Tang Y, Wang L X, Chen J J, Liu J Q, Ren L C, Liu X S, Yin M F, Zhang D X, Huang Y S, Zhang J P
Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, Chongqing 400038, China.
Zhonghua Shao Shang Za Zhi. 2016 Oct 20;32(10):599-605. doi: 10.3760/cma.j.issn.1009-2587.2016.10.006.
To analyze the epidemiological characteristics of hospitalized children with severe burn from several regions in China during 3 years, so as to provide evidence for prevention of burns in children. Relying on the entry system of epidemiology data and biological sample of severe burn from multicenter in clinic, medical records of children with severe burn, aged 18 and under, hospitalized in 6 burn wards from February 2012 to February 2015 were collected. The children were divided into 5 age brackets: less than or equal to 1 year old, more than 1 year old and less than or equal to 3 years old, more than 3 years old and less than or equal to 6 years old, more than 6 years old and less than or equal to 12 years old, more than 12 years old and less than or equal to 18 years old. Meanwhile the children were divided into rural and urban children according to their residences. Data of gender and residence of children in the 5 age brackets, cause of injury, location of injury, total burn area, wound site, inhalation injury and combined injury, and source of hospitalization expenses of children in the 5 age brackets and two types of residence, and outcome and length of hospital stay of the children were analyzed. The cause of injury of children in different location of injury was analyzed. In addition, they were divided into 2 age brackets: less than or equal to 6 years old and more than 6 years old and less than or equal to 18 years old, and then incidences of hand and foot burn injury were compared. Data were processed with chi-square test, and the correlation between age and total burn area was processed with Spearman correlation analysis. Four hundred and forty out of 1 106 inpatients with severe burn were children, accounting for 39.8% who were included in the system. (1) The majority of children were male (270, 61.4%). The number of children more than 1 year old and less than or equal to 3 years old ranked the first (222, 50.5%) in the 5 age brackets. The ratio of children from rural areas to that from urban areas was 2.9∶1.0. There were no statistically significant differences in both gender and residence of children among the 5 age brackets (with values respectively 7.649 and 9.399, values above 0.05). (2) Scald was the most common cause of burn. There was statistically significant difference in injury cause of children among the 5 age brackets (=136.307, <0.001). There was no statistically significant difference in injury cause of children among the two types of residence (=5.164, >0.05). (3) Private house was the most common location of injury. There was statistically significant difference in location of injury of children among the 5 age brackets (=124.930, <0.001). There was no statistically significant difference in location of injury of children among the two types of residence (=3.364, >0.05). There was statistically significant difference in injury cause of children in different location of injury (=118.284, <0.001). (4) Most of children were with total burn areas from 10% to 39% total body surface area. There was statistically significant difference in total burn area of children among the 5 age brackets (=103.568, <0.001). There was positive correlation between age and total burn area (=0.177, <0.001). There was no statistically significant difference in total burn area of children among the two types of residence (=16.213, >0.05). (5) Trunk, lower extremity, and upper extremity were the most common wound sites, respectively. There was statistically significant difference in wound site of children among the 5 age brackets (=45.674, =0.019). There was statistically significant difference in incidence of hand and foot burn between children less than or equal to 6 years old and children more than 6 years old and less than or equal to 18 years old (with values respectively 29.188 and 14.612, values below 0.01). There was no statistically significant difference in wound site of children among the two types of residence (=8.515, >0.05). (6) Twenty-seven children suffered inhalation injury. The main age bracket was more than 12 years old and less than or equal to 18 years old (8 children). The main residence was rural area (18 children). The main cause of inhalation injury was flame burn (23 children). Nine children suffered combined injury, among which the children more than 12 years old and less than or equal to 18 years old accounted for the highest ratio (5 children), and the urban children accounted for higher ratio (5 children). (7) Among the 437 children, most of their hospitalization expenses were at their own expense. There was statistically significant difference in the source of hospitalization expenses of children among the 5 age brackets (=17.917, =0.001). There was no statistically significant difference in the source of hospitalization expenses of children among the two types of residence (=0.749, >0.05). (8) Among the 437 children, 34 children abandoned treatment and were discharged from hospital, attributed to lack of funding. Seventy-eight children were discharged with a better health condition and 347 were cured. The condition of 6 children worsened and 6 children died. Mean length of hospital stay was 28.6 days for all the children, and 8.8 days for the deteriorated and dead children. Children were the major group of patients with severe burn in China. Male children less than or equal to 6 years old were common with scald as the major cause of injury, private house as the major location of injury, and trunk, lower and upper extremity as the most common wound sites, their own expenses as the major source of hospitalization expenses. There were statistically significant differences in cause of injury, location of injury, total burn area, wound site, and hospitalization expenses source of children among the 5 age brackets.
