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Published on: February 23, 2024
Epidemiology and trend of US pediatric burn hospitalizations, 2003-2016
Megan Armstrong1, Krista K Wheeler2, Junxin Shi3
1Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
Insights
Pediatric burn hospitalizations and mortality rates have declined significantly. Care is increasingly concentrated in specialized centers, indicated by more transfers and admissions to high-volume pediatric burn facilities.
Area of Science:
- Pediatric Trauma Care
- Burn Injury Epidemiology
- Healthcare Systems Analysis
Background:
- Thermal injuries are a primary cause of unintentional harm, leading to significant morbidity and mortality in children.
- Understanding trends in pediatric burn admissions is crucial for public health initiatives and resource allocation.
Purpose of the Study:
- To analyze trends in US pediatric burn hospital admissions from 2003 to 2016.
- To describe patient and hospital characteristics for pediatric burn admissions in 2016.
- To evaluate the impact of ICD-10 implementation on trend analysis.
Main Methods:
- Retrospective analysis of the Kids' Inpatient Database (KID) from 2003-2016.
- Inclusion criteria: children under 18 with a principal diagnosis of burn.
- Separate trend analyses for 2003-2012 and 2012-2016 due to ICD-10 implementation.
Main Results:
- Pediatric burn admission rates decreased by 4.6% (2003-2012) and 13.4% (2012-2016).
- Hospital mortality rates for pediatric burn patients dropped by 48.1%.
- Admissions to high-volume burn centers (≥100 patients) increased by 63.9% (2003-2012), suggesting care regionalization.
Conclusions:
- Pediatric burn hospitalizations and associated mortality have decreased.
- Increased patient transfers and admissions to specialized centers indicate a trend towards regionalized pediatric burn care.
Background:
Thermal injury is a leading cause of unintentional pediatric trauma morbidity and mortality.
Methods:
This retrospective analysis of the 2003-2016 Kids' Inpatient Database (KID) included children <18 years old with a burn principal diagnosis. The objectives were to describe the trend of US pediatric burn hospital admissions and the patient and hospital characteristics of admitted children in 2016. The trends (2003-2012) and (2012-2016) were evaluated separately due to the 2015 implementation of International Classification of Diseases, Tenth Revision (ICD-10).
Results:
The population rate of pediatric burn admissions decreased by 4.6% from 2003 to 2012, but the proportion of admissions to hospitals with burn pediatric patient volumes≥100 increased by 63.9%. The overall mortality rate of hospitalized burn patients decreased by 48.1%. Median length of stay increased slightly for patients with a burn ≥20% total body surface area (TBSA) but decreased for patients with TBSA burn <20%. From 2012 to 2016, the population rate decreased by 13.4%. In 2016, an estimated 8160 children were admitted with a burn principal diagnosis, and 41.4% transferred in from other facilities. Children age 1-4 years were the most commonly admitted age group (49.7%). Patients with ≥20% TBSA burns accounted for 7.8% of admissions (95% confidence interval [CI]: 5.1-10.4%). Burn-related complications were documented in 5.9% of admissions (95% CI: 4.6-7.1%).
Conclusion:
Pediatric burn hospitalizations and burn-related mortality have decreased over time. The increases in transfers and admissions to hospitals with high pediatric burn volumes suggest increasing regionalization of care.
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