Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Paediatric Surgery, Meibergdreef 9, Amsterdam, The Netherlands.
Amsterdam UMC, Location VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Burns. 2020 Sep;46(6):1243-1253. doi: 10.1016/j.burns.2020.01.008. Epub 2020 Feb 11.
The estimated incidence of non-accidental burns varies between 1-25% in children. Distinguishing non-accidental burns from accidental burns can be very complicated but is of utmost importance for prevention of future injuries. Several studies concerning non-accidental burns have been published, however a clear overview is lacking.
To conduct a systematic review of the existing literature to identify the incidence and characteristics of burns due to intentional causes and neglect.
The protocol of this systematic review was prospectively registered in an international database (PROSPERO, National Institute for Health Research, York, United Kingdom). We searched literature in electronic databases published from 1948 until July 2018 written in English, Dutch, German and French. Two researchers screened, selected and graded the included articles, using standard methodology. We included primary studies of confirmed non-accidental burns in children. We excluded literature reviews, case-reports and unpublished data. We extracted data regarding demographics, burn characteristics, Child Protective Services (CPS) referral information and parent/household characteristics.
825 studies were screened, 17 were included. The incidence of non-accidental burns was pooled out of 10 studies and is 9.7%. Indicators raising a very high suspicion of intentional burns are deep partial thickness and full thickness burns, burns to the posterior trunk and burns caused by hot tap water. Indicators raising a high to moderate suspicion of an intentional cause are burns to buttocks, genital and legs, a younger age of the child, additional injuries such as cutaneous injuries/bruises and fractures. More commonly caused by accidents are burns to head, neck, anterior trunk, upper extremities and feet. Little data are available regarding burns as a result of neglect. Quality of studies was often low to moderate mostly due to a high heterogeneity. This review is mainly based on retrospective studies.
From this review of the literature, the incidence of non-accidental burns in children was 9.7%. Indicators raising a very high suspicion of intentional burns are: location at the posterior trunk, deep partial thickness and full thickness burns and burns caused by hot tap water.
儿童非意外伤害性烧伤的发生率估计在 1%至 25%之间。区分非意外伤害性烧伤和意外伤害性烧伤可能非常复杂，但对预防未来的伤害至关重要。已经发表了几项关于非意外伤害性烧伤的研究，但缺乏明确的概述。
对现有文献进行系统回顾，以确定因故意原因和疏忽导致的烧伤的发生率和特征。
本系统评价的方案在一个国际数据库（PROSPERO，英国约克国家卫生研究院）中进行了前瞻性注册。我们搜索了自 1948 年至 2018 年 7 月发表的英文、荷兰文、德文和法文电子数据库中的文献。两名研究人员使用标准方法筛选、选择和评估纳入的文章。我们纳入了经证实的儿童非意外伤害性烧伤的原始研究。我们排除了文献综述、病例报告和未发表的数据。我们提取了关于人口统计学、烧伤特征、儿童保护服务（CPS）转介信息和父母/家庭特征的数据。
筛选了 825 项研究，纳入了 17 项研究。10 项研究汇总了非意外伤害性烧伤的发生率为 9.7%。深部分厚度和全厚度烧伤、后躯干烧伤和热水烫伤是高度怀疑故意烧伤的指标。臀部、生殖器和腿部烧伤、儿童年龄较小、有皮肤损伤/瘀伤和骨折等额外损伤是高度怀疑故意原因的指标。头部、颈部、前躯干、上肢和脚部烧伤更常见于意外事故。关于因疏忽而导致的烧伤，可用数据很少。研究质量往往较低，主要是由于高度异质性。本综述主要基于回顾性研究。
从对文献的回顾中，儿童非意外伤害性烧伤的发生率为 9.7%。高度怀疑故意烧伤的指标有：位于后躯干、深部分厚度和全厚度烧伤以及由热水引起的烧伤。
