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贫困、人口密度与在美国一家儿科烧伤治疗机构接受治疗的墨西哥幼儿烧伤流行病学

Poverty, population density, and the epidemiology of burns in young children from Mexico treated at a U.S. pediatric burn facility.

作者信息

Patel Dipen D, Rosenberg Marta, Rosenberg Laura, Foncerrada Guillermo, Andersen Clark R, Capek Karel D, Leal Jesus, Lee Jong O, Jimenez Carlos, Branski Ludwik, Meyer Walter J, Herndon David N

机构信息

Department of Psychiatry and Behavioral Sciences at the University of Texas Medical Branch, Galveston, TX 77555, USA.

Shriners Hospitals for Children in Galveston Texas, 77550, USA; Department of Psychiatry and Behavioral Sciences at the University of Texas Medical Branch, Galveston, TX 77555, USA.

出版信息

Burns. 2018 Aug;44(5):1269-1278. doi: 10.1016/j.burns.2018.02.003. Epub 2018 Mar 7.

Abstract

INTRODUCTION

Children 5 and younger are at risk for sustaining serious burn injuries. The causes of burns vary depending on demographic, cultural and socioeconomic variables. At this pediatric burn center we provided medical care to children from Mexico with severe injuries. The purpose of this study was to understand the impact of demographic distribution and modifiable risk factors of burns in young children to help guide prevention.

METHODS

A retrospective chart review was performed with children 5 and younger from Mexico who were injured from 2000-2013. The medical records of 447 acute patients were reviewed. Frequency counts and percentages were used to identify geographic distribution and calculate incidence of burns. Microsoft Powermap software was used to create a geographical map of Mexico based on types of burns. A binomial logistic regression was used to model the incidence of flame burns as opposed to scald burns in each state with relation to population density and poverty percentage. In all statistical tests, alpha=0.05 for a 95% level of confidence.

RESULTS

Burns were primarily caused by flame and scald injuries. Admissions from flame injuries were mainly from explosions of propane tanks and gas lines and house fires. Flame injuries were predominantly from the states of Jalisco, Chihuahua, and Distrito Federal. Scalds were attributed to falling in large containers of hot water or food on the ground, and spills of hot liquids. Scald injuries were largely from the states of Oaxaca, Distrito Federal, and Hidalgo. The odds of a patient having flame burns were significantly associated with poverty percentage (p<0.0001) and population density (p=0.0085). Increasing levels of poverty led to decrease in odds of a flame burn, but an increase in the odds of scald burns. Similarly, we found that increasing population density led to a decrease in the odds of a flame burn, but an increase in the odds of a scald burn.

CONCLUSIONS

Burns in young children from Mexico who received medical care at this pediatric burn center were attributed to flame and scalds. Potential demographic associations have been identified. Different states in Mexico have diverse cultural and socioeconomic variables that may influence the etiology of burns in young children and this information may help efficiently tailor burn prevention campaigns for burn prevention efforts in each region.

APPLICABILITY OF RESEARCH TO PRACTICE

This information will be used to develop and help modify existing prevention campaigns.

摘要

引言

5岁及以下儿童面临严重烧伤风险。烧伤原因因人口统计学、文化和社会经济变量而异。在这家儿科烧伤中心,我们为来自墨西哥的重伤儿童提供医疗护理。本研究的目的是了解幼儿烧伤的人口分布和可改变风险因素的影响,以帮助指导预防工作。

方法

对2000年至2013年期间受伤的5岁及以下墨西哥儿童进行回顾性病历审查。审查了447名急性患者的病历。使用频数计数和百分比来确定地理分布并计算烧伤发生率。使用微软PowerMap软件根据烧伤类型创建墨西哥地理地图。使用二项逻辑回归模型来模拟每个州火焰烧伤与烫伤的发生率与人口密度和贫困率的关系。在所有统计检验中,95%置信水平下的α = 0.05。

结果

烧伤主要由火焰和烫伤引起。火焰伤导致的入院主要来自丙烷罐和燃气管道爆炸以及房屋火灾。火焰伤主要来自哈利斯科州、奇瓦瓦州和联邦区。烫伤归因于跌入地面上的大热水或食物容器以及热液体溢出。烫伤主要来自瓦哈卡州、联邦区和伊达尔戈州。患者发生火焰烧伤的几率与贫困率(p < 0.0001)和人口密度(p = 0.0085)显著相关。贫困程度增加导致火焰烧伤几率降低,但烫伤几率增加。同样,我们发现人口密度增加导致火焰烧伤几率降低,但烫伤几率增加。

结论

在这家儿科烧伤中心接受治疗的墨西哥幼儿烧伤归因于火焰和烫伤。已确定潜在的人口统计学关联。墨西哥不同州具有不同的文化和社会经济变量,可能会影响幼儿烧伤的病因,这些信息可能有助于为每个地区的烧伤预防工作有效地量身定制烧伤预防活动。

研究在实践中的适用性

这些信息将用于制定和帮助修改现有的预防活动。

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