Epidemiology of Scalds in Vulnerable Groups in New South Wales, Australia, 1998/1999 to 2002/2003

The prevalence and predictors of reconstructive surgery in pediatric burn care

OBJECTIVE

This study aimed to examine the prevalence and predictors of reconstructive surgery among pediatric burn patients in the Netherlands.

METHODS

Pediatric burn patients were identified through the Dutch Burn Repository R3. Eligibility criteria included a burn requiring hospital admission or surgical treatment at one of the Dutch burn centers in 2009-2019. First, patient, burn, and treatment characteristics were summarized using descriptive statistics. Second, time to the first reconstructive surgery was modelled using Kaplan Meier curves. Third, a prediction model was developed using univariate and multivariate logistic regression. The model's performance was assessed using calibration, discrimination, and explained variance. Fourth, internal validation was performed using bootstrapping.

RESULTS

Approximately three percent (n = 84) of pediatric patients (n = 3072) required reconstructive surgery between the initial burn-related hospital admission and September 2021. Median time to the first reconstructive surgery was 1.2 (0.7-1.6) years. Most surgeries were performed on the face, arm, neck, hand, or anterior trunk, owing to contractures or hypertrophic scarring. Predictors of reconstruction included the etiology, anatomical site, extent of full-thickness burn, surgical treatment in the acute phase, and length of hospital stay.

CONCLUSION

Our study provided an overview of the prevalence and independent predictors of reconstructive surgery in the pediatric burn population.

A Decade Epidemiological Study of Pediatric Burns in South West of Iran

BACKGROUND

Burn is one of the most traumatic injuries and life-threatening states which expose children at a higher risk. The aim of this study was evaluating the epidemiology of pediatric burns in age less than eighteen years old during the last decade.

METHODS

This cross-sectional study was carried out during 2008-2017 in Amir-al Momenin Burn Center, affiliated by Shiraz University of Medical Sciences, Shiraz, Iran. The subjects consisted of burn victims under 18 years old who were registered as outpatients and inpatients.

RESULTS

During the study period, 1893 and 12431 patient were registered as inpatients and outpatients of the hospital. The burn victims were males. Children under 5 years old were prone to scald injuries more than children in any other age. More than 90% of inpatients children burned accidentally, while 116 (6.12%) burn injuries were suicidal; which was mostly seen in girls (75%, 87 out of 116).

CONCLUSION

Most burns involved scalds from hot liquids especially in children age less than 5 years. Different strategies can be executed by means of broadcast flashes in mass media and educational programs through schools to show risk situation and statements calling attention to prevent childhood burn injuries.

Epidemiology of severe burn among children in Newfoundland and Labrador, Canada

PURPOSE

The objective of this study was to identify the epidemiologic characteristics of childhood burns in the province of Newfoundland and Labrador.

METHODS

A population-based study was carried out on children aged 0-16 years who were hospitalized due to burns in Newfoundland and Labrador between April 1995 and March 2001. Hospital and mortality data were obtained from the provincial hospital admission database and Mortality System, respectively. The Newfoundland and Labrador population was considered as a whole and as two separate geographic areas.

RESULTS

A total of 157 hospital admissions due to burns were identified during the study period. The rate of burns requiring hospitalization in the province was 22.3 per 100,000 person-years (P-Y). The rates for males and females was 27.7 and 16.6 per 100,000 P-Y, respectively (P=0.006). Infants (0-1 year) had the highest rate of burn (88.8 per 100,000 P-Y) followed by children aged 2-4 years (26.0 per 100,000 P-Y) (P<0.0001). Labrador, a region with high Aboriginal population (51.4 per 100,000 P-Y), had a higher rate of burn compared to Newfoundland (20.3 per 100,000 P-Y) (P<0.0001). Median age of patients with burns was 2 years for the island portion of the province and 9 years in Labrador (P<0.01). Overall, scald burn (52.2%) was the most frequent type of burn followed by flame (32.5%). In the island portion of the province, scald burn was the most common type of burn (56.4%), while in Labrador flame was the most frequent type (66.7%). Overall mortality rate due to burns was 0.9 per 100,000 P-Y.

