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Published on: February 23, 2024
Epidemiology of paediatric burns in Iran
H Karimi1, A Montevalian, A R Motabar
1Department of Plastic and Reconstructive Surgery.
Insights
This study analyzed burn injuries in Tehran from 2005-2009, finding scalds common in young children and flames/electricity in older ones. Infants faced the highest injury risk, while older children had severe burns, with a 10.6% overall mortality rate.
Area of Science:
- Burn epidemiology
- Trauma research
- Public health
Background:
- Burn injuries represent a significant public health concern globally.
- Understanding the epidemiology of burn injuries is crucial for developing effective prevention and treatment strategies.
- Tertiary burn care centers play a vital role in managing severe burn cases.
Purpose of the Study:
- To investigate the epidemiological characteristics of burn patients treated at a tertiary burn care center in Tehran.
- To identify risk factors associated with burn injuries, including age, burn type, and location.
- To analyze the microbial patterns and mortality rates in burn patients.
Main Methods:
- A retrospective study was conducted on patients admitted to Motahari Burn Hospital in Tehran between 2005 and 2009.
- Data collected included patient demographics, burn etiology, total body surface area (TBSA) burned, burn depth, length of hospital stay, and mortality.
- Wound and blood cultures were analyzed to identify causative microorganisms.
Main Results:
- Scalding was the predominant cause of burns in children under 6, while flame and electrical burns were more common in older children.
- Males constituted the majority of burn patients (male to female ratio, 1.7:1).
- The most frequent burn locations were kitchens, and most injuries occurred during summer.
- Infants were at the highest risk for burn injuries, and older children for severe burns.
- The overall mortality rate was 10.6%, with factors like older age, flame burns, inhalation injury, TBSA > 40%, and sepsis being critical.
- Coagulase-negative Staphylococcus was the most common pathogen in wound cultures (66.8%), and Pseudomonas aeruginosa in blood cultures (12% of positive wound cultures).
Conclusions:
- Burn injuries in Tehran exhibit distinct epidemiological patterns based on age and burn etiology.
- Targeted prevention and treatment programs are essential for high-risk groups, focusing on factors like age, burn type, and severity.
- Effective pre-hospital care is vital, while traditional home therapies can be detrimental.
- The prevalence of specific bacterial infections highlights the need for vigilant infection control and appropriate antimicrobial strategies in burn care.
Abstract:
We surveyed the epidemiology of the patients in a tertiary burn care centre (the Motahari Burn Hospital) in Tehran in the 4-yr period 2005-2009. Scalding was the major cause of burn injury for patients under the age of 6, while there were many more flame and electrical burns in late childhood. Males were mainly affected (male to female ratio, 1.7:1). Most burns occurred in the summer, probably due to older children's increased outdoor activities during school vacations. Most of the injuries took place in the kitchen. Age was directly related to the higher total body surface area and mortality rate. Explosion of propane gas at home had a high incidence. Length of hospital stay increased in relation to the burn surface area. Infants were found to be at greatest risk for burn injuries, while older children were at higher risk for severe burns. Before arriving at the hospital, 22 patients had received traditional therapy in the home which was not effective and caused some problems. Pre-hospital care by emergency medicine service personnel was complete and effective. 374 patients had positive results for wound culture (42.9%). The most frequent bacteria found in burn wound cultures was coagulase-negative Staphylococcus (66.8%). Blood culture was positive in 12% of the patients with positive burn wound culture and the most frequent bacteria in blood culture was Pseudomonas aeruginosa. The overall mortality rate was 10.6%. Treatment and prevention programmes should target high risk groups. Important criteria include older age, flame burn, presence of inhalation injury, total body surface area burned above 40%, and sepsis.
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