Loos Marie-Louise H J, Meij-de Vries Annebeth, Nagtegaal Michelle, Bakx Roel
Emma Children's Hospital, Paediatric Surgical Centre Amsterdam, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Paediatric Surgery, Amsterdam, The Netherlands.
Emma Children's Hospital, Paediatric Surgical Centre Amsterdam, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Paediatric Surgery, Amsterdam, The Netherlands; Red Cross Hospital, Burn Center Beverwijk, Vondellaