Epidemiology Of Burns Research Articles

A Structured Review to Assess the Current Status of Cost-Based Burns Research in Nepal.

The management of burns is costly and complex. The problem is compounded in low and middle income countries (LMICs) where the incidence of burn injuries is high but infrastructure and funding for management and prevention is limited. Cost of illness studies allows for quantification of the costs associated with public health problems. Without cost quantification, focus and allocation of funding is challenging. The authors explored the availability of cost-focused burns research data in a target LMIC. The focus of their research was Nepal. A structured literature review including published papers, Ministry of Health (MOH) and World Health Organization (WHO) statistics was conducted to identify cost of illness studies or evidence relating to burn-related resource and costs. Gaps in the evidence base were highlighted. Research methodologies from other LMICs were reviewed. We found 32 papers related to burn injury in Nepal, one key MOH document and one relevant WHO data source. Most research focused on the epidemiology and etiology of burns in Nepal. Of the papers, only 14 reported any type of burn-related resource use and only 1 paper directly reported (limited) cost data. No studies attempted an overall quantification of the cost of burns. MOH statistics provided no additional insight into costs. Our study found an almost complete lack of cost-focused burns research in Nepal. Primary research is needed to quantify the cost of burns in Nepal. Initial focus could usefully be on the cost of care in tertiary hospitals. A full cost of burns for Nepal remains some way off.

Epidemiology and Outcome Analysis of Burns During Explosion Accident at a Major Center in Southwestern China From 2002 to 2016.

Explosions always lead to serious public health, social, and economic problems. We investigated the epidemiology, outcomes, and costs of burn patients caused by explosion accident in Southwest China to explore more effective prevention and treatment strategies. This retrospective study included 497 inpatients with burns during explosion accident admitted to the Institute of Burn Research of Army Medical University from 2002 to 2016. A total of 497 cases (77.78% males) were found, accounting for 2.37% of the total burn patients. The average age was 34.38 ± 15.02 years. The most common etiology was gas explosions (51.51%). Most of the cases were caused by work-related activities. The average TBSA was 31.30 ± 28.32%. The median length of stay (LOS) was 31 days. The LOS was correlated with TBSA, full-thickness burns, older age, number of operations and outcome. The major factors determining the cost were larger TBSA, full-thickness burns, and higher cure rate. The mortality was 6.44%. Larger TBSA and older age were the most important risk factors for the mortality. This study suggested that special attention should be paid to prevent burns during explosion accident in adult males with occupational exposure. In the future, more effective and practical strategies for preventing and treating burns during explosion accident based on related risk factors should be implemented.

Demographics and clinical outcomes of adult burn patients admitted to a single provincial burn centre: A 40-year review

IntroductionThis study evaluated trends in demographics and outcomes of cutaneous burns over a forty-year period at a Canadian burn centre. MethodsRetrospective review was performed of all consecutive adult burn admissions to the Vancouver General Hospital (VGH) between 1976 and 2015. Comparison was made to the 2016 American Burn Association – National Burn Repository. ResultsThere were 4105 admissions during study period. Both overall admissions and admissions per 100,000 BC residents declined (p < 0.0001). Males represented three quarters of admissions. There was a decrease in large burns (p < 0.05). Flame burns were most commonly associated with larger TBSA, ICU stays, and mortality.Mortality decreased from 11.3% to 2.8% (p < 0.05). Factors found to affect mortality included: increased length of stay, age and burn size, male gender, and number of complications. Baux50 and rBaux50 increased, from 102.8 to 116.7 and 112.2 to 125.3 respectively (p < 0.05, respectively). ConclusionsThis study represents the largest report on burn epidemiology in Canada. The incidence of burns has decreased significantly over the last forty years. Mortality has improved over this time frame, as evident by increases in Baux50 and rBaux50 scores. Further data is largely in concurrence with that of the National Burn Repository’s amalgamation of US centres.

A systematic review of epidemiological patterns and proposed interventions to address pediatric burns in Nigeria.

