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Published on: February 23, 2024
Risk factors for mortality in burn children
Maria Teresa Rosanova1, Daniel Stamboulian2, Roberto Lede3
1Hospital de Pediatría J P Garrahan, Argentina.
Insights
Young children (≤ 4 years), severe burns (Garces score 4), and specific treatments like mechanical ventilation or colistin for resistant infections increase mortality risk in pediatric burn patients.
Area of Science:
- Pediatric Burn Care
- Infectious Diseases in Children
- Critical Care Medicine
Background:
- Studies on pediatric burn mortality risk factors are limited.
- Understanding these factors is crucial for improving outcomes in critically ill children.
Purpose of the Study:
- To identify and analyze risk factors associated with mortality in pediatric burn patients.
- To inform clinical practice and targeted interventions for high-risk children.
Main Methods:
- Retrospective analysis of 110 pediatric burn patients.
- Inclusion of demographic, burn characteristics, injury severity (Garces index), treatments, and infection data.
- Univariate and multivariate statistical analyses to determine independent risk factors for mortality.
Main Results:
- Mortality rate was 15%, with 14 deaths linked to infection.
- Univariate analysis identified age ≤ 4 years, full thickness burns, large burn surface area (≥ 40%), inhalatory syndrome, and various invasive procedures as risk factors.
- Multivariate analysis revealed age ≤ 4 years, Garces score 4, colistin use for multiresistant infections, mechanical ventilation, and graft requirement as independent predictors of mortality.
Conclusions:
- Young age (≤ 4 years) and severe burns (Garces score 4) are significant risk factors.
- Use of colistin for multiresistant infections, mechanical ventilation, and graft requirements are independently associated with increased mortality.
- Findings highlight the need for vigilant management of infections and tailored care for high-risk pediatric burn patients.
Unlabelled:
Studies about risk factors for mortality in burn children are scarce. We conducted this study to evaluate the risk factors for mortality in pediatric burn patients. We included 110 patients. Mean age was 31.5 months (range: 1 to 204). The burn surface was between 1% and 95%(median 27%) Type of burn was: A or superfitial in 39 patients (36%), AB or intermediate in 19 (17%), and B or full thickness in 52 (47%). Inhalatory injury was present in 52 patients (47%). Invasive procedures were: venous catheter, 90 patients (82%), arterial catheter, 83 patients (75.5%), urinary catheter, 86 patients (78%), and mechanical ventilation, 75 patients (68%). In 84 patients, 128 infections were diagnosed. in 53 cases (48%). Multiresistant Pseudomonas aeruginosa and Acynetobacter baumannii were the most common organisms isolated. The median length of hospital stay was 33 days (r: 8-139 days). Seventeen patients (15%) died and 14 of them of infection-related causes. Age ≤ <4 years, Garcés 4, full thickness burn, ≥ 40% burn surface, presence of inhalatory syndrome, use of venous catheter, arterial catheter, urinary catheter and mechanical ventilation, positive blood cultures, colistin use in documented multiresistant infections, antifungal use and graft requirement, were identified as risks factors for mortality in the univariate analysis. By multivariate analysis: age ≤ 4 years, Garcés 4, colistin use in multiresistant infections, mechanical ventilation and graft requirement were independent variables related with mortality.
Conclusions:
In this series of burn children age ≤ 4 years, Garces index score 4, colistin use in documented multiresistant infections, mechanical ventilation and graft requirement were identified as independent variables related with mortality.
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