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Published on: February 23, 2024
Factors associated with mortality and morbidity among pediatrics with burn injuries in Riyadh, Saudi Arabia
Zainab Alnjeidi1, Nesrin Alharthy1, Suliman Alghnam1
1From the Department of Prevention and Research (Alnjeidi), National Family Safety Program; from the Department of Emergency Medicine (Alharthy), College of Applied Medical Sciences; from the Department of Epidemiology and Biostatistics (Badri), College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, and from the Population Health Section (Alghnam), King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Insights
Pediatric burn injuries are often caused by scalds, with most affecting young males. Female gender, larger burn surface area, and longer hospital stays are linked to increased morbidity and mortality risks.
Area of Science:
- Pediatric Burn Injury Research
- Trauma Care
- Public Health
Background:
- Pediatric burn injuries represent a significant cause of morbidity and mortality globally.
- Understanding the specific characteristics and risk factors is crucial for effective clinical management and prevention strategies.
Purpose of the Study:
- To delineate the demographic, mechanistic, and clinical features of pediatric burn injuries.
- To identify factors associated with increased morbidity and mortality in pediatric burn patients.
Main Methods:
- A retrospective, cross-sectional study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia (2015-2020).
- Data collected included patient demographics, burn mechanism, total body surface area (TBSA) burned, affected body region, and incidence of complications such as infection, renal failure, and respiratory events.
Main Results:
- The study analyzed 370 pediatric patients, with 47.0% aged ≤2 years and 61.0% males. Scald burns were most common (54%), typically affecting the upper limbs (60.3%) with a TBSA of 0-10% (59.2%).
- Mortality incidence was 1.60 per 100 patient-years. Key morbidities included wound infection (21.72/100 PYs) and urine infection (8.30/100 PYs).
- Independent predictors of combined morbidity and mortality were female gender (HR=1.64), increased TBSA (HR=3.20), and longer hospital stay (HR=3.14).
Conclusions:
- Certain patient characteristics and injury factors are associated with poorer outcomes in pediatric burn injuries.
- Findings can inform clinical management and public health prevention programs for pediatric burns.
- Further multicenter research is needed to comprehensively understand pediatric burn injury prognosis.
Objectives:
To describe characteristics, mechanism, and factors associated with morbidity and mortality of pediatrics with burn injuries.
Methods:
This cross-sectional retrospective study examined all pediatrics with burn injuries carried out at King Abdulaziz Medical City, Riyadh, Saudi Arabia, from 2015-2020. Collected data included demographics, mechanism of burn, total body surface area (TBSA) burned, body region burned, incidence of infection, renal failure, scars, and respiratory events.
Results:
The study included 370 patients. Approximately 47.0% were aged ≤2 years, and 61.0% were males. The most common burn mechanism was scald burn (54%), 59.2% had a TBSA of 0-10%, and 60.3% had regional burns on the upper limbs. During follow-up, 5 patients died (incidence rate [IR]=1.60/100 patient/years [PYs]). Morbidity events included blood/sepsis infection (IR=2.87/100 PYs), urine infection (IR=8.30/100 PYs), wound infection (IR=21.72/100 PYs), renal failure (IR=0.96/100 PYs), and respiratory infections (IR=1.60/100 PYs). In a multivariate Cox regression analysis, factors independently associated with combined hazard of morbidity and mortality were female gender (hazard ratio [HR]=1.64, 95% confidence intervel [CI]: [1.01-2.67], p=0.047), TBSA (HR=3.20, 95% CI: [1.828-5.585], p<0.0001), and length of hospital stay (HR=3.14, 95% CI: [1.91-5.17], p=0.000).
Conclusion:
This study identifies certain characteristics suggestive of poor outcomes of pediatric burn injuries that are relevant to clinical management and prevention programs. Larger multicenter studies are required to fully characterize pediatric patients with burn injuries and to identify factors that adversely affect their prognosis.
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