Prevalence and predictors of scar contracture-associated re-hospitalisation among burn inpatients in China

Zhe Zhu,Yu Sun,Haibo Wang,Haibo Wang,Haibo Wang,Yongqiang Xiao,Lanxia Gan,Zhaofan Xia,Hongtai Tang,Weishi Kong,Ying Shi

doi:10.1038/s41598-021-94432-w

Abstract

Scar contracture, a common destructive complication causing increased re-hospitalisation rate of burn survivors and aggravated burden on the medical system, may be more seriously in Chinese population because of their higher susceptibility to scar formation. This study aims to evaluate the prevalence and predictors of scar contracture-associated re-hospitalisation among Chinese burn inpatients. This cross-sectional study screened burn inpatients hospitalised during 2013 to 2018 through the Hospital Quality Monitoring System database, among whom re-hospitalised for scar contracture were identified. Variables including sex, age, occupations, burn area, burn site and surgical treatment were analysed. Potential predictors of scar contracture-associated re-hospitalisation among burn inpatients were determined by univariate regression analyses. Of the 220,642 burn inpatients, 2146 (0.97%) were re-hospitalised for scar contracture. The re-hospitalised inpatients were predominantly men and blue-collar workers, showing younger median age at the time of burns, larger burn sizes, and higher percentage of surgical treatment compared other burn inpatients. Significant univariate predictors of scar contracture-associated re-hospitalisation included male sex, age < 50 years, blue-collar work, ≥ 40% total body superficial area burned, inhalation injured, and surgical treatment. Scar contracture is an intractable complication and a significant factor to increase re-hospitalisation rate among Chinese burn inpatients.

Highlights

Scar contracture, a common destructive complication causing increased re-hospitalisation rate of burn survivors and aggravated burden on the medical system, may be more seriously in Chinese population because of their higher susceptibility to scar formation
As the burn area increased, the number of burn inpatients decreased significantly and those with ≥ 40% total body superficial area (TBSA) burned constituted 7.56% of patients (Fig. 3), while the male to female ratio increased gradually and the proportion of ≥ 40%TBSA burned was larger in males (8.27% VS 6.21%) (Fig. 4)
We evaluated the rate and associated risk factors of re-hospitalisation caused by post-burn scar contracture in a Chinese population

Summary

Introduction

A common destructive complication causing increased re-hospitalisation rate of burn survivors and aggravated burden on the medical system, may be more seriously in Chinese population because of their higher susceptibility to scar formation. Significant univariate predictors of scar contracture-associated re-hospitalisation included male sex, age < 50 years, blue-collar work, ≥ 40% total body superficial area burned, inhalation injured, and surgical treatment. One of the most common post-burn injury complications, attracts attention from clinicians due to its high morbidity r ate[1], crucial impacts on burn survivors’ quality of life, and aggravating burden on the public health system[2]. It commonly occurs in areas around joints and fine motor parts, including the dorsum of the hands or feet and facial area (e.g., eyelid ectropion, microstomia, and nasolabial contracture)[3]. The clinical management status and consumed medical resources of post-burn scar contracture remain unknown, especially in China, the largest developing country, with a population predisposed to scar development[9,10,11]

Objectives

Methods

Results

Conclusion