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Epidemiological and clinical features of paediatric inpatients for scars: A retrospective study
Zhe Zhu1, Weishi Kong2, Yahuan Lu3
1Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai, China; Clinic of the 91681 troop of PLA, Zhejiang, China.
Insights
Paediatric scar patients are predominantly male and prone to scalds and surgical scars, with higher incidence on limbs and perineum. Scar contracture is common, necessitating surgical intervention for improved outcomes.
Area of Science:
- Dermatology
- Paediatric Surgery
- Epidemiology
Background:
- Scars represent a significant cause of hospitalization and disease burden in children.
- Understanding the unique epidemiological and clinical characteristics of paediatric scars is crucial for effective management.
Purpose of the Study:
- To delineate the epidemiological and clinical features of paediatric scar inpatients.
- To inform and facilitate optimized therapeutic strategies for children with scars.
Main Methods:
- A cross-sectional study analyzing data from 53,741 paediatric scar cases admitted to 1064 tertiary hospitals between 2013 and 2018.
- Data extracted from the Hospital Quality Monitoring System (HQMS) database.
- Statistical analysis comparing paediatric scar patients with adult and elderly cohorts.
Main Results:
- Paediatric scar patients were predominantly male (62.27%) and commonly affected by scalds (37.10%) and operative interventions (34.11%).
- Scars were more prevalent on upper limbs, lower limbs, and perineum in children compared to older age groups.
- Scar contracture (45.27%) was the most frequent complication, with 66% undergoing surgical treatment, primarily lesion release (56.35%). Keloid proportion was lower in children (6.20%).
Conclusions:
- Scars are a significant factor in paediatric hospitalizations, highlighting the need for targeted interventions.
- Male children, burn survivors, and those with injuries to extremities and the perineum require specific attention.
- Improved therapeutic strategies and prognoses for paediatric scar patients can be achieved through focused care.
Objectives:
To describe the epidemiological and clinical features of paediatric scar inpatients and then to facilitate therapeutic schedule for children with scars.
Methods:
In this cross-sectional study, data of patients admitted for scar treatment in 1064 tertiary hospitals from 2013 to 2018 were extracted through the Hospital Quality Monitoring System (HQMS) database. Demographic and clinical features of children with scars were analysed statistically and highlighted compared with those of adults and the elderly scar cases.
Results:
In this study, 53,741 paediatric scar cases, accounting for 30.29% of all hospitalized for scar, were analysed. Compared to adults and the elderly, children with scars were mainly males (62.27% vs 50.98% vs 49.85%, P < 0.001) and were vulnerable to scalds (37.10%) and operative intervention (34.11%). Although the scalp/face/neck was the most common affected location, the proportion of scars involving upper limbs (27.88% vs 21.69% vs 7.28%, P < 0.001), lower limbs (15.14% vs 10.28% vs 6.56%, P < 0.001) and perineum (4.59% vs 3.13% vs 2.65%, P < 0.001) was higher in children than that in other two groups. Scar contracture was the most common complications in children (45.27%). Nearly 66% of paediatric scar cases received surgical treatment during hospitalization, among whom release of lesion was the most frequent operation (56.35%). The proportion of keloids was relatively lower in child cases than in other two groups (6.20% vs 14.48% vs 18.15%, P < 0.001). Additionally, the median LOS in child cases was 9 (5-15) days, slightly exceeding that in adult/elderly cases.
Conclusions:
Scars were common inducing factors of hospitalization and contributed greatly to the disease burden of children. More attention should be paid to those who are males, burn survivors, or skin-injured at extremities and perineum to improve therapeutic strategies and prognoses for paediatric scar patients.
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