CONCLUSION

Age (infants) and sex (male) are factors associated with burn in Newfoundland and Labrador. Study results indicate a difference in the epidemiologic pattern of burn between the island portion of the province, Newfoundland, and mainland Labrador. It is recommended that preventive programs be directed towards high risk groups to reduce the incidence of burns.

A study of burn hospitalizations for children younger than 5 years of age: 1983-2008

OBJECTIVE

Burn injury is a leading cause of emergency department visits and hospitalizations for young children. We aimed to use statewide linked health administrative data to evaluate the incidence, temporal trends, and cause of burn injuries for children younger than 5 years hospitalized for burn injuries in Western Australia for the period 1983-2008.

METHODS

Epidemiologic analysis of linked hospital morbidity and death data of children younger than 5 years hospitalized with an index burn injury in Western Australia for the period 1983-2008. Poisson regression analyses were used to estimate temporal trends in hospital admissions and the external cause of the burn injury.

RESULTS

From 1983 to 2008, there were 5398 hospitalizations for an index burn injury and 3 burn-related deaths. Hospital admission rates declined by an average annual rate of 2.3% (incidence rate ratio: 0.977 [95% confidence interval: 0.974-0.981]). More than half of the admissions were for scald burns. Hospitalizations declined for injury caused by scald, flame, contact, and electrical burns; however, the number of hospital admissions increased for chemical burns during the study period.

CONCLUSIONS

The burn-injury hospitalizations reported in this study were preventable. Most burns occurred in the home and resulted from exposure to a household hazard. Further effort needs to be devoted to burn prevention and safety strategies, particularly in relation to scalds, to further reduce the incidence of burn injury in young children.

Hot tap water legislation in the United States

Excessively hot tap water results in an estimated 1500 hospital admissions and up to 50 deaths in the United States every year. This study reviewed the current state of tap water temperature regulation in the United States, including the model plumbing code standards on which state legislation in this area is based; assessed the level of public awareness regarding the risk, prevalence, and severity of such injuries; and identified specific prevention measures. Relevant information was obtained from state legislative codes, model code development organizations, the US Consumer Product Safety Commission, and a survey of knowledge, attitudes, and behaviors related to tap water temperature safety. Model building and plumbing codes related to tap water temperature regulation and their subsequent adoption by state legislatures vary widely across the United States. The states also vary with respect to the authority provided to lower levels of government (counties or municipalities) to modify and enforce code provisions. Public awareness of hot tap water hazards and implementation of preventive measures are limited. A broader and more uniform application of codes for regulating tap water temperature in both institutional and residential settings can be achieved through input from affected users, government agencies, legislators, advocacy organizations, and the general public. Safer hot water temperatures and a reduction in scald injuries can be achieved through regulating hot water temperature level at the thermostat, installing temperature-regulating valves at the tap, and raising public awareness of hot tap water hazards.

A systematic review of accidental injury from fire, wandering and medication self-administration errors for older adults with and without dementia

The assessment of risk of injury in the home is important for older adults when considering whether they are able to live independently. The purpose of this systematic review is to determine the frequency of injury for persons with dementia and the general older adult population, from three sources: fires/burns, medication self-administration errors and wandering. Relevant articles (n=74) were screened and 16 studies were retained for independent review. The studies, although subject to selection and information bias, showed low proportions of morbidity and mortality from the three sources of injury. Data did not allow direct comparison of morbidity and mortality for persons with dementia and the general older adult population; however, data trends suggested greater event frequencies with medication self-administration and wandering for persons with dementia. Assessment targeting these sources of injury should have less emphasis in the general older adult population compared to persons with dementia.