Risk Factors For Burn Injuries Research Articles

Techniques to Assess Long-Term Outcomes after Burn Injuries

Burn injuries have a tremendous impact on not only the physical health of the burn survivor, but also mental health and social outcomes of the individual and their support systems. While much effect occurs at the point of injury, post-injury pain, infection, scarring, inflammatory response and metabolic changes all impact the long-term health of the burn survivor. The goal of the following article is to explore how to examine long term outcomes associated with burn injury, including mental disorders, suicide, loss of work and quality of life in the context of risk factors for burn injury, including social determinants of health. We then discuss ways to examine post-burn outcomes, including the important role of administrative data, the advantages of mixed methodology research studies including qualitative research, and the importance of considering sex, gender and vulnerable populations, not only in study design, but in prevention and intervention programs.

The effect of neighborhood Area Deprivation Index on residential burn injury severity

IntroductionResidential fires account for the majority of burn-related injuries and fatalities. Established risk factors for burn injury include male gender, racial minority, children and elderly individuals, poverty, and substandard housing characteristics. In North Carolina, the rate of residential fire injuries and deaths is higher than the national average. Therefore, we sought to describe residential fire hospitalizations at a large regional burn center and describe the neighborhoods in which they live. We hypothesized that patients living in areas with higher Area Deprivation Index (ADI) are more likely to have major residential burns. MethodsWe conducted a retrospective analysis of burn admissions from January 2002 to December 2015. We dichotomized patients into two cohorts: residential and non-residential burns and performed a bivariate analysis. Multivariate Poisson regression models were utilized to determine if ADI was associated with inhalation injury and ≥20% total body surface area burn. ResultsOf the 10,506 patients presented during the study period. Of these, 10,016 (95.3%) patients resided in North Carolina, and 7894 (78.8%) had a residential burn. Of the overall cohort, 6.0% (n=458) of patients had ≥20% TBSA burns and 6.4% (n=506) had inhalation injury. The majority of patients were in the highest (most disadvantaged) ADI quartile (n=3050, 39.5%), and only 6.8% of patients (n=525) were in the lowest (least disadvantaged) ADI quartile. In the Poisson multivariate regressions to determine if the ADI was associated with severe burns, patients in the highest ADI quartile had an increased relative risk of ≥20% TBSA burn (RR 1.31, 95% CI 1.02–1.68) and inhalation injury (RR 1.39, 95% CI 1.09–1.76) when compared to patients in the second-lowest ADI quartile when controlled for pertinent covariates. ConclusionResidential structure fires represent the major source of burns and fatalities. People who reside in the highest ADI quartile are more like to present with higher burn injury severity in terms of burn size and the presence of inhalation injury. The use of the ADI to target neighborhoods for burn prevention is imperative.

Risk factors for burn injuries and fire safety awareness among patients hospitalized at a public hospital in Nairobi, Kenya: A case control study

IntroductionBurn injuries are some of the most physically and psychologically devastating forms of trauma and most common injuries affecting children, especially in the home environment. They are more prevalent and are a public health problem in developing countries mainly because of poor socio-economic conditions. Effective prevention programs should be guided by the results of well-designed studies aimed at investigating risk factors for burns. Study objectiveTo establish the risk factors for burn injuries among patients hospitalized at the Kenyatta National Hospital (KNH). MethodologyThis was an age and gender matched case-control study comprising 202 patients admitted with burns (cases) and 202 non-surgical patients (controls) admitted into the pediatric and medical wards. The study site was KNH, a 1800-bed national referral and teaching hospital in Kenya. Data analytical methodsSPSS version 17 was used for data analysis, with descriptive statistics used for demographic data, whereas in the analysis for risk factors chi square test and odds ratio (OR) were used to determine the relationship between the predictive (risk factors) and outcome variables (burn injury). Logistic regression was used to determine the strength of association between risk factors and burn injury. ResultsThe risk factors found to be significant for burn injuries were: low level of education (p=0.043), use of kerosene as fuel for cooking (OR=2.027; 95% CI: 1.361–3.019, p=0.000) and lack of knowledge of burn injury prevention and fire safety (OR=4.009; CI: 2.603–6.172, p=0.000). ConclusionLow level of education, use of kerosene for cooking and lack of knowledge of burn injury prevention and fire safety were identified as risk factors for burn injury among patients hospitalized at KNH. These risk factors should be addressed in burn injury prevention programs for Kenya.

Burns in Tehran: demographic, etiological, and clinical trends

Abstract Background: Burns are a major public health problem. They often require intensive care and long periods of hospitalization. In Tehran, about 5% of all hospitalized injuries are burns. There are no published long-term epidemiological studies regarding burn injuries of adults in Iran. Objective: To identify risk factors for burn injuries and provide a starting point for the establishment of an effective prevention plan. Methods: We analyzed the demographic, etiological, and clinical data of 1860 burn patients admitted to a major acute care hospital in Tehran between March 2010 and April 2011. Data were obtained from the registry recorded in Shahid Motahari Trauma Hospital and evaluated using a chi-square test. Results: Males were more than twice as likely to be burn patients than females (72.0% vs. 28.0%). Second and third-degree burns with a body surface area of 21%-30% constituted the highest injury reported (75.3%). The most common causes of the recorded burns were natural gas, gasoline (42%) and open fire (10.2%). Unintentional burns were reported in 85% of the cases, and 15% of the burn victims were suicide-related incidents; mainly among women. In 75% of suicide attempts, women set themselves on fire to commit suicide. The mean duration of hospitalization was 25 days and the mortality rate was 10.7%. Mean age of reported deaths was 38.6 years; with a mean of 30 years among women and 51.5 years among men. Conclusion: The group at highest risk was young men 21-30 years old. However, an astonishing finding was that 75% of suicidal-related incidents involved women setting themselves on fire. Those with the highest mortality rate were victims of burns with gas, gasoline, and kerosene; with a mean age of 30 years of death among women.

Risk factors for burns at home in Kurdish preschool children: a case-control study

BackgroundIt is globally reported that young children are at a higher risk of burns but little is known about the individual risk factors. This study was undertaken in 2008 to...

Mortality pattern of burn patients admitted in S. G. M. Hospital Rewa: A teaching institute of central India

Background: Burn injuries rank among the most severe types of injuries suffered by the human body with an attendant high mortality and morbidity rate. In previous studies, incidence, severity and deaths due to burn were found higher in young married women in India. Study to find out mortality pattern in burn patient was not carried out in this part of country. Objective: To identify demographic and sociocultural factors, type, modes, causes and risk factors for burn injuries and their gender-wise association. Materials and Methods: It was a retrospective study. Data were collected from all burn patients who admitted and died while on the treatment from 2004 to 2009. A total of 586 patients were included in this study. Data were gathered from hospital records and entered in the excel sheet. Analysis of data was done by using SPSS version 17 statistical software. Results: The mean age of patients was 22.66 years (range 1 m to 80 years). Episodes of burn were 4.63 times common in female (82.25%) than in male (17.75%). It was statistically significant in females of age group 21-30 years (93.93% vs. 15.33% P < 0.0001). Married females (86.80%) burned more commonly than married males (13.19%) P < 0.0001. Flame burn was the major cause of death (95.56%). Kerosene was the most common (69%) source of flame burn. Clothes caught fire while working on Chullha were 25% cases ( P < 0.0001). Accidental (86.44%) burn was the most common intention of injury. The majority of burn deaths (68%) occurred within one week of the incident due to septicemia (57%). Conclusion: Factors associated with an increase in mortality were accidental burns, burn size, young age, married women, and flame burns. For planning and implementing prevention programs, the approach has to be multidisciplinary and coordinated.

Epidemiology of burn injuries II: Psychiatric and behavioural perspectives

Modern technological advances have decreased the incidence and severity of burn injuries, and medical care improvements of burn injuries have significantly increased survival rates, particularly in developed countries. Still, fire-related burn injuries are responsible for 300,000 deaths and 10 million disability-adjusted life years lost annually worldwide. The extent to which psychiatric and behavioural factors contribute to the incidence and outcomes of these tragedies has not been systematically documented, and the available data is often insufficient to reach definitive conclusions. Accordingly, this article reviews the evidence of psychiatric and behavioural risk factors and prevention opportunities for burn injuries worldwide. Psychiatric prevalence rates and risk factors for burn injuries, prevalence and risks associated with ‘intentional’ burn injuries (self-immolation, assault, and child maltreatment), and prevention activities targeting the general population and those with known psychiatric and behavioural risk factors are discussed. These issues are substantially interwoven with many co-occurring risk factors. While success in teasing apart the roles and contributions of these factors rests upon improving the methodology employed in future research, the nature of this entanglement increases the likelihood that successful interventions in one problem area will reap benefits in others.

Epidemiology of Childhood Burn Injuries in Newfoundland and Labrador, Canada

Purpose The objective of this study was to identify the epidemiologic characteristics of childhood burn injuries in the province of Newfoundland and Labrador. Methods A population-based study was carried out on children aged 0–16 years who were hospitalized due to burn injuries in Newfoundland and Labrador between April 1995 and March 2001. Hospital and mortality data were obtained from the provincial hospital separation database and the Mortality Surveillance System, respectively. The Newfoundland and Labrador population was considered as a whole and as two separate geographic areas. Results A total of 157 hospital separations due to burn injuries were identified during the study period. The incidence rate of burns requiring hospitalization in the province was 22.6 per 100,000 person-years (P-Y). The rates for males and females were 28.1 and 16.8 per 100,000 P-Y, respectively (P Conclusion Age (infants) and gender (male) are potential risk factors for burn injury in Newfoundland and Labrador. Study results indicate a difference in the epidemiologic pattern of burn injury between Newfoundland and Labrador. It is recommended that preventive programs be directed towards high risk groups to reduce the incidence of burns.

Epidemiology of childhood burn injuries in Newfoundland and Labrador, Canada

The objective of this study was to identify the epidemiologic characteristics of childhood burn injuries in the province of Newfoundland and Labrador. A population-based study was carried out on children aged 0–16 years who were hospitalized due to burn injuries in Newfoundland and Labrador between April 1995 and March 2001. Hospital and mortality data were obtained from the provincial hospital separation database and the Mortality Surveillance System, respectively. The Newfoundland and Labrador population was considered as a whole and as two separate geographic areas. A total of 157 hospital separations due to burn injuries were identified during the study period. The incidence rate of burns requiring hospitalization in the province was 22.6 per 100,000 person-years (P-Y). The rates for males and females were 28.1 and 16.8 per 100,000 P-Y, respectively (P < 0.000001). Infants (0–1 year) had the highest rate of burn injury (89.6 per 100,000 P-Y) followed by children aged 2–4 years (26.2 per 100,000 P-Y) (P < 0.000001). Labrador, a region with high Aboriginal population (51.5 per 100,000 P-Y), had a higher rate of burn injury compared to Newfoundland (20.5 per 100,000 P-Y) (P = 0.00001). Median age of patients with burns was 2 years in Newfoundland and 9 years in Labrador, respectively (P < 0.01). Overall, scald burn (52.2%) was the most frequent type of burn followed by fire (32.5%). In Newfoundland, scald burn was the most common type of burn (56.4%), while in Labrador fire was the most frequent type (66.7%). Overall mortality rate due to burns was 0.9 per 100,000 P-Y. Age (infants) and gender (male) are potential risk factors for burn injury in Newfoundland and Labrador. Study results indicate a difference in the epidemiologic pattern of burn injury between Newfoundland and Labrador. It is recommended that preventive programs be directed towards high risk groups to reduce the incidence of burns.

Severe Burns as a Consequence of Seizure while Showering: Risk Factors and Implications for Prevention

Severe Burns as a Consequence of Seizure while Showering: Risk Factors and Implications for Prevention

A survey of risk factors for burns in the elderly and prevention strategies.

Elderly burn patients suffer from greater morbidity and mortality than younger patients with similar burn extents. The purpose of this study was to identify risk factors for burn injuries in the elderly to develop an effective preventive program. A cross-sectional survey was conducted among 20 elderly (> or =65 years of age) burn survivors on the circumstances surrounding their burn injury and on burn prevention. A control group of 20 nonburned elderly completed a similar survey only on burn prevention. The majority of burned subjects believed that their injury was preventable (85%). The home was the commonest location for burn injury (70%), and scalds (50%) and flame burns (25%) were the most common etiologies. Most subjects felt that a burn prevention program would be useful (95%) and television, news, and posters were the preferred sources of prevention information. Compared with the burn group, the control group had more risk factors for burn injury. However, the control group also took more active preventive measures. Burn prevention campaigns for elderly should focus on reducing flame and scald burns that occur in the home, preferably using television, news, and poster media.

Epidemiology of burn injuries in Mekele Town, Northern Ethiopia: A community based study

Introduction: Epidemiological study on burn injuries and exploration of the risk factors in different settings is important for effective intervention. Very little is known about burn injuries in Ethiopia. Objectives: The aims of this study were to assess the annual incidence of burn injuries and to describe the local knowledge about burns in Mekele town in Tigray, Ethiopia. Methodology: We did a cross sectional survey of burn injuries on 7309 individuals in 1390 households. Results: The annual incidence in burns was 1.2%. Burn had the highest incidence among children less than 5 years old (4.8%). Scald (59%) was the leading cause of burn followed by flame (34%). Most burns occurred at home (81%). Eighty nine point four percent of the burns healed with minor or no sequelae, 9.4% developed sequelae and the mortality was 1%. Crowding and employment were significant risk factors for burn injury. Domestic burn injuries were common among women of reproductive age and work related burns were more common among men. Many people (36%) used harmful substances with deleterious consequences as first aid measure for burn. Discussion: This is the first study from northern Ethiopia and underlines that burn represents a major public health problem. However as we have used a long recall period people may have forgotten minor injuries and we may have underestimated the true incidence. Many people either do not know or have harmful misconceptions about first aid measures for burn injuries. Thus we recommend health education about burn prevention and first aid measures be given to the public. [Ethiop. J. Health Dev. 2002;16(1):1-7]

A STUDY OF EPIDEMIOLOGICAL ASPECTS OF BURN INJURIES

A study was conducted of the epidemiological aspects of 500 fresh cases of burns during the period February to August 1989. Women in the reproductive age group from the lower socioeconomic strata were the most frequently victims (52.8%). Four hundred and thirteen (82.5%) patients sustained accidental burns, 62 (12.4%) were suicidal and 25 (5%) homicidal. Majority (72%) of the accidents occurred as a consequence of garments catching fire. Though most of the subjects wore cotton garments, mortality was higher among those wearing synthetic fabric. Low socioeconomic conditions, overcrowding in the house, floor-level cooking, unsafe cooking appliances and the prevalent clothing pattern stand out prominently as risk factors for burn injury.

Determinants of behavioural risk factors for burn injuries

Systematically developed health education should be based on a thorough knowledge of the determinants of the behavioural risk factors. Compared to other health-related behaviours, safety behaviour has some specific characteristics, which complicate studying its determinants. First, there is a multitude of circumstances leading to injuries, which means that it is not possible to pinpoint one desired behaviour to be linked with the prevention of injuries. Secondly, people are often not familiar with (the advantages and disadvantages of) all the possible preventive measures. Thirdly, the usefulness of preventive measures may depend on housing situations. So far, no elegant way of coping with these problems in examining the determinants of safety behaviour seems to have been suggested in the literature. In this article an approach to the study of determinants of safety behaviour is presented. The general description of this approach is illustrated by a study on the determinants of the behavioural risk factors for burn injuries in young children, which was conducted among Dutch and Turkish parents of children aged 0-4 years. The results indicate, for instance, that parents who implemented the safety behaviour reported that safety behaviour had become habitual to them.

How to study the aetiology of burn injury: The epidemiological approach

Effective prevention of burn injury should be based on sound aetiological knowledge. This article deals with epidemiological methods to study the incidence of burn injury as a function of its risk factors. Central methodological issues are comparability of baseline prognosis, comparability of measurements (of effects in cohort studies and of risk factors in case-control studies), and comparability of external circumstances. These principles are clarified with a number of fictitious examples of risk factors for burn injury. It is explained that in preventive trials comparability may be achieved by randomization, blinding and placebo intervention. The main tools in non-experimental studies are deliberate selection and multivariate analysis. Special attention is given to the definition of the source population and to reducing measurement incomparability in case-control studies. Some well-designed case-control studies following these principles might bring effective prevention of burn injury some steps nearer.