Unintentional injuries from burns comprise a significant proportion of public health morbidity in Nigeria. In order to understand the type and impact of burns on youth in Low-and-Middle-Income countries, the epidemiology of burns must be adequately assessed. This review describes the epidemiological patterns of burn occurrences in the pediatric populations and proposes interventions using the Haddon Matrix to address injuries in specific populations in Nigeria. A literature search was conducted using the Proquest, CINAHL, and PubMed databases at the Johns Hopkins University library (January 1, 1990 to August 14, 2018), on burns or thermal injury among pediatric populations in Nigeria. The review focused on the forms of injury, risk factors and potential interventions. Ten studies were identified and the main risk factors for burns were socioeconomic status, overcrowding, and involving young girls in traditional cooking roles. The main types of injuries include scald injuries (50%) and fire burns (45%) affecting mainly children aged 14 and below with significant regional epidemiological variations. We created a novel intervention to develop countermeasures and reduce the number of pediatric burns based on biological, physical and sociocultural environment.. Interventions such as improved supervision of children, improved emergency infrastructure and culturally sensitive first aid education and treatment can help ensure a reduction in morbidity and mortality resulting from burns. Epidemiological studies can provide an accurate depiction of the burden of burn injuries in different regions of Nigeria.

Epidemiology of Burns Injury in dr. Iskak General Hospital Tulungagung: Two Years (2017-2018) Retrospective Study

Introduction: Burn injury is one of the leading causes of morbidity and mortality in low and middle-income countries. Yet in Indonesia, the epidemiology of burn is rarely reported. The study aims to obtain the epidemiological characteristics of burn patients in Dr. Iskak General Hospital.&#x0D; Methods: A retrospective analysis study was used and the medical records of patients with burns admitted at Dr. Iskak General Hospital between January 2017 and December 2018 were collected and analyzed statistically.&#x0D; Results: A total of 80 patients were involved in this study. The most burn victims fell in the adult group (&gt;18 years old), which was 56.3% (n=45). Children were six times more likely to sustain scald burn than adults (OR=6.75I; CI95% 2.47-18.41), meanwhile adults were three times more likely to sustain flame burn than children (OR=3.643; CI95% 1.186-11.190). Most of burn patients (91.25%) were treated surgically. The median of hospital stay was 8 days. Flame burn was the primary etiology for longer hospitalization and there was zero mortality in this study.&#x0D; Conclusion: We found that the adult group was at the highest risk of acquiring burns. Scald was the major cause of burns in children, while flame was the main etiology in the adult group that caused severe burn and prolonged hospitalization.

Epidemiology and Outcome Analysis of 470 Patients with Hand Burns: A Five-Year Retrospective Study in a Major Burn Center in Southwest China.

BackgroundThis retrospective study aimed to investigate the epidemiology of burns to the hand, including the causes, demographic data, management, and outcome in a single center in Southwest China between 2012 and 2017.Material/MethodsA retrospective study included 470 patients with hand burns who were treated at a single hospital in Southwest China between 2012 and 2017. Demographic, injury-related, and clinical data were obtained from the clinical electronic data collection system.ResultsIn 470 patients, men were more commonly admitted to hospital with hand burns (73.62%). Children under 10 years (29.57%) were the main patient group. Hospital admissions occurred in the coldest months, from December to March (55.11%). In 60.21% of cases, hand burns occurred outside the workplace. Fire (40.42%), electricity (30.85%), and hot liquids (20.21%) were the main causes of hand burns. Data from 428 patients showed that burns with a larger total body surface area and deeper burns were associated with surgery and amputation. Burn depth was a risk factor for skin grafting, and lack of burn cooling before hospital admission increased the risk of amputation. Data from 117 patients with localized burns showed that full-thickness burns and lack of cooling before admission were associated with an increased hospital stay.ConclusionsThe findings suggest that in Southwest China, prevention programs for children aged 0–9 years, injuries occurring in winter and non-workplace sites, and fire burns were imperative.

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

BACKGROUNDBurn 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. METHODSThis 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. RESULTSDuring 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). CONCLUSIONMost 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 electrical burns: a 10-year retrospective analysis of 376 cases at a burn centre in South China.

