Burn Injury Outcomes Research Articles

Patient, or Prisoner? - Acute Burn Injuries in Prisoners: The Birmingham Burns Centre Experience.

Increased risk of violence and self-harm means prisoners are a vulnerable population with complex health needs. They account for a small proportion of patients with burn injuries, however present a unique set of challenges. This study investigates the incidence, pattern and outcomes of burn injuries in prison population. Prisoners referred from 2010-2021 were identified using the International‎‎‎‏‏‎ Burn Injury Database(iBID). Patient demographics, burn injury characteristics and outcomes were collected. Patients were then stratified based on mechanism of injury, treatment modality (surgery/conservative), hospital admission (inpatient/outpatient) and compliance with outpatient follow-up, for subgroup analyses. Sixty-eight prisoners sustained burns during the study period, with a median age of 28.5 years and TBSA of 3%. The majority were male (98.5%) and required hospital admission (75%). Scalds were the most common injury type (77.9%) and assault the most frequent cause of burns (63.2%). Eighteen patients (26.5%) underwent a surgical procedure and there were two mortalities. Of patients for whom follow-up was planned, 22% attended no appointments, with a further 49% of prisoners missing at least one appointment. Relative to patients managed non-operatively, prisoners undergoing surgery had a longer stay and all attended outpatient follow-up appointments. Prisoners represent a unique population with exceptional challenges. Attention should be given to protecting vulnerable patients at risk of assault, education of prison staff around burn prevention and first aid, and ensuring that prisoners are able to access burns follow-up to minimise long term sequelae. Opportunities exist to aid this such as the adoption of telemedicine.

In-hospital outcomes of paediatric burn injuries managed in children’s hospitals compared to general hospitals

IntroductionIn Australia and New Zealand, children with burn injuries are cared for in either general hospitals which cater to both adult and paediatric burn injuries or in children’s hospitals. Few publications have attempted to analyse modern burn care and outcomes as a function of treating facilities. AimThe aim of this study was to compare in-hospital outcomes of paediatric burn injuries managed in children’s hospitals to those treated in general hospitals that regularly treated both adult and paediatric burn patients. MethodsA retrospective cohort study of cases was undertaken using data from the Burns Registry of Australia and New Zealand (BRANZ). All paediatric patients with data for an acute or transfer admission to a BRANZ hospital and registered with BRANZ with a date of admission between 1 July 2016 and 30 June 2020 were included in the study. The primary outcome of interest was the acute admission length of stay. Secondary outcome measures of interest included admission to the intensive care unit and readmission to a specialist burn service within 28 days. The Alfred Hospital Ethics Committee granted ethical approval for this study (project 629/21). ResultsA total of 4630 paediatric burn patients were included in the analysis. Approximately three quarters of this cohort (n = 3510, 75.8%) were admitted to a paediatric only hospital, while the remaining quarter (n = 1120, 24.2%) were admitted to a general hospital. A greater proportion of patients admitted to general hospitals underwent burn wound management procedures in the operating theatre (general hospitals 83.9%, children’s hospitals 71.4%, p < 0.001). Patients admitted to children’s hospitals had a longer median time to their first episode of grafting (children’s hospitals 12.4 days, general hospitals 8.3 days, p < 0.001). The adjusted regression model for hospital LOS indicate that patients admitted to general hospitals had a 23% shorter hospital LOS, compared to patients admitted to children’s hospitals. Neither the unadjusted or adjusted model for intensive care unit admission was significant. After accounting for relevant confounding factors, there was no association between service type and hospital readmission rates. ConclusionsComparing children’s hospitals and general hospitals, different models of care seem to exist. Burn services in children’s hospitals adopted a more conservative approach and were more inclined to facilitate healing by secondary intention rather than surgical debridement and grafting. General hospitals are more “aggressive” in managing burn wounds in theatre early, and debriding and grafting the burn wounds whenever considered necessary.

Burn injury characteristics, referral pattern, treatment (costs), and outcome in burn patients admitted to a hospital with or without a specialized Burn Centre (BURN-Pro)

PurposeData on the epidemiology, treatment, and outcome of burn patients treated at non-burn centre hospitals are not available. The primary aim was to compare the burn characteristics of patients admitted to a hospital with or without a specialized burn centre.MethodsThis multicentre, prospective, cohort study enrolled patients with burns admitted to a hospital without a burn centre and patients with < 10% total body surface area (TBSA) burned admitted to the burn centre. Primary outcome measure was the burn-related injury characteristics. Secondary outcome measures were adherence to the Emergency Management of Severe Burns (EMSB) referral criteria, treatment (costs), quality of life, and scar quality.ResultsDuring the 2-year study period, 48 patients were admitted to a non-burn centre and 148 patients to the burn centre. In the non-burn centre group, age [44 (P25–P75 26–61) versus 30 (P25–P75 8–52) years; P = 0.007] and Injury Severity Score [2 (P25–P75 1–4) versus 1 (P25–P75 1–1); P < 0.001] were higher. In the burn centre group, the TBSA burned was significantly higher [4% (P25–P75 2–6) versus 2% (P25–P75 1–4); P = 0.001], and more surgical procedures were performed (in 54 versus 7 patients; P = 0.004). At 12 months, > 85% of the non-burn centre group and > 75% of the burn centre group reported no problems in quality of life. Scar quality score was < 1.5 in both groups, with significantly poorer scores in the burn centre group (P ≤ 0.007).ConclusionBoth groups differed in patient, burn, and treatment characteristics. At 12 months, quality of life and scar quality were good in both groups. Significantly poorer scar quality scores were found in the burn centre group. This might be related to their larger burns and more frequent surgery. The organization of burn care in the Netherlands seems to work adequately. Patients are treated locally when possible and are transferred when necessary.

Clinical Pattern and Outcome of Burn Injury in Children in AaBet Trauma Center Addis Ababa Ethiopia: Prospective Study.

Burn injuries are among the most prevalent health conditions worldwide that happen mainly in children, military, and victims of fire accidents. The previous literature had general limitations in that it focused on the retrospective study design, which can be prone to incomplete data or lack the full evidence of the problem, however, this study is a prospective study that gives a clue to the possible determinant factors of burn injury in pediatrics. The purpose of this study was to assess the clinical pattern and outcome of burn injury in children at the AaBet trauma center in Addis Ababa, Ethiopia, between July 2016 and July 2020. An institutional-based prospective study was conducted in an AaBet trauma center. The study participants were chosen using a systematic random sampling method and followed for 4 years to determine their clinical outcomes after burn injury. A pretested observational check list was used to collect the data. The collected data were coded, entered Epi-data version 4.6, and exported to SPSS version 26 for descriptive and inferential analysis. A binary logistic regression model was used to identify factors associated with burn injury on the adjusted odd ratio with a 95% confidence interval at a p-value of < .05. A total of 256 patients were recruited for this study. Scald burns accounted for 50.8% of the injury mechanisms, with 93.8% of the incidents occurring in private residences. Second-degree burns were the most common presentation of the victims (83%). Lower limbs were the most frequently burned body part (47%). Over 70% of the victims had 20% of their body surface area burned. Intentional burns accounted for 1.2% of all burn victims. The length of the hospital stay ranged from 1 day to 164 days with a mean stay of 24.73 days. Eight patients (3.1%) died during the study period. Pediatric burn incidences showed no significant discrepancies between males and females. Scald and open flame are the common causes of burn injury. Most incidents occurred in indoor settings, and most of the victims had not received first aid at home. Most patients left the hospital with no or minimal complications. Only 3.1% of the patients died. Patients who had burn-associated injuries were 98.8% less likely to be alive than those who had no associated injuries at all. For all governmental and non-governmental bodies, it is highly recommended to give priority to preventive measures and education on the need for appropriate prehospital care.

The Effect of Drug Abuse on Clinical Outcomes of Adult Burn Patients Admitted to a Burn Center in the North of Iran.

Burn trauma is a life-threatening incident that may be accompanied by several risk factors that increase morbidity and mortality. Drug abuse is one of the lifestyle dangers on the rise globally and can have an impact on the outcomes of burn injuries. This study aimed to evaluate the effect of drug abuse on the clinical outcomes of adult burn patients who were admitted to a burn center in the North of Iran. This retrospective cross-sectional study included adult burn patients who were referred to Velayat Hospital, between March 1, 2021, and March 20, 2022. The hospital information system (HIS) was used to select patients with a history of drug use and then were compared with burn victims who had never used drugs before. In both groups, demographic information, the cause of the burn, the comorbid diseases, total body surface area, length of stay, and outcomes were collected and recorded for both groups. This study included 114 inpatients, 90 of whom (78.95%) were men. The mean age of the patients was 43±15 years. The mean length of hospitalization in the drug-user group was significantly higher than in the non-drug abuse group (p=0.004). The drug abuse group had significantly higher rates of comorbid diseases (p=0.021), inhalation injury (p<0.001), mortality (p=0.002), and pneumonia (p<0.001). However, there were no statistically significant differences in the Infection and Sir's rates (p=0.583) between the groups. Drug abuse is a risk factor in adult burn patients, which can affect the length of stay and burn-related morbidities.

Evaluation of clinical outcomes and comparison of prediction models in the burn population hospitalized from the emergency department: Can burn mortality scores be used in a post-conflict area such as northwest Syria?

Burns are a global health problem, especially in low- and middle-income countries. The use of models to predict mortality is more common in developed countries. In northern Syria, internal unrest has continued for 10 years. A lack of infrastruc-ture and difficult living conditions increase the incidence of burns. This study in northern Syria contributes to the predictions of health services provided in conflict regions. The first objective of this study specific to northwestern Syria was to assess and identify risk factors in the burn victim population hospitalized as emergencies. The second objective was to validate the three well-known burn mortality prediction scores to predict mortality: the Abbreviated Burn Severity Index (ABSI) score, Belgium Outcome of Burn Injury (BOBI) score, and revised Baux score. This was a retrospective analysis of the database of patients admitted to the burn center in northwestern Syria. Patients who were admitted to the burn center as emergencies were included in the study. Bivariate logistic regression analysis was performed to compare the effectiveness of the three included burn assessment systems in determining the risk of patient death. A total of 300 burn patients were included in the study. Of them, 149 (49.7%) were treated in the ward, and 46 (15.3%) in the intensive care unit; 54 (18.0%) died, and 246 (82.0%) survived. The median revised Baux scores, BOBI scores, and ABSI scores of the deceased patients were significantly higher than those of the surviving patients (p=0.000). The cut-off values for the revised Baux, BOBI, and ABSI scores were set at 105.50, 4.50, and 10.50, respectively. For predicting mortality at these cut-off values, the revised Baux score had a sensitivity of 94.4% and a specificity of 91.9%, and the ABSI score had a sensitivity of 68.8% and a specificity of 99.6%. However, the cut-off value of the BOBI scale, calculated as 4.50, was found to be low (27.8%). The low sensitivity and negative predictive value of the BOBI model suggest that it was a weaker predictor of mortality than the others. The revised Baux score was successful in predicting burn prognosis in northwestern Syria, a post-conflict region. It is reasonable to assume that the use of such scoring systems will be beneficial in similar post-conflict regions where limited opportunities exist.

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

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. 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. 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. 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. 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.

COMPARISON OF ASSESSMENT OF ABBREVIATED BURN SEVERITY INDEX (ABSI) AND BELGIAN OUTCOME OF BURN INJURY (BOBI) AT H. ADAM MALIK GENERAL HOSPITAL

Background: Assessment of length of stay and mortality in patients with burn injuries is essential to support clinicians in making clinical decisions. In Indonesia, there are several scoring systems used by hospital centers to assess the mortality of burn patients, such as the Belgian Outcome of Burn Injury (BOBI) and the Abbreviated Burn Severity Index (ABSI). However, different results were obtained in studies that examined the comparison of the results of the scoring system.&#x0D; Method: The type of research used in this research is unpaired comparative analysis research using a cross-sectional design. The data to be used is secondary data taken from medical records.&#x0D; Results: Respondents with death status were found in the serious, severe, and maximum ABSI categories, p=0.001 (p&lt;0.05) and the BOBI 50% category as many as three people and 85% as many as one person, p=0.0001 (0&lt;0.05). Length of stay based on the ABSI score for the length of stay was 23 days with an ABSI score of 12-13 (maximum), and based on the BOBI Score, the majority was 28 days with a BOBI score of 8 (85%). ABSI in this study had a sensitivity of 100% and a specificity of 86.4%, while the use of BOBI in this study had a sensitivity of 100% and a specificity of 88.1%.&#x0D; Discussion: The BOBI scoring system is more accurate than the ABSI. This difference may occur due to differences in demographics and quality of service in each region. Therefore, the analysis of the validity of the scoring model before the research is carried out in a new population is considered crucial to be carried out.

Accurate and early prediction of the wound healing outcome of burn injuries using the wavelet Shannon entropy of terahertz time-domain waveforms.

Severe burn injuries cause significant hypermetabolic alterations that are highly dynamic, hard to predict, and require acute and critical care. The clinical assessments of the severity of burn injuries are highly subjective and have consistently been reported to be inaccurate. Therefore, the utilization of other imaging modalities is crucial to reaching an objective and accurate burn assessment modality. We describe a non-invasive technique using terahertz time-domain spectroscopy (THz-TDS) and the wavelet packet Shannon entropy to automatically estimate the burn depth and predict the wound healing outcome of thermal burn injuries. We created 40 burn injuries of different severity grades in two porcine models using scald and contact methods of infliction. We used our THz portable handheld spectral reflection (PHASR) scanner to obtain the in vivo THz-TDS images. We used the energy to Shannon entropy ratio of the wavelet packet coefficients of the THz-TDS waveforms on day 0 to create supervised support vector machine (SVM) classification models. Histological assessments of the burn biopsies serve as the ground truth. We achieved an accuracy rate of 94.7% in predicting the wound healing outcome, as determined by histological measurement of the re-epithelialization rate on day 28 post-burn induction, using the THz-TDS measurements obtained on day 0. Furthermore, we report the accuracy rates of 89%, 87.1%, and 87.6% in automatic diagnosis of the superficial partial-thickness, deep partial-thickness, and full-thickness burns, respectively, using a multiclass SVM model. The THz PHASR scanner promises a robust, high-speed, and accurate diagnostic modality to improve the clinical triage of burns and their management.

ASSESSMENT OF MICROALBUMINURIA AND BLOOD PLATELET COUNT AND ITS ASSOCIATION WITH THE SEVERITY OF BURNS AND OUTCOMES

Background: Burn injury causes a systemic inflammatory response, leads to reduced platelet count, and leakage of a significant amount of albumin in the interstitium and urine. Prognostic indicators play a critical role in patient management. There are not set prognostic factors indicating the outcome of a patient post burn injury. Objective: Correlate microalbuminuria and platelet count with clinical variables in the post-burn injury patients. It is carried out in an attempt to find a simple, cost-effective and at the same time reliable prognostic factor in burn patients. Methodology: This is a Prospective Cohort study conducted from May 2017 to December 2018. Any patient presenting with thermal burn injury fulfilling the inclusion criteria was included. Patients with a history of renal dysfunction or co-morbidities precipitating were excluded. Inhalational injury, Systemic inflammatory response, renal failure were assessed along with microalbuminuria and platelet count to outcome variable of survivors and non-survivors. A total of 49Results: patients were included. The presence of microalbuminuria showed a strong association with outcome variables but quantitative analysis of the same was not indicative more over microalbuminuria was strongly positive in presence of Inhalational injury and renal failure. Platelet count reached minimum value at 3 - 5 days from injury showing a strong correlation with outcomes. : Microalbuminuria and Platelet count are promising prognostic factors and canConclusion be used to direct the management of the patient with burn injury.

Factors associated with mortality and morbidity among pediatrics with burn injuries in Riyadh, Saudi Arabia.

Objectives:To describe characteristics, mechanism, and factors associated with morbidity and mortality of pediatrics with burn injuries.Methods:This cross-sectional retrospective study examined all pediatrics with burn injuries carried out at King Abdulaziz Medical City, Riyadh, Saudi Arabia, from 2015-2020. Collected data included demographics, mechanism of burn, total body surface area (TBSA) burned, body region burned, incidence of infection, renal failure, scars, and respiratory events.Results:The study included 370 patients. Approximately 47.0% were aged ≤2 years, and 61.0% were males. The most common burn mechanism was scald burn (54%), 59.2% had a TBSA of 0-10%, and 60.3% had regional burns on the upper limbs. During follow-up, 5 patients died (incidence rate [IR]=1.60/100 patient/years [PYs]). Morbidity events included blood/sepsis infection (IR=2.87/100 PYs), urine infection (IR=8.30/100 PYs), wound infection (IR=21.72/100 PYs), renal failure (IR=0.96/100 PYs), and respiratory infections (IR=1.60/100 PYs). In a multivariate Cox regression analysis, factors independently associated with combined hazard of morbidity and mortality were female gender (hazard ratio [HR]=1.64, 95% confidence intervel [CI]: [1.01-2.67], p=0.047), TBSA (HR=3.20, 95% CI: [1.828-5.585], p<0.0001), and length of hospital stay (HR=3.14, 95% CI: [1.91-5.17], p=0.000).Conclusion:This study identifies certain characteristics suggestive of poor outcomes of pediatric burn injuries that are relevant to clinical management and prevention programs. Larger multicenter studies are required to fully characterize pediatric patients with burn injuries and to identify factors that adversely affect their prognosis.

Частота и исходы ожоговой травмы органа зрения

Purpose. Study of the structure, functional outcomes of burn injuries of the organ of vision in patients receiving inpatient treatment in an ophthalmological clinic. Material and methods. A continuous sample of patients with burns of the eyes and its appendages hospitalized in the ophthalmological department for 2017 and 2019. Results. 42 patients were hospitalized in the ophthalmology department, including 12 children under 18 years of age. The largest proportion was the age group from 30 to 50 years (51 %). Men predominated – 30 people (72 %). Thermal burns were in 5 patients (12 %). 37 patients (88 %) had chemical burns. All patients had corneal burns, in particular I degree in 19 people, II degree in 16 people, III degree in 7 people. The burn of the conjunctiva of the eyeball and the conjunctiva of the eyelids was noted in all eyes. Treatment of severe burns was carried out in accordance with the stages of burn injury. Conclusion. During the study period, there were 42 cases of eye burn injuries among residents of Khabarovsk and the Khabarovsk Territory, of which 12 were children under 18 years of age. All of them required hospital treatment. Keywords: thermal, chemical burns of the eye, severity of burn injury to the eyes.

Comparison of prognostic models for severe burn patients in an Indonesian tertiary hospital: retrospective study

Background: Despite the high burn-related mortality rate, few studies investigate the discriminating power of various mortality prognostic models for burn patients in the Indonesian setting. Thus, the objective of our study is to describe and compare the discriminating power of several prognostic models for burn patients, including the Prognostic Burn Index (PBI), Belgian Outcome of Burn In-jury (BOBI), Revised Baux Score (rBaux), and Abbreviated Burn Severity Index (ABSI). Patients and methods: We conducted a retrospective study using medical records data with analysis including patients with severe burn (&gt;20% Total Body Surface Area (TBSA), &gt;10% for children and elderly), excluding those with known chronic conditions. Statistical analyses were performed on IBM SPSS 23.0 and included ROC curve and diagnostic values calculation, including sensitivity, specificity, positive, and negative predictive values with 95%CI. Results: Final analysis included 117 subjects with a 38.9% mortality rate. All prognostic models were statistically significant discriminating power with Area Under the Curve (AUC) values of 0.817, 0.849, 0.929, and 0.859, respectively. Comparing diagnostic values identified rBaux to have the strongest discriminating power with the highest specificity, PPV, and NPV. PBI score was identified with the highest sensitivity score. Conclusion: Discrepancy of results between our study and another Indonesian study with a similar design pointed to the need for a multi-centered study with a larger sample size to improve generalizability and statistical power of analysis.

A five-year prospective study of the Aetiology, Pattern of Presentation, and Management of patients with burns in Ekiti State University Teaching Hospital

Background: Burns constitute a significant public health problem worldwide, with most reported mortalities occurring in low and medium-income countries (LMICs). Therefore, this study aimed to generate epidemiological data on the aetiologies, patterns of presentations, and outcomes of burn injuries in Ado Ekiti, the capital of Ekiti State. Methodology: This was a five-year prospective study of all patients with burns managed at Ekiti State University Teaching Hospital. The required information was entered into a hospital-based burn data collection form from admission to discharge. The data generated were exported to IBM SPSS version 23 for analysis. Results: A total of 160 patients were included in this study. The median age was 10.5 years (IQR 2 – 33). Half of the patients were aged &lt;10 years old. About 66.9% of the injuries occurred indoors, with the kitchen being the most common injury site (49.4%). Scald was the most common aetiology, and most injuries occurred in the morning. While 71.9% had first aid at the injury site, the first aid agents used were potentially harmful in most cases. The injuries were predominantly partial-thickness with a mean TBSA burn of 14% and a median ABSI of 4 (IQR 3 – 5). The lower limbs were the most frequently affected body regions, with an overall mortality rate of 5%. Conclusion: Scalds are the most common aetiology of burns in Ado Ekiti, with most injuries occurring in the kitchen. The populace needs to be adequately educated on the suitable materials to provide first aid to burn victims

Knowledge, Attitudes, and Practices toward First Aid Management of Skin Burns in Saudi Arabia.

Background: Burns are considered a serious health affection that leads to several consequences affecting a person both physically and emotionally. Herbal and traditional medicine have become popular remedies among patients worldwide. Aim: This study explores common practices followed in burns as first aid management. Methods: A cross-sectional study was conducted in the Eastern province of Saudi Arabia using a designed questionnaire distributed electronically through different social media. The questionnaire consisted of socio-demographic details, history of burns, causative material, and practices followed in response to burns. Results: 461 individuals have participated in this study. The commonest reason for burns was hot water or steam. The majority of the respondents (63%) had a satisfactory response to self-aid alone at home. The most common first aid options for managing burns at home were cold water alone 195 (42%), any sort of cream alone 177 (38%), or both 317 (69%). Overall, the result shows no statistically significant difference between the outcome of burn injury and the most commonly used burn aids. Conclusions: Most people use creams and water as the first-aid management of burns, while a good number of people use traditional medicine. Overall, people who receive hospital treatment after getting first aid at home give a better outcome.

Long-term mental health outcomes of severe burn injury: A 5-year follow-up of the 2015 Formosa Fun Coast Water Park fire disaster

ObjectiveSevere burn injuries have profound mental health impacts on individuals, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Many burn survivors also report positive psychosocial changes, termed posttraumatic growth (PTG). This study investigated long-term mental health of severe burn injury (i.e., PTSD, MDD, and PTG) and the longitudinal influences of coping strategies and social support. MethodsNinety-nine adult burn survivors of the 2015 Formosa Fun Coast Water Park fire disaster participated in the 5-year follow-up (Wave 3, W3), with 93% completing the earlier 2- (Wave 1, W1) and 3-year follow-up (Wave 2, W2). Participants averaged 22.1 years of age at burn, and 62.6% were females. The mean total body surface area burned (TBSA) was 50.3%, with a mean length of hospital stay of 87.6 days. ResultsFive years after the 2015 fire disaster, 13.1%, and 14.1% of the survivors met probable DSM-5 PTSD and MDD, while 51.5% reported significant PTG. After controlling for demographic, burn-specific, and baseline outcome variables, avoidance coping at W2 prospectively predicted PTSD and depressive symptoms at W3 (p = .003 and 0.04), with medium-to-large and medium effect sizes (sr2 = 0.10 and 0.05). Approach coping at W2 prospectively predicted PTG at W3 (p = .014), with a medium-to-large effect size (sr2 = 0.07). ConclusionRates of probable PTSD and MDD were still relatively high in long-term burn survivors. However, PTG continued to be highly prevalent. Our findings highlight the importance of coping in affecting the long-term mental health of severe burn injury.

Burn Injuries in People Who Used Drug, 2009 to 2017: A Case-Control Study in Shiraz, Southern Iran.

Burn injury is a critical health issue, which is associated with several morbidities and mortalities. Substance abuse, which is an important public health problem in Iran, can affect burn injury outcomes and etiologies in victims. This study was aimed to evaluate different aspects of burn injuries in people who used drug (PWUD) in two referral centers in the south of Iran. This case-control study was conducted on burn victims referred to Amir-al Momenin Hospital and Ghotb-al-din Hospital from 2009 to 2017. Patients with a history of drug consumption were selected from the database and compared to randomly selected burn victims with no history of drug use. Demographics, burn etiology, underlying disease, total body surface area, hospitalization duration, and also the outcomes were collected and recorded in both groups. Data analysis was done by SPSS software. A total of 5912 inpatients were included in this study, of which 2397 of them (40.54%) were female. The mean age of the patients was 26.12 ± 19.18. Drug history was positive in 659 patients (11.15%). Familial issues and mental disorders were significantly higher in the PWUD group compared to the control group (P < .001). Explosion etiology was significantly higher in the PWUD group (P < .001). Psychiatric disorders (P < .001), total body surface area (P = .023), and hospital stay (P < .001) were significantly higher in PWUD; however, the mortality rate had no statistically significant differences between the groups (P = .583). Substance abuse is a risk factor in burn victims, which can affect burn etiology and burn-related morbidities.

Epidemiology, Clinical Pattern and Management Outcome of Paediatric Burn Injuries in Nepal

Introduction: Burn injuries are third commonest type of injury in Nepal and 61% of burn victims are children. This represents a significant morbidity and mortality burden for patients and families. This study was carried out to describe epidemiology, clinical pattern and therapeutic outcome of children with burn. Methods: It is a retrospective observational study of routinely collected data of children up to 14 years admitted to the Burns Ward at Kanti Children’s Hospital, Kathmandu, Nepal, from July 2016 to July 2019. Statistical analysis was done on the collected data. Results: Total 935 patients were admitted with an average of 311.7 per year, among which 63% were males and 83.0% were aged five years or under. Patients travelled from all over Nepal for treatment at this hospital. 50.6% of patients presented with fresh burns &lt; 24 hours after injury. Scald burn was the commonest (82.6%). Children under five were more likely to have scald burns, whereas older children more likely to have flame or electric burns. Majority of cases (70%) were of mild burns &lt; 10% TBSA and only 3.2% TBSA &gt; 30%. 68.5% were managed conservatively and 18.4% required debridement and skin grafting. Mean length of stay was 15 days. Overall mortality was 1.0%. In children with &gt; 30% burns mortality was 12.9%. Conclusions: Scald burn was the commonest while proportion of flame burn increases with age. Majority of burns occur in male under five years of age. Most cases presented with &lt; 10% TBSA and were managed conservatively.

Neonatal burns: a 10-year review of community- and hospital-acquired neonatal burns in Western Australia.

There are very few studies in the literature focusing on neonatal burns, and to our knowledge this is the largest study on this topic. A retrospective review was conducted over a 10-year period from 2010 to 2020 to investigate the incidence, mechanisms involved and outcomes for burn injuries in neonates in Western Australia. This study included children aged 4 weeks or younger who sustained a burns injury requiring admission to hospital or during their hospital admission. Premature infants who sustained burns during a hospital admission in the neonatal intensive care unit and were under 4 weeks corrected age were also included. Short-term outcomes of burn injuries included infection and need for surgery, and the long-term outcomes included scarring and requirement for laser therapy. Over the 10-year period, 30 burn injuries were sustained by 27 neonates. Thirteen (43.3%) of these burns occurred at home or in the community, and 17 (56.7%) occurred in hospital. Scalds (n=4) and sunburn (n=4) were the most common mechanism in the community, while chemical (n=12) burns including extravasation injuries were the most common sustained in hospital. No neonates required theatre for skin grafting or laser therapy for scarring. There were no infected burns in the cohort. Time to healing ranged from 2 to 62 days with a mean of 12.1 days. Outcomes for burns sustained in the neonatal period in Western Australia are generally positive, and have not been associated with infection and have low rates of scarring.

The Impact of Race/Ethnicity on the Outcomes of Burn Patients: A Systematic Review of the Literature.

Racial and ethnic disparities are endemic to the United States and are only beginning to attract the attention of researchers. With an increasingly diverse population, focused and tailored medicine to provide more equitable care is needed. For surgical trauma populations, this topic is a small but expanding field and still rarely mentioned in burn medicine. Disparities in prevention, treatment, and recovery outcomes between different racial and ethnic minorities who are burned are rarely discussed. The purpose of this study is to determine the current status of identified disparities of care in the burn population literature and areas of future research. A systematic review was conducted of literature utilizing PubMed for articles published between 2000 and 2020. Searches were used to identify articles that crossed the burn term (burn patient OR burn recovery OR burn survivor OR burn care) and a race/ethnicity and insurance status-related term (race/ethnicity OR African-American OR Black OR Asian OR Hispanic OR Latino OR Native American OR Indigenous OR Mixed race OR 2 or more races OR socioeconomic status OR insurance status). Inclusion criteria were English studies in the United States that discussed disparities in burn injury outcomes or risk factors associated with race/ethnicity. One thousand one hundred and sixty-nine papers were populated, 55 were reviewed, and 36 articles met inclusion criteria. Most studies showed minorities had poorer inpatient and outpatient outcomes. While this is a concerning trend, there is a paucity of literature in this field and more research is needed to create culturally tailored medical care and address the needs of disadvantaged burn survivors.