Comparison of patterns of burn severity and clinical characteristics of pediatric patients in a referral burn center: a retrospective analysis

Abstract

Objective: Burn injuries continue to be an important public health problem worldwide, and childhood burns constitute the most critical burden among these injuries. Although less common, pediatric non-scald burn injuries (NSBIs) generally have a more severe course and cause more significant morbidity and mortality than scald burns (SBs). Many studies only address SBs or NSBIs separately. There are limited studies comparing severity patterns and clinical characteristics of both injuries. It aimed to investigate the severity patterns and clinical characteristics of SBs and NSBIs in hospitalized pediatric patients and compare them with the existing literature. Methods: A retrospective comparative study design was created among hospitalized pediatric patients. The most frequently observed SBs caused by hot water-tea/hot milk/oil-sauce-soup formed the first group. At the same time, as burn severity was thought to be relatively varied according to initial burn conditions, the NSBIs (fire-flame-related/electrical/contact/chemical-burns) constituted the other group. Data were extracted from the University of Health Sciences- Adana Faculty of Medicine (UHS-AFM) patient files and the electronic registry system. Results: While SBs constituted 83% of 1715 hospitalized pediatric patients, NSBIs formed only 17% of the study group. Additionally, pediatric non-scald burn injuries had a more severe course in this study. It was determined that NSBIs were responsible for more than two-thirds of mortality compared to SBs. This patient group also required approximately three times more surgical procedures (escharotomy/fasciotomy). Also, the length of hospital stay (LOS) was approximately two times longer than SBs, 23.5±30.5 (1-258), vs. 11.8±9.9 (1-136) (p<0.001). While 31.4% of NSBIs required skin grafts (n=91), only 14% of SBs had (p<0.001). This identified high trend was consistent with the depth of deep partial-/full-thickness burns, which was detected in only 28.6% of SBs and more than 51% of NSBIs (p<0.001). Conclusion: Further comparative studies on the actual mechanisms of SBs and NSBIs may help develop new strategies from a different perspective on burn prevention programs. In addition to the education of school-age children and their families, there is also a need to raise public awareness on the prevention of burn injuries by using all possible mass media.