ObjectiveTo investigate the epidemiological profile and associated outcomes of electrical injuries at a major burn centre in southern China.MethodsThis retrospective study enrolled consecutive electrical burn patients admitted to the burn centre of the First Affiliated Hospital of Guangxi Medical University between 2008 and 2017. Demographic and clinical data and outcomes were recorded. Mann–Whitney U tests/Pearson’s chi-squared tests were used to examine the differences between low-voltage and high-voltage injuries.ResultsThere were 217 high-voltage injuries and 159 low-voltage injuries. High-voltage burns were frequently observed between March and August, and low-voltage burns peaked between June and September. Burn patients were mainly men. Most burns occurred in participants aged 21 to 50 years and in industrial workers and electricians at work or householders at home. Only one person with high-voltage burns died (a mortality rate of 0.46%). Amputation rates were 37.33% for high-voltage burns and 22.01% for low-voltage burns. High-voltage injuries were associated with more extensive burns, longer hospital stays, and more complications and amputations.ConclusionsMore attention should be paid to prevention of electrical burns in male adults. Particular focus is needed on industrial workers, incidents in the spring and summer, and high-voltage injuries.

Epidemiology and outcome analysis of facial burns: A retrospective multicentre study 2011–2015

BackgroundThe head and neck regions are frequent sites of burns, but few studies have analysed and reported the epidemiology of facial burns. As the face is the centre of one’s identity and persona, facial injuries often result in physical and psychological morbidity. The aim of this article is to describe the epidemiology and outcome of facial burns in China and to suggest future preventive strategies. MethodsThis retrospective analysis included all patients with facial burns in a database at eight institutions from 2011–2015. The data collected included sex, age, month distribution, aetiology, location, presence of inhalation injury, total burn surface area, burn surface area with full-thickness and outcome including Post-traumatic stress disorder Checklist-Civilian Version scores and mortality. SPSS 19.0 software was used to analyse the data. ResultsA total of 1126 patients were included; 65.63% (739) had facial burns, of which 546 (73.88%) were male patients and 193 (26.12%) were female patients. Predictors of facial burns were being of male sex, working-related place, flame burns, total body surface area, and full-thickness burns. In addition, total body surface area and full-thickness burns increased the risk of poor prognosis for post-traumatic stress disorder and mortality. ConclusionsFacial burns benefit not only the healing of wound, but also the prevention of their incidence and PTSD symptom. This study may contribute to the elaboration of strategies to prevent facial burns and the establishment of a nationwide burn database in China.

Epidemiology of severe burns in North-East of Iran: How is the burn size different in a developing country from developed ones?

In contrast to the high prevalence of burn injuries in the low and middle-income countries, accurate data about the epidemiological and etiologic pattern of burns in these countries is limited and scattered. The aim of this study is to present accurate information about the demographical and geographical pattern of burns severely enough to be hospitalized, in the northeast of Iran, in the years 2010–2015. In this cross-sectional study, we included all patients admitted because of acute burn injuries to Imam Reza Burn Center. There were 3352 admissions and approximately three-quarter of them were from Razavi Khorasan province (73.3%, 2458). The mean age of patients was 26.5 ± 19.3 years and 2065 (62%) were male. The overall mortality rate was 21.4% (7 1 7). The mean of burnt total body surface area (TBSA) (50.7 ± 26.3%), mortality rate (41.3%) hospitalization period (20.1 ± 16.7 days) and Abbreviated Burn Severity Index (8.8 ± 3.1) were higher in patients referred from the South Khorasan Province (all p < 0.001). Patients referred from other provinces had the second rank for all mentioned indices. In 63% of patients, burnt TBSA was ≥20% and the mortality rate in this group was 10 folds more than patients with burns less than 20% of TBSA. Burn injury was more common in individuals with lower skills and competencies. About two-thirds of patients had a burnt TBSA ≥ 20% and it was the most important factor involved in high mortality rate in this center. In designing preventive policies in developing countries, safety aspects of mechanisms and activities which lead to severe forms of burn injury must be considered as a priority.