分析我国部分地区3年住院儿童重度烧伤的流行病学特征,为儿童烧伤预防提供依据。依托临床多中心重度烧伤流行病学数据及生物样本录入系统,收集2012年2月至2015年2月在6个烧伤病房住院的18岁及以下重度烧伤患儿的病历资料。将患儿分为5个年龄组:小于或等于1岁、大于1岁且小于或等于3岁、大于3岁且小于或等于6岁、大于6岁且小于或等于12岁、大于12岁且小于或等于18岁。同时,根据患儿居住地将其分为农村和城市儿童。分析5个年龄组及两种居住地患儿的性别、居住地、受伤原因、受伤部位、烧伤总面积、创面部位、吸入性损伤及合并伤情况、住院费用来源,以及患儿的转归和住院时间。分析不同受伤部位患儿的受伤原因。此外,将患儿分为2个年龄组:小于或等于6岁和大于6岁且小于或等于18岁,比较手足烧伤发生率。数据采用卡方检验处理,年龄与烧伤总面积的相关性采用Spearman相关分析处理。1106例重度烧伤住院患者中,440例为儿童,占纳入系统患者的39.8%。(1)患儿以男性居多(270例,61.4%)。5个年龄组中,大于1岁且小于或等于3岁的患儿数量最多(222例,50.5%)。农村患儿与城市患儿的比例为2.9∶1.0。5个年龄组患儿的性别和居住地差异均无统计学意义(χ²值分别为7.649和9.399,P值均大于0.05)。(2)烫伤是最常见的烧伤原因。5个年龄组患儿的受伤原因差异有统计学意义(χ² =136.307,P<0.001)。两种居住地患儿的受伤原因差异无统计学意义(χ² =5.164,P>0.05)。(3)家中是最常见的受伤地点。5个年龄组患儿的受伤地点差异有统计学意义(χ² =124.930,P<0.001)。两种居住地患儿的受伤地点差异无统计学意义(χ² =3.364,P>0.05)。不同受伤部位患儿的受伤原因差异有统计学意义(χ² =118.284,P<0.001)。(4)多数患儿烧伤总面积为10%~39%体表面积。5个年龄组患儿的烧伤总面积差异有统计学意义(χ² =103.568,P<0.001)。年龄与烧伤总面积呈正相关(r =0.177,P<0.001)。两种居住地患儿的烧伤总面积差异无统计学意义(χ² =16.213,P>0.05)。(5)躯干、下肢和上肢是最常见的创面部位。5个年龄组患儿的创面部位差异有统计学意义(χ² =45.674,P =0.019)。小于或等于6岁患儿与大于6岁且小于或等于18岁患儿的手足烧伤发生率差异有统计学意义(χ²值分别为29.188和14.612,P值均小于0.01)。两种居住地患儿的创面部位差异无统计学意义(χ² =8.515,P>0.05)。(6)27例患儿发生吸入性损伤。主要年龄组为大于12岁且小于或等于18岁(8例)。主要居住地为农村地区(18例)。吸入性损伤的主要原因是火焰烧伤(23例)。9例患儿发生合并伤,其中大于12岁且小于或等于18岁患儿占比最高(5例),城市患儿占比更高(5例)。(7)437例患儿中,多数住院费用为自费。5个年龄组患儿的住院费用来源差异有统计学意义(χ² =17.917,P =0.001)。两种居住地患儿的住院费用来源差异无统计学意义(χ² =0.749,P>0.05)。(8)437例患儿中,34例因经济困难放弃治疗出院。78例患儿好转出院,347例患儿治愈。6例患儿病情恶化死亡。所有患儿平均住院时间为28.6天,病情恶化及死亡患儿平均住院时间为8.8天。儿童是我国重度烧伤的主要患者群体。小于或等于6岁男性患儿常见,主要受伤原因是烫伤,主要受伤地点是家中,最常见的创面部位是躯干、下肢和上肢,住院费用主要来源是自费。5个年龄组患儿的受伤原因、受伤部位、烧伤总面积、创面部位及住院费用来源差异有统计学意义。