Child Supervision and Burn Outcome among Admitted Patients at Major Trauma Hospitals in the Gambia

Survival Status and Predictors of Mortality Among Pediatrics Burn Victims Admitted to Burn Centers of Addis Ababa Public Hospitals, Ethiopia: A Retrospective Cohort Study

Background. Burn is a major public health problem in pediatric populations worldwide. This study aimed to determine the survival status and predictors of mortality among pediatric burn victims admitted to burn centers in Ethiopia. Methods. A retrospective cohort study was conducted on the patient charts of 412 pediatric patients with burn injuries at burn centers in Addis Ababa from the 1st of January 2016 to the 30th of December 2019. Data was entered into the Epi-Data manager. Then, the data was exported to STATA V-14 for cleaning and analysis. For the analysis, the proportional hazard model was used. After the model fitness test, variables with a P-value of <.25 in the bivariate analysis were fitted to the multivariate analysis. Finally, statistical significance was decided at a P-value of <.05, and the hazard ratio was used to determine the strength of the association. Result. The study reported an overall incidence rate of 2.4 per 1000 child days. Additionally, it revealed that the median hospital length of stay was 25.00 days (95% CI: 21.57, 28.45). During the follow-up period, 8.25% of deaths occurred among pediatric patients with burn injuries. Specifically, having a full-thickness burn (adjusted hazard ratio [AHR] 2.51, 95% CI: 1.12, 5.62) and neck burn (AHR 2.82, 95% CI: 1.04, 7.68) were identified as significant predictors contributing to increased mortality among burn-injured pediatric individuals. Conclusion. The study highlighted significant mortality rates among pediatric patients suffering from burn injuries. Based on the findings a full-thickness burn injury and burns in the neck area are independent predictors of mortality in pediatric burn patients. Based on the identified predictors of mortality in pediatric burn patients, clinicians should prioritize early recognition, prompt intervention, multidisciplinary management, vigilant monitoring, and preventive strategies to optimize outcomes and reduce mortality rates in this vulnerable population.

An 11-year retrospective study on the epidemiology of paediatric burns in the north of Iran

Burn injuries in children are distressing physical and emotional events with long-term disability. However, there is little research on the epidemiology of paediatric burns. This information is essential for the development of prevention intervention and acute management. This study aimed to describe epidemiologic characteristics and clinical outcomes of paediatric burns in a burn center in the north of Iran. A retrospective, single-center study was conducted of children (<18 years) admitted to the burns center between 2011 and 2021. The data were analysed by SPSS 24.0 software. The chi-squared test and Fisher's exact test were used to assess categorical variables, and Student's t-tests or One-Way ANOVA was used to evaluate continuous variables. 2951 paediatric burns with mean age 5.30 ± 5.27 years, were admitted during the 11 years, with 1777 boys (60.2%) and 1174 girls (39.8%). By age groups, the majority of children (59.7%) were between 0 and 4 years old, followed by 5 to 8 years (15.7%), 13 to 18 years (14.6%), and 9 to 12 years (10.0%), respectively. The most cause of injury was Hot liquids & vapours (1604, 54.4%). The mean age for burns with fire & flames, hot liquids & vapours, contact, chemical, and electrical was 4.46 ± 4.84, 5.70 ± 5.39, 5.44 ± 5.42, 3.93 ± 3.86, and 3.53 ± 4.06 years, respectively. The total body surface area (TBSA) burned was 14.96 ± 11.94. The longest length of stay (LOS) related to fire and flame was 5.63 ± 7.57 days. The mortality rate was 1.56%. There were significant differences among aetiology groups for the cost per % TBSA (F = 15.784, P < 0.001), which correlated with the burn depth, TBSA, aetiology, LOS, and age. The Ministry of Health should establish strategies for burn prevention and incorporate data surveillance for burn injuries. Community education on kitchen and cooking safety could positively impact the prevalence and outcomes of paediatric burns.

Outcome of burn injury and associated factor among patient visited at Addis Ababa burn, emergency and trauma hospital: a two years hospital-based cross-sectional study

BACKGROUND

Burn is one of the critical health problems worldwide. Developing countries with sub-Saharan and Asian populations are affected more. Its mortality and non-fatal complications depend on several factors including age, sex, residency, cause, the extent of the burn, and time and level of care given.

OBJECTIVE

The purpose of this study was to assess the outcome of burn injury and its associated factor among patients who visited Addis Ababa burn emergency and trauma hospital.

