Department of Surgery, University of North Carolina at Chapel Hill, United States.
Kamuzu Central Hospital, Lilongwe, Malawi.
Burns. 2021 Feb;47(1):228-233. doi: 10.1016/j.burns.2020.05.005. Epub 2020 May 19.
There is increasing evidence that sex differences may influence pathophysiology after thermal injury and affect clinical outcomes. This study aimed to assess the relationships between sex, thermal injury, and inpatient mortality in a pediatric burn cohort in a resource-limited setting.
This is a retrospective analysis of data collected from the Kamuzu Central Hospital Burns Unit, in Lilongwe, Malawi, from May 2011 to December 2019 on all pediatric patients (≤12 years). We performed a bivariate analysis by sex comparing demographics, burn characteristics, surgical intervention, and mortality. Standardized estimates were adjusted using the inverse probability of treatment weights to account for confounding. Following weighting, odds of mortality based on sex were obtained via logistic regression modeling.
A total of 1904 children were admitted with a male preponderance (n = 1065, 55.9 %). Overall, the median age was 3 years (IQR1-4). Females had a higher percent total body surface area (%TBSA) burn than males, 15 % vs. 13 % (p = 0.03), respectively. Flame burns were more frequent in females compared to males, 32 % and 23 %, respectively (p < 0.001). There were higher rates of surgical intervention in females than males (20.9 % vs. 16.7 %, p = 0.02). The propensity score weighted logistic regression predicting mortality revealed no difference in the odds of mortality based on sex (OR 1.12, 95 % CI 0.82-1.52, p = 0.5).
We show males are just as likely to die from burns compared to females with similar injuries in this propensity-matched analysis. A lack of difference in mortality may be attributable to the similarities in the hormonal profile in the prepubescent child.
越来越多的证据表明，性别差异可能会影响热损伤后的病理生理学，并影响临床结果。本研究旨在评估在资源有限的环境中，性别、热损伤与儿科烧伤患者住院死亡率之间的关系。
这是对 2011 年 5 月至 2019 年 12 月期间在马拉维利隆圭的卡姆祖中央医院烧伤科收治的所有儿科（≤12 岁）患者数据进行的回顾性分析。我们按性别进行了双变量分析，比较了人口统计学特征、烧伤特征、手术干预和死亡率。使用逆概率治疗权重对标准估计值进行调整，以校正混杂因素。加权后，通过 logistic 回归模型获得基于性别的死亡率比值比。
共有 1904 名儿童入院，其中男性（n = 1065，55.9%）居多。总体而言，中位年龄为 3 岁（IQR1-4）。女性的总体表烧伤百分比（%TBSA）高于男性，分别为 15%和 13%（p = 0.03）。与男性相比，女性火焰烧伤更为常见，分别为 32%和 23%（p < 0.001）。女性接受手术干预的比例高于男性（20.9%和 16.7%，p = 0.02）。预测死亡率的倾向评分加权 logistic 回归显示，性别对死亡率的比值比无差异（OR 1.12，95%CI 0.82-1.52，p = 0.5）。
在这项倾向评分匹配分析中，我们发现具有相似损伤的男性与女性相比，死于烧伤的可能性相同。死亡率无差异可能归因于青春期前儿童激素谱的相似性。