Inpatient Data of Occupational Burn Injuries Treated at a Tertiary Burn Center.

Occupational burns are among the important causes of work-related injuries. We aimed to investigate the epidemiology and reasons of occupational burns and thereby to emphasize preventive measures. Between January 2017 and December 2018, the data of major occupational burn injury patients admitted to our burn center were evaluated in this cross-sectional retrospective study. During the study period 342 patients older than 16 years were admitted to the burn center. Among them 80 patients with occupational burns (23.4%) were identified. The mean age of the patients was 34.73 ± 12.3 years. Seventy-eight patients (97.5%) were male. Electrical burns and flame burns were the two leading type of occupational burns. The most common occupation of our patients was construction work. Dangerous behavior, carelessness, lack of protective equipment, and failure to follow instructions were causes of injury. Only 14 patients (17.5%) experienced unavoidable accident. Thirty-seven patients (46.3%) worked on temporary basis. Occupational experience was under 5 years in majority of the cases (62.5%). For the occupational burns the percentage of burned TBSA was 17.08 ± 14.5 (1-60) and the length of hospital stay was 23.94 ± 21.9 days (2-106). There were no significant differences between occupational and nonoccupational burn injuries considering TBSA, total length of hospital stay, and complications (P > .05). Occupational burn injuries are common in less experienced and younger workers. Therefore, recognition of the problem and maintaining awareness is important. In order to prevent occupational accidents and burns, occupational health and safety rules must be obeyed.

Epidemiology of caustic burns in the upper gastrointestinal tract in adult: our experience with 212 cases

Ingestion of caustic products remains a common emergency in Morocco.Our study covers 212 cases of ingestion of caustics collected in the VisceralSurgical Emergency Department of university hospital Mohammed VI inMarrakech. The average age of our patients is 35. Most of our patientscome from a disadvantaged socio-economic class. They ingested causticsubstances as part of an attempt at autolysis in 54.24% of cases. Salt spiritis the most commonly used product (56.60% of cases) with quantitiesexceeding 150cc in 18% of cases. Fibroscopy often performed within 48hours showed stage I digestive lesions in 21.90% and stage II and IIIlesions in 52% and 7.80% of the cases respectively. Public education oncaustic products is an essential measure in any prophylactic action againstthis problem.Keywords: Caustic ingestion–adult–autolysis-hydrochloric acid- Morocco

A Six-Year Study on Epidemiology of Electrical Burns in Northern Iran: Is It Time to Pay Attention?

BACKGROUNDAlthough electrical burns are less prevalent than other types, they put socioeconomic burden on communities, yielding higher mortalities. Therefore, the frequency and causes of electrical burns in the largest burn center in northern Iran were studied.METHODSAll patients with electrical burn injuries admitted to Velayat Hospital, Rasht, Iran participated in this descriptive cross-sectional study. The data collection tool was a checklist including demographic data, damage mechanism, voltage classification (high or low), injured organ, ICU need, length of stay (LOC), electrical burn severity (degree and area of burns based on TBSA), surgical interventions, and return to work. All data were gathered through HIS system and analyzed.RESULTSMost electrical burns occurred in men (99.4%) and most of whom had electricity-related jobs (26%). The majority of victims had third-degree burns (63%), and electrical current-induced burns in entry points occurred in the upper and lower extremities, head and other organs ranked the first to fourth, respectively. Most burns happened due to abrupt contact with electrical current (83.33%) in routine home activities (52.78%). The mean LOC was 8.73 days, suggesting that LOC increased significantly, if the electrical current entered the body through lower extremities, while it decreased significantly, if the electrical current exited through lower extremities. CONCLUSIONThe majority of electrical burn victims were men. Most burns occurred in urban communities in summer. Most people were affected by high voltage electricity.

EPIDEMIOLOGY OF BURNS AND ITS OUTCOME IN A TEACHING HOSPITAL - A 10 YEARS STUDY.

EPIDEMIOLOGY OF BURNS AND ITS OUTCOME IN A TEACHING HOSPITAL - A 10 YEARS STUDY.