METHODS

The institutional-based, retrospective cross-sectional study design was conducted from April 1, 2019, to March 30, 2021. After checking the data for its consistency the data were entered and analyzed by using SPSS version 25. A total of 241 patients who had visited Addis Ababa burn, emergency and trauma Hospitals after sustained burn injury were recruited through convenience sampling method for final analysis. Model goodness-of-fit was checked by Hosmer and Lemeshow test (0.272). After checking multi-collinearity both the bi-variable and multivariable logistic regression model was fitted and variables having a p-value less than or equal to 0.05 at 95% CI in the multivariable analysis were considered statistically significant.

RESULT

Adults (age 15 to 60 years) are the most affected groups accounting for 55.2% followed by pediatric age groups (age <15 years) (43.6%) and the elderly (age > 60 years) (1.2%). Scald burn was the major cause accounting for 39 % followed by Flame burn (33.6%), Electrical burn (26.6%), and chemical burn (0.8%). The mean TBSA% was 15.49%, ranging from1% to 64%. Adult males are more affected by electrical burns while adult females and the elderly encounter flame burn. 78.4% of patients were discharged without complications, 14.9% were discharged with complications and 6.6% died. The commonest long-term complication is the amputation of the extremity (19, 7.9%). Age greater than 60 years and TBSA% greater than 30% is a strong predictors of mortality with odds of 2.2 at 95% CI of [1.32, 3.69] and 8.7 at 95% CI of [1.33, 57.32] respectively.

CONCLUSION AND RECOMMENDATION

The mortality rate show decrement from previous studies. Overall scald burn is common in all age groups but electrical burns and flame burns affected more adult and elderly age groups. Extremities were by far, the commonest affected body parts. The extent of burn injury and the age of the patient independently predict mortality. Early intervention will reduce mortality and complications.

3D PED BURN app: A precise and easy-to-use pediatric 3D burn surface area calculation tool

Background and aims

Calculating the precise total burn surface area is crucial when treating burn patients, particularly children. The Lund and Browder chart and Rule of Nines, 2-dimensional diagrams that are widely used, are subject to high interrater variance, and they can severely overestimate the burn area. Previously, the adult 3-dimensional burn area calculation mobile application was developed. Aiming to improve accuracy, a 3-dimensional pediatric burn surface area calculation mobile application ("3D PED BURN") was developed to overcome the limitations of the conventional methods.

Method

Fifteen 3-dimensional pediatric burn surface area models based on detailed anthropometric measurements collected from 85 patients were developed and categorized into four age groups: <1 year; 1-4 years; 5-9 years, and 10-15 years. According to their weight and height, the models in each group were fractionated into large, medium, and small body sizes.

Result

A precise and easy-to-use application was developed based on these data. This application is a promising and more accurate calculation tool for burn surface area in pediatric patients. Its low inter-rater variance makes it reliable for use by various healthcare personnel.

Conclusion

The 3D PED BURN app is a pediatric 3D burn surface area calculation tool that is both accurate and simple to use.

Burns in Israel: Etiologic, Demographic, and Clinical trends—A 9-Year Updated Comprehensive Study, 2004–2010 versus 2011–2019

Based on the Israeli National Trauma Registry (INTR) data, this study reports etiological, demographic, and clinical trends and includes all admissions to burn and trauma centers across Israel from 2011 to 2019 and compares these with 2004 to 2010 rates. From 2011 to 2019, 5,710 patients were admitted to burn centers across Israel. Children aged 0 to 1 years (25.9%), non-Jews (40.7%), and males (67.2%) remain the main groups of the burn casualties. Most of the casualties sustained 1 to 9% total body surface area (TBSA) burns with various depths. Scalds were less fatal than fire/flame-related casualties (<1 vs. 11.5%). Fewer surgical procedures were conducted for burns under 9% TBSA compared with greater TBSA. The percentage of TBSA and burn depth were found to be the most significant predictor of mortality among all age groups (>200 times increased risk with full-thickness burns >30% TBSA burn) and correlated with prolonged length of stay (>7 days).

Magnitude of mortality and its associated factors among Burn victim children admitted to South Gondar zone government hospitals, Ethiopia, from 2015 to 2019

BACKGROUND

Burn is one of the leading causes of preventable death and disability every year in low and middle-income countries, which mainly affects those aged less than 15 years. Death from burn injuries carries the most significant losses, which often have grave consequences for the countries. Even though data from different settings are necessary to tackle it, pieces of evidence in this area are limited. Thus, this study was aimed to answer the question, what is the Magnitude of Mortality? And what are the factors associated with mortality among burn victim children admitted to South Gondar Zone Government Hospitals, Ethiopia, from 2015 to 2019?

METHODS

Institutional-based cross-sectional study design was used to study 348 hospitalized burn victim pediatrics', from 2015 to 2019. A simple random sampling method was used. Data were exported from Epidata to SPSS version 23 for analysis. Significant of the variables were declared when a p-value is < 0.05.

