Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75 8032, Zurich, Switzerland.
Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75 8032, Zurich, Switzerland.
Burns. 2019 Aug;45(5):1231-1241. doi: 10.1016/j.burns.2019.02.009. Epub 2019 May 13.
Despite advances in surgical management and critical care for burn surgery, morbidity and mortality of patients with severe burns remains high. Especially in the pediatric population, burns often lead to devastating consequences such as the necessity of corrective surgery until adulthood. Worldwide, 80%-90% of all severe burns occur in low to middle income countries. But also in high income countries, burns are distributed inequitably. Risk factors include age, sex, socioeconomic status, and ethnicity.
The objective of this study was to determine the typical demographics and injury-related data of pediatric burn patients in order to contribute to preventive measures. Special interest was paid to the question of whether the incidence of severe burns is higher among patients with an immigration background.
Patient records of the 4373 patients admitted to the Pediatric Burn Unit of the University Children's Hospital of Zurich from 2006 to 2018 were analyzed. Demographic data and injury patterns are presented descriptively. Temporal trends concerning duration of hospitalization and setting (inpatient versus outpatient), differences in relative incidence and in burn mechanism in distinct cohorts (by nation and Human Development Index (HDI)) and seasonal trends were analyzed. Furthermore, risk factors for large burns and for (prolonged) inpatient treatment were examined using a multivariate approach.
Temporal resolution shows considerable variation between inpatient and outpatient treatment (p>0.001) and with shorter hospital stays (p=0.004). Swiss citizens and patients with an immigration background from very highly developed countries sustain a significantly lower incidence of heat-related injuries than all others (p<0.001). The most common burn causes among all children, independent of their country of citizenship, are related to kitchen items or hot tea and coffee (35.57%±4.01% resp. 32.39%±5.95%). Logistic regression revealed that migration background from a low HDI country is significantly associated with larger burns (>5% TBSA) and with a need for inpatient treatment.
The study emphasizes the need for highly specific measures of burn prevention and indicates the necessity of focusing on certain target groups who are especially vulnerable to burns, such as immigrants from less developed countries.
尽管在烧伤外科的手术管理和重症监护方面取得了进展，但严重烧伤患者的发病率和死亡率仍然很高。特别是在儿科人群中，烧伤常常导致严重后果，例如需要进行矫正手术直至成年。在全球范围内，所有严重烧伤中有 80%-90%发生在中低收入国家。但在高收入国家，烧伤的分布也不均衡。危险因素包括年龄、性别、社会经济地位和种族。
本研究旨在确定儿科烧伤患者的典型人口统计学和与损伤相关的数据，以便为预防措施做出贡献。特别关注的问题是，是否具有移民背景的患者发生严重烧伤的几率更高。
分析了 2006 年至 2018 年期间苏黎世大学儿童医院儿科烧伤病房收治的 4373 名患者的病历。描述性地介绍了人口统计学数据和损伤模式。分析了住院时间和治疗场所（住院与门诊）、不同队列（按国家和人类发展指数 (HDI)）的相对发病率和烧伤机制以及季节性趋势的时间趋势。此外，还使用多变量方法检查了大面积烧伤和（延长）住院治疗的风险因素。
时间分辨率显示住院和门诊治疗之间（p>0.001）以及住院时间较短（p=0.004）存在相当大的差异。与所有其他人相比，瑞士公民和来自高度发达国家的移民背景的患者发生热相关损伤的发病率显著降低（p<0.001）。所有儿童中最常见的烧伤原因与厨房物品或热茶和咖啡有关（35.57%±4.01%和 32.39%±5.95%），与国籍无关。逻辑回归显示，来自低人类发展指数国家的移民背景与较大面积烧伤（>5%TBSA）和需要住院治疗显著相关。
该研究强调了烧伤预防措施需要高度具体，并表明需要特别关注某些特别容易受到烧伤影响的目标群体，例如来自欠发达国家的移民。