Fireworks and Seafood Boils: The Epidemiology of Burns in Louisiana.

Epidemiological trends provide a means for targeting efforts in burn prevention. There have been but few regional-specific studies concerning burns in the southern United States. This study describes burn injury trends experienced by a single burn center in Louisiana. We also investigate the temporal relationships of several activities informally known for having a high risk for burn injury among local providers. Data were retrospectively extracted from the records of all patients treated for burn injuries at the regional burn center from 2012 to 2018 in both inpatient and outpatient settings. Demographical data and burn injury characteristics were noted. A total of 6,498 patients were included (1,593 inpatient, 4,905 outpatient). The most common burn etiologies were scald and flame, with flame being associated with more severe injuries. Overall incidence was disproportionally high in males and children less than 4 years of age. Total incidence was highest in Caucasians, though African Americans held the highest annual incidence rate specific to this population. The most common situation at the time of burn injury involved the consumption or preparation of food or beverages. Significant variation was observed in the rates of different injury situations throughout the year. Notably, burns related to seafood, heating, and firework activity occurred more often during crawfish season, colder months, and the months of January and July, respectively. In addition to establishing preliminary trends, these data may be useful in guiding the development of future evidence-based prevention efforts to target the most detrimental burn injuries in this population.

EPIDEMIOLOGY OF BURNS AND ITS OUTCOME IN A TEACHING HOSPITAL - A 10 YEARS STUDY.

EPIDEMIOLOGY OF BURNS AND ITS OUTCOME IN A TEACHING HOSPITAL - A 10 YEARS STUDY.

Severe burns in Australian and New Zealand adults: Epidemiology and burn centre care

IntroductionStudies describing the epidemiology of severe burns (>20% total body surface area) in adults are limited despite the extensive associated morbidity and mortality. This study aimed to describe the epidemiology of severe burn injuries admitted to burn centres in Australia and New Zealand. Materials and methodsData from the Burns Registry of Australia and New Zealand (BRANZ) were used in this study. Patients were eligible for inclusion if they were admitted between August 2009 and June 2013, were adults (18-years or older), and had burns of 20% total body surface area (TBSA) or greater. Demographics, burn characteristics and in-hospital mortality risk factors were investigated using multivariable Cox proportional hazards analysis. ResultsThere were 496 BRANZ registered patients who met the inclusion criteria. Over half of the patients were aged 18–40 years and most were male. The median (IQR) TBSA was 31 (25–47). Most (75%) patients had burns involving <50% TBSA, 58% sustained their burn injury at home, and 86% had sustained flame burns. Leisure activities, working for income and preparing food together accounted for over 48% of the activities undertaken at the time of injury. The in-hospital mortality rate was 17% and the median (IQR) length of stay was 24 (12–44) days. Seventy-two percent were admitted to an intensive care unit (ICU) and 40% of patients had an associated inhalation injury. Alcohol and/or drug involvement was suspected in 25% of cases. ConclusionThis study describes the demographics, burn injury characteristics and in-hospital outcomes of severe burn injuries in adults whilst also identifying key predictors of inpatient mortality. Key findings included the over-representation of young males, intentional self-harm injuries and flame as a cause of burns and highlights high risk groups to help aid in the development of targeted prevention strategies.

Epidemiology and Burn out Consequences in a Large Therapeutic Center in Iran (2010-2015)

Introduction: Burns have impacts including medical, psychological, economic and social that involve patients and health care system. Epidemiologic factors of burns vary in different societies. While the effects of some burn variables on mortality rate, in similar circumstances, are expected to be universal. The present study was carried out to analyze the epidemiology, mortality, and current etiological factors of burn injuries.Material and Methods: This cross-sectional study was conducted during a period of 6 years (from 2010 to 2015). Data were obtained by the analysis of medical records of patients hospitalized in the Imam Reza Burn Center in Mashhad, Iran. The data were recorded by the nurses and staffs in the burn ward.Results: In our study, 1334 in-hospital burn patients were recorded. The mean age was 27 ± 5.67 years. The most common mechanism of burn was flame. The multivariable logistic regression modeling revealed, that the most important risk factors of patient mortality were length of stay (LOS) (OR=2.53(95% CI: 1.75-3.66), percentage of burn regarding body surface (BBS) OR=10.64(95% CI: 7.58-14.43), degree of burns OR=6.39(95% CI: 1.46-27.99). Conclusion: The results of our study revealed a high incidence of burns. Prevention plans should be made in this regard