RESULT

The mortality rate of burn victim children in this study was 8.5% (95% CI = 5.5-11.4). Medical insurance none users burn victim children were more likely (AOR 3.700; 95% CI =1.2-11.5) to die as compared with medical insurance users, burn victim children with malnutrition were more risk (AOR 3.9; 95% CI = 1.3-12.2) of mortality as compared with well-nourished child. Moreover, electrical (AOR 7.7; 95% CI = 1.8-32.5.2) and flame burn (AOR 3.3; 95% CI = 1.2-9.0), total body surface area greater than 20% of burn were more likely (AOR 4.6; 95% CI 1.8-11.8) to die compared to less than 20% burn area and burn victim children admitted with poor clinical condition at admission were four times (AOR 4.1, 95% CI = 1.3-12.0) of mortality compared to a good clinical condition.

CONCLUSION

The mortality among burn victim children was higher than most of the studies conducted all over the world. Medical insurance none users, being malnourished, burned by electrical and flame burn, having total body surface area burnt greater than 20%, and having poor clinical condition at addition were significantly associated with mortality of burn victim pediatrics. Therefore, timely identification and monitoring of burn injury should be necessary to prevent mortality of burn victim pediatrics.

Analysis of 12,661 pediatric burns in Wuhan institute of burns: A retrospective study of fifteen years

BACKGROUND

By analyzing the epidemic characteristics of pediatric burns in a burn center serving large areas of Hubei Provence and partly surrounding provinces around Wuhan City, the aim of this study is to provide better strategies for the prevention and care for pediatric burns.

METHODS

Pediatric burn patients who were younger than 13 years old in Wuhan Third Hospital from 2004 to 2018 were included. Demographic and clinical data were collected, analyzed and compared among groups.

RESULTS

12,661 pediatric burns, mean aged 2.37 ± 2.30 y, were admitted during the 15 years, with 7973 boys (62.97%) and 4688 girls (37.03%). By age groups, infant (<3y), preschool (>3-6y) and school children (>6-13y) accounted for 81.12% (10,270 cases), 12.08% (1530 cases) and 6.80% (861 cases) respectively. The most cause of injury was scalds (11,232, 88.71%), followed by flame burns (917, 7.24%), electric burns (201, 1.59%), contact burns (127, 1.00%), firework or firecracker (124, 0.98%), chemical burns (40, 0.32%) and hot crush injury (20, 0.16%). The mean age of firework or firecracker burns was 6.19 ± 2.83y, electric burns 5.18 ± 3.31y, flame burns 4.73 ± 3.53y, hot crush injury 3.85 ± 2.37 y, contact burns 3.66 ± 3.35y, chemical burns 3.03 ± 2.50y, and scald 2.06 ± 1.91y. Over half cases (57.34%) were small burns less than 10% total burn surface area (TBSA) and the larger TBSA, the fewer number of patients. The mortality rate was 0.11% and correlated with TBSA, age and etiology. The mean length of stay (LOS) was 12.63 ± 11.91 days and highly correlated with etiology and TBSA. The mean hospital cost was 11210.76 ± 21248.87 RMB (about 1600 USD) or 1626.91 ± 3957.59 RMB (about 230 USD) per % TBSA, which was correlated with depth of burn, TBSA, etiology, LOS and age.

CONCLUSION

Pediatric burns in central China was still common and even increasing. Majority of the pediatric burn victims were boys under three years old, while the mean ages of different etiologies varied from about 2-6 years old. Education and prevention aiming the high risks are the key point to decrease pediatric burns.

Nonadult Supervision of Children in Low- and Middle-Income Countries: Results from 61 National Population-Based Surveys

Despite scarce empirical research in most countries, evidence has shown that young children are unsupervised or under the supervision of another young child while their adult caregivers attend work or engage in other activities outside the home. Lack of quality supervision has been linked to unintentional childhood injuries and other negative outcomes. Nationally representative, population-based data from rounds four and five of the Multiple Indicator Cluster Surveys (MICS) and four to eight of the Demographic and Health Surveys (DHS) from 61 low- and middle-income countries were used to estimate prevalence and socio-economic factors associated with leaving children under five years old home alone or under the care of another child younger than 10 years of age. Socio-economic factors included age and sex of the child, rurality, wealth, maternal education, and household composition. Large variations in the prevalence rates (0.1⁻35.3% for children home alone and 0.2⁻50.6% for children supervised by another child) and associated factors have been recorded within and across regions and countries. Understanding why and under what conditions children are home alone or under the supervision of another child is crucial to the development of suitable policies and interventions to protect young children, promote healthy growth, and support caregivers.