Causes of burn based on hospitals reports in mainland France in 2014

Abstract

Introduction Burns are defined as an injury to the skin or other organic tissue primarily caused by thermal or other acute trauma. Every year in France, burns are responsible for several hundreds of deaths and about 11,500 hospitalizations. Furthermore, burns often result in heavy physical, psychological or social sequelae. They are one of the most expensive traumatic injuries due to costly wound treatment and very long care (hospitalization and rehabilitation). Prevention of burns is therefore a necessity. In order to prevent burns, knowledge about their causes is essential. There is a lack of large-scale results about causes of burns in France. Therefore, the aim of this work it to analyze causes of burns in mainland France in 2014, using data from the hospital nationwide database - “Programme de medicalisation des systemes d’information (PMSI)”. Coding of causes is expected to present high-quality because three French agencies “Agence technique de l’information sur l’hospitalisation” - (ATIH), “Societe francaise de brulologie” (SFB) [formerly “Societe francaise d’etude et de traitement des brulures” (SFETB)] and “Sante publique France” [formerly “Institut de veille sanitaire” (InVS)] implemented in 2011 a thesaurus of burns causes in order to facilitate and harmonize the coding in the PMSI and make it mandatory in 2013. Methods Analyses were performed on first hospital stays in a burn center, in 2014 in mainland France, registered in the PMSI database with a principal diagnosis of burns, coded from T20 to T32 in the International Classification of Diseases, 10th revision (ICD10), and at least one associated diagnosis mentioning a cause of burn. Data collected for patients whatever the age included: demographics, circumstances (accident, assault, suicide attempt), etiology (scald, contact, fire and flames, radiation, electrical, chemical). Results In 2014 in mainland France, 2712 patients were hospitalized in a burn center and presented information regarding the cause of burn, 61.5% were men, mean/median age of 31/28 years. Burns occurred mostly in accidental circumstances (93.7% of patients) and are more rarely due to suicide attempt (4.9%) or assault (1.4%). Half of accidental burns were scald (50.8%), 27.2% fire and flame burns, 8% contact burns, 4.5% chemical burns, other etiologies are scarcer. Causes of burns varied according to age and sex. Scald was the first cause of burns for children (83.8% for boys and 88.2% for girls among 0–4 years) and for women whatever the age. Fire and flames burns were the first cause of burns for men after 15 (42.6% among 15–59 years, 56% among 60 years and older). Conclusions For the first time in France, this study provides results about causes of burns at a large-scale. In spite of numerous prevention measures, burns and in particular scald, are very frequent in France. Further research aiming at improving knowledge about causes of burns could be useful to better target prevention measures. Moreover, a precise evaluation of prevention measures already implemented could be useful.