89 Felony Legislation and the Shifting Epidemiology of Butane Hash Oil Burns

In 2012, with the passage of Amendment 64, our state legalized marijuana for recreational use. Afterwards, an exponential increase in butane hash oil (BHO) extraction explosions occurred. In response, the state enacted Revised Statute CRS18-18–406.6 (CRS 18) in July 2015, making manufacture of marijuana concentrate using flammable means a felony. We sought to investigate the impact of this legislation on the epidemiology of BHO burns and felony prosecutions. A retrospective review was performed on patients admitted to our ABA-verified burn center with BHO burns occurring in our state from January 2012 to December 2017. Data collected included patient demographics, location of incident, and total body surface area burned (% TBSA). De-identified statewide data on CRS 18 prosecutions were provided by the Division of Criminal Justice. Prosecutions were grouped by judicial districts, and were geocoded along with BHO explosions. County-wide population estimates were provided by the state demography office. Mapping was performed using R statistical software with chi square analysis. Within the study period, 56 patients were admitted for BHO burns. Median age was 28 years old (range 18–60), male 88% (n=49), median TBSA 11.5% (range 1 - 72%). In 2012, only one BHO burn was admitted, followed by 11 admissions in 2013. After passage of CRS 18, the number of BHO burns dropped from 12 in 2014 to only 6 in 2015. All admissions in 2015 occurred before CRS 18 passage, with no BHO admissions documented in the subsequent 9 months. However, 2016 and 2017 admissions increased to 12 and 14, respectively. The number of annual prosecutions filed remained similar: 34.5 per million (pm) in 2015, 34.0 pm in 2016, and 37.1 pm in 2017. Geographically, the largest metropolitan area had some of the highest numbers of prosecutions filed, whereas, BHO related burns in this metropolitan region decreased after passage (18 injuries prior, 7 injuries after, p=0.019). Areas outside Denver saw increases in BHO burns, see Figure. Overall, the impact of felony legislation on BHO burns was dramatic, but short lived. Despite consistent prosecutions filed, the incidence of burns is increasing. The geographic distribution of BHO burns has also changed. Continued research will evaluate what long-term impact felony legislation, if any, has on BHO extraction burns. This may help states considering marijuana legalization develop prevention strategies.

Epidemiology and outcome of suspected inhalational burn injury in a Ghanaian tertiary hospital

BackgroundApproximately 6–20% of burned patients have a concurrent inhalational injury, and the combination of inhalational injury and cutaneous injury may increase the patient’s risk for increased mortality. ObjectiveTo assess the epidemiology and outcomes of burns associated inhalational injury in a Ghanaian tertiary facility. MethodologyA retrospective approach was utilised, from January 2010 to December 2016. Patients’ folders were retrieved to confirm data obtained. Descriptive statistics were generated to understand the characteristics of the study participants. ResultsOut of 616 patients admitted at our Burns Intensive Care Unit with cutaneous burns, 59 (9.57%) of them had concurrent inhalational injury. Fifty-four out of the fifty-nine patients died with percentage mortality of 91.53%. More males were admitted with inhalational injury (81.40%) as compared to females. Majority of patients with inhalational injury were within the ages of 21–40 years (n = 21). The total burned surface areas were within 10%–50% with most patients within the limits of 41%–50%. Mean cutaneous burn size was obtained as 41.29% (SD = 21.7). Most patients spent 5–15 days (n = 32) on admission with mean of 11.91 days. ConclusionMortality resulting from concurrent burns and inhalational injury is very high. Various advanced techniques and equipment need to be made available for excellent patient management.