Division of Physical Medicine and Rehabilitation, Departments of Clinical Neurosciences, Pediatrics and Surgery, Faculty of Medicine, University of Calgary, Canada; Department of Comparative Biology & Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Canada.
Unidad de Niños Quemados Dra. Thelma Rosario (UNIQUEM), Santiago, Dominican Republic.
Burns. 2019 Mar;45(2):471-478. doi: 10.1016/j.burns.2018.03.014. Epub 2018 Dec 17.
Pediatric burns are preventable with legislative and infrastructural changes. Although retrospective audits of many low- and middle-income countries have aided preventative efforts, the epidemiological status of burns in the Caribbean is not known. This study characterizes pediatric burns in the Dominican Republic (DR) and compares these to age-matched North American records captured by the National Burn Repository.
A retrospective audit of 1600 patients admitted to the Unidad de Niños Quemados Dra. Thelma Rosario Hospital, the island's only major pediatric burn center, between January 2010 to March 2017 was performed. Epidemiological variables analyzed included age, gender, burn mechanism, year, month, city, admission duration, nationality, mortality, and %TBSA.
Pediatric burn patients in the DR sustained larger burns (8.2% vs. 6.5% TBSA) and spent more days in the hospital (10 vs. 6 days). Females were overrepresented (M:F=1:1.5) and mortality amongst admitted patients was 4-fold higher (2.8% vs. 0.7%). Electrical burns were significantly overrepresented in DR (21%) compared to age-matched North American patients (2%). Although electrical burns were smaller (4% TBSA), compared to scald (14% TBSA), and flame (19% TBSA), these burns preferred hands and had a high mortality rate (3%). No significant seasonality in burn mechanisms were observed. Finally, we report geographical and age group differences in the distribution of burn mechanisms and highlight particularly vulnerable subpopulations.
This investigation identifies a demographical profile where electrical burns account for a significant percentage of the burn population. This provides a basis for concentrating preventative efforts in vulnerable populations.
通过立法和基础设施的改变,可以预防儿科烧伤。虽然对许多低收入和中等收入国家的回顾性审计有助于预防工作,但加勒比地区的烧伤流行病学状况尚不清楚。本研究描述了多米尼加共和国(DR)儿科烧伤的特点,并将其与国家烧伤资料库中匹配年龄的北美记录进行了比较。
对 2010 年 1 月至 2017 年 3 月期间,该岛唯一的主要儿科烧伤中心——德拉·特丽莎·罗萨里奥医院收治的 1600 名患者进行了回顾性审计。分析的流行病学变量包括年龄、性别、烧伤机制、年份、月份、城市、住院时间、国籍、死亡率和 %TBSA。
DR 的儿科烧伤患者烧伤面积更大(8.2% vs. 6.5% TBSA),住院时间更长(10 天 vs. 6 天)。女性比例过高(M:F=1:1.5),住院患者的死亡率高出 4 倍(2.8% vs. 0.7%)。与匹配年龄的北美患者(2%)相比,DR 中电烧伤明显更为常见(21%)。尽管电烧伤面积较小(4% TBSA),但与烫伤(14% TBSA)和火焰烧伤(19% TBSA)相比,这些烧伤更喜欢手部,且死亡率较高(3%)。未观察到烧伤机制的明显季节性差异。最后,我们报告了烧伤机制在地理和年龄组分布上的差异,并强调了特别脆弱的亚人群。
本研究确定了一个人口统计学特征,其中电烧伤占烧伤人群的很大比例。这为集中预防工作提供了基础,以针对脆弱人群。