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Published on: February 23, 2024
Pediatric burn injury at home over 30 years: A road to future prevention
Ryo Yamamoto1, Yukio Sato1, Junichi Sasaki1
1Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan.
Insights
Pediatric home burn injuries show decreasing flame burns and burn severity over 30 years. However, scald burns remain prevalent, necessitating targeted prevention strategies for child safety.
Area of Science:
- Pediatric burn research
- Public health
- Injury prevention
Background:
- Home-acquired pediatric burns are a significant concern.
- Understanding trends in burn injuries is crucial for effective prevention.
Purpose of the Study:
- To analyze the characteristics and temporal changes of pediatric burn injuries sustained at home in an urban setting.
- To identify trends in burn mechanisms, severity, and outcomes over three decades.
Main Methods:
- Retrospective observational study utilizing a comprehensive database from Tokyo burn centers and related organizations.
- Inclusion of pediatric patients (≤15 years) with home burn injuries over 30 years.
- Analysis of burn mechanism, severity (%, total body surface area), and outcomes across five 6-year intervals.
Main Results:
- No significant change in the overall incidence of home burn injuries.
- A marked decrease in flame burns (7.7% to 1.6%) contrasted with a persistent high incidence of scald burns (>80%).
- Reduction in burn area (%TBSA), hospital stay duration, and stable low in-hospital mortality rates.
Conclusions:
- Flame burns and burn severity have decreased in pediatric home injuries, correlating with improved clinical outcomes.
- Scald burns remain a consistent and significant issue, indicating a need for enhanced public health interventions and social strategies for prevention.
Introduction:
Injury prevention is valuable for pediatric burns at home. To develop future target of prevention, we aimed to elucidate characteristics and chronological changes of pediatric burn injuries at home in urban areas.
Patients And Methods:
We conducted a retrospective observational study using the database of the Tokyo Burn Unit Association, which comprises 14 tertiary burn centers, the Tokyo Fire Department, Tokyo Medical Association, and the Tokyo city government. We included pediatric patients aged ≤ 15 years who had a burn injury at home in the last 30 years and divided them into five groups at 6-year intervals. We compared the mechanism, severity, and outcome of burn injuries between the groups.
Results:
We included 1092 pediatric patients, with no significant chronological changes in the incidence of burn injuries at home (approximately 200 patients in each 6-year period). The median age was 1 year in all the groups. Flame burns decreased from 7.7 % to 1.6 %, whereas scald burns remained at > 80 %. The burn area decreased from 10 (5-16) % total body surface area (%TBSA) to 7 (3-11) %TBSA. The length of hospital stay was reduced from 6 to 2 days, and in-hospital mortality was 0.4-0.5 % in the last decade.
Conclusions:
The incidence of flame burns and burn area decreased over time with improving clinical outcomes in pediatric burns. The number of scald burns remained the same over time; thus, further social intervention is needed to prevent scald burns.
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