mortality are usually in the context of deaths occurring during the admission or within a short time period after the incident burn. Limited data are available that examine long term mortality after burn injury. This study aimed to assess the impact of burn injury on long-term mortality and quantify any increased risk of death attributable to burn injury. METHODS A population-based cohort study of persons 15-44 years of age hospitalised for burn injury (n=14,559) in Western Australia (1980-2012) and a matched non-injured comparison group (n=56,822) using linked health administrative data was used. Hospital morbidity and death data were obtained from the Western Australian Hospital Morbidity Data System and Death Register. De-identified extraction of all linked hospital morbidity and death records for the period 1980-2012 were provided by the Western Australian Data Linkage System. Survival analysis was conducted using the Kaplan-Meier method and Cox proportional hazards modelling. RESULTS The adjusted all-cause Mortality Rate Ratio (MRR) for burn injury was 1.8 (95%CI: 1.7-2.0); those with burn injury had a 1.8 times greater rate of mortality than those with no injury. The index burn injury was estimated to account for 44% of all recorded deaths in the burn injury cohort during the study period after discharge. Increased risk of mortality was observed for both severe (MRR, 95%CI: 1.9, 1.3-2.9) and minor (MRR, 95%CI: 2.5, 2.2-3.0) burns. CONCLUSIONS An increased risk of long-term all-cause mortality is associated with both minor and severe burn injury. Estimates of total mortality burden based on the early in-patient period alone, significantly underestimates the true burden of burn injury in adolescents, and young and middle aged adults. These results have significant implications for burn injury prevention.
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Affiliation(s)
- Janine M Duke
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Western Australia, Perth, Australia.
| | - James H Boyd
- Population Health Research Network, Centre for Data Linkage, Curtin University, Western Australia, Perth, Australia
| | - Sean M Randall
- Population Health Research Network, Centre for Data Linkage, Curtin University, Western Australia, Perth, Australia
| | - Fiona M Wood
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Western Australia, Perth, Australia; Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Western Australia, Perth, Australia
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Heng JS, Clancy O, Atkins J, Leon-Villapalos J, Williams AJ, Keays R, Hayes M, Takata M, Jones I, Vizcaychipi MP. Revised Baux Score and updated Charlson comorbidity index are independently associated with mortality in burns intensive care patients. Burns 2015; 41:1420-7. [PMID: 26187055 DOI: 10.1016/j.burns.2015.06.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 06/08/2015] [Accepted: 06/11/2015] [Indexed: 01/31/2023]
Abstract
PURPOSE The purpose of the current study was to utilise established scoring systems to analyse the association of (i) burn injury severity, (ii) comorbid status and (iii) associated systemic physiological disturbance with inpatient mortality in patients with severe burn injuries admitted to intensive care. METHODS Case notes of all patients with acute thermal injuries affecting ≥15% total body surface area (TBSA) admitted to the Burns Intensive Care Unit (BICU) at Chelsea and Westminster Hospital during a 10-year period were retrospectively reviewed. Revised Baux Score, Belgian Outcome in Burn Injury (BOBI) Score, Abbreviated Burn Severity Index (ABSI), APACHE II Score, Sequential Organ Failure Assessment (SOFA) Score and Updated Charlson Comorbidity Index (CCI) were computed for each patient and analysed for association with inpatient mortality. RESULTS Ninety mechanically ventilated patients (median age 45.7 years, median % TBSA burned 36.5%) were included. 72 patients had full thickness burns and 35 patients had inhalational injuries. Forty-four patients died in hospital while 46 survived to discharge. In a multivariate logistic regression model, only the Revised Baux Score (p<0.001) and updated CCI (p=0.014) were independently associated with mortality. This gave a ROC curve with area under the curve of 0.920. On multivariate cox regression survival analysis, only the Revised Baux Score (p<0.001) and the updated CCI (p=0.004) were independently associated with shorter time to death. CONCLUSION Our data suggest that the Revised Baux Score and the updated CCI are independently associated with inpatient mortality in patients admitted to intensive care with burn injuries affecting ≥15% TBSA. This emphasises the importance of comorbidities in the prognosis of patients with severe burn injuries.
