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Influence of demographics and inhalation injury on burn mortality in children

Robert E Barrow1, Marcus Spies, Laura N Barrow

  • 1Department of Surgery, Shriners Hospitals for Children, The University of Texas Medical Branch, 815 Market Street, Galveston, TX 77550, USA. rbarrow@utmb.edu

Burns : Journal of the International Society for Burn Injuries
|December 25, 2003
PubMed

Insights

Inhalation injury significantly increases burn mortality in children. Young children under 3 years old face higher mortality risks from burns, with or without inhalation injury.

Area of Science:

  • Pediatric Burn Care
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Pulmonary failure is a leading cause of mortality in pediatric burn patients.
  • Advances in sepsis management, surgery, and nutrition have shifted mortality causes.
  • This study evaluates factors influencing mortality in burned children.

Purpose of the Study:

  • To assess the impact of pulmonary injury, age, gender, race, and burn size on mortality in children.
  • To determine the lethal burn area (LBA) for varying mortality rates.
  • To identify specific risk factors for mortality in pediatric burn survivors.

Main Methods:

  • Retrospective review of 3179 pediatric burn patients admitted between 1985 and 2001.
  • Analysis of 1246 patients with burns >20% total body surface area (TBSA) admitted within 14 days.
  • Estimation of LBAs using probit curve analysis and statistical tests (chi-squared, t-test, Fisher's exact).

Main Results:

  • A 50% TBSA burn with inhalation injury predicted 10% mortality, versus 73% TBSA for burn only.
  • Children under 3 years with >20% TBSA burns had 9.9% mortality, higher than older age groups.
  • Mortality was significantly higher for burn plus inhalation injury (13.9%) vs. burn only (2.9%) in the 21-80% TBSA range.

Conclusions:

  • Inhalation injury is a major determinant of burn mortality in children.
  • Young children (<3 years) exhibit increased mortality risk, irrespective of inhalation injury.
  • Age and inhalation injury are critical factors influencing outcomes in pediatric burn care.
Abstract

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