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Affiliation(s)
- Jacob S Heng
- Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, United Kingdom; Imperial College London Faculty of Medicine, London, United Kingdom
| | - Olivia Clancy
- Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, United Kingdom; Imperial College London Faculty of Medicine, London, United Kingdom
| | - Joanne Atkins
- Plastic Surgery and Burns Service, Chelsea and Westminster Hospital, London, United Kingdom
| | - Jorge Leon-Villapalos
- Plastic Surgery and Burns Service, Chelsea and Westminster Hospital, London, United Kingdom
| | - Andrew J Williams
- Plastic Surgery and Burns Service, Chelsea and Westminster Hospital, London, United Kingdom
| | - Richard Keays
- Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, United Kingdom
| | - Michelle Hayes
- Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, United Kingdom
| | - Masao Takata
- Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, United Kingdom; Imperial College London Faculty of Medicine, London, United Kingdom
| | - Isabel Jones
- Plastic Surgery and Burns Service, Chelsea and Westminster Hospital, London, United Kingdom
| | - Marcela P Vizcaychipi
- Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, United Kingdom; Imperial College London Faculty of Medicine, London, United Kingdom.
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Heng JS, Atkins J, Clancy O, Takata M, Dunn KW, Jones I, Vizcaychipi MP. Geographical analysis of socioeconomic factors in risk of domestic burn injury in London 2007–2013. Burns 2015; 41:437-45. [DOI: 10.1016/j.burns.2014.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/02/2014] [Accepted: 12/03/2014] [Indexed: 11/15/2022]
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Duke JM, Boyd JH, Rea S, Randall SM, Wood FM. Long-term mortality among older adults with burn injury: a population-based study in Australia. Bull World Health Organ 2015; 93:400-6. [PMID: 26240461 PMCID: PMC4450710 DOI: 10.2471/blt.14.149146] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 02/10/2015] [Accepted: 02/16/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To assess if burn injury in older adults is associated with changes in long-term all-cause mortality and to estimate the increased risk of death attributable to burn injury. METHODS We conducted a population-based matched longitudinal study - based on administrative data from Western Australia's hospital morbidity data system and death register. A cohort of 6014 individuals who were aged at least 45 years when hospitalized for a first burn injury in 1980-2012 was identified. A non-injury comparison cohort, randomly selected from Western Australia's electoral roll (n = 25 759), was matched to the patients. We used Kaplan-Meier plots and Cox proportional hazards regression to analyse the data and generated mortality rate ratios and attributable risk percentages. FINDINGS For those hospitalized with burns, 180 (3%) died in hospital and 2498 (42%) died after discharge. Individuals with burn injury had a 1.4-fold greater mortality rate than those with no injury (95% confidence interval, CI: 1.3-1.5). In this cohort, the long-term mortality attributable to burn injury was 29%. Mortality risk was increased by both severe and minor burns, with adjusted mortality rate ratios of 1.3 (95% CI: 1.1-1.9) and 2.1 (95% CI: 1.9-2.3), respectively. CONCLUSION Burn injury is associated with increased long-term mortality. In our study population, sole reliance on data on in-hospital deaths would lead to an underestimate of the true mortality burden associated with burn injury.
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Affiliation(s)
- Janine M Duke
- Burn Injury Research Unit, School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, M318 35 Stirling Highway, Crawley, 6009, Perth, Western Australia, Australia
| | - James H Boyd
- Centre for Data Linkage, Curtin University, Perth, Australia
| | - Suzanne Rea
- Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Australia
| | - Sean M Randall
- Centre for Data Linkage, Curtin University, Perth, Australia
| | - Fiona M Wood
- Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Australia
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Duke JM, Rea S, Boyd JH, Randall SM, Wood FM. Mortality after burn injury in children: a 33-year population-based study. Pediatrics 2015; 135:e903-10. [PMID: 25802351 DOI: 10.1542/peds.2014-3140] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the impact of burn injury sustained during childhood on long-term mortality and to quantify any increased risk of death attributable to burn injury. METHODS A population-based cohort study of children younger than 15 years hospitalized for burn injury in Western Australia (1980-2012) and a matched noninjured comparison group. Deidentified extraction of linked hospital morbidity and death records for the period 1980-2012 were provided by the Western Australian Data Linkage System. An inception cohort (1980-2012) of burn cases younger than 15 years of age when hospitalized for a first burn injury (n = 10,426) and a frequency matched noninjured comparison cohort (n = 40,818) were identified. Survival analysis was conducted by using the Kaplan-Meier method and Cox proportional hazards regression. Mortality rate ratios and attributable risk percent adjusted for sociodemographic and preexisting heath factors were generated. RESULTS The median follow-up time for the pediatric burn cohort was 18.1 years after discharge. The adjusted all-cause mortality rate ratios for burn injury was 1.6 (95% confidence interval: 1.3-2.0); children with burn injury had a 1.6 times greater rate of mortality than those with no injury. The index burn injury was estimated to account for 38% (attributable risk percent) of all recorded deaths in the burn injury cohort during the study period. CONCLUSIONS Burn injury sustained by children is associated with an increased risk of long-term all-cause mortality. Estimates of the total mortality burden based on in-hospital deaths alone underestimates the true burden from burn injury.
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Affiliation(s)
- Janine M Duke
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Australia;
| | - Suzanne Rea
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Australia; Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Australia; and
| | - James H Boyd
- Population Health Research Network Centre for Data Linkage, Curtin University, Perth, Australia
| | - Sean M Randall
- Population Health Research Network Centre for Data Linkage, Curtin University, Perth, Australia
| | - Fiona M Wood
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Australia; Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Australia; and
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Stylianou N, Buchan I, Dunn KW. A review of the international Burn Injury Database (iBID) for England and Wales: descriptive analysis of burn injuries 2003-2011. BMJ Open 2015; 5:e006184. [PMID: 25724981 PMCID: PMC4346673 DOI: 10.1136/bmjopen-2014-006184] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To describe, for the first time, distribution (by geography, age, sex) and time trends in burn injury in England and Wales over the period that the international Burn Injury Database (iBID) has been in place. SETTING Data from the iBID for the years 2003-2011 were used for a retrospective descriptive observational study of specialised services workload and admissions in England and Wales. PARTICIPANTS All patients who have been visited or admitted to the burn injury specialised health service of England and Wales during the time period 2003-2011. Data cleaning was performed omitting patients with incomplete records (missingness never exceeded 5%). OUTCOME MEASURES Workload, admissions, mortality, length of stay (LOS), geographical distribution, sex differences, age differences, total burn surface area, mechanism of Injury. RESULTS During 2003-2011, 81,181 patients attended the specialised burn service for assessment and admission in England and Wales. Of these, 57,801 were admitted to the services. Males accounted for 63% of the total workload in specialised burn injury services, and females for 37%. The median (IQR) burn surface area was 1.5% (3.5%). The most frequent reason for burn injury was scald (38%). The median (IQR) age for all the referred workload for both genders was 21 (40). The overall mortality of the admitted patients was 1.51% and the median (IQR) LOS was 1 (5) days. CONCLUSIONS Mortality from burn injuries in England and Wales is decreasing in line with western world trends. There is an observed increase in admissions to burn services but that could be explained in various ways. These results are vital for service development and planning, as well as the development and monitoring of prevention strategies and for healthcare commissioning.
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Affiliation(s)
- Neophytos Stylianou
- Centre for Health Informatics, Institute of Population Health, University of Manchester, Manchester, Lancashire, UK
| | - Iain Buchan
- Centre for Health Informatics, Institute of Population Health, University of Manchester, Manchester, Lancashire, UK
| | - Ken W Dunn
- Centre for Health Informatics, Institute of Population Health, University of Manchester, Manchester, Lancashire, UK
- University Hospital South Manchester, Manchester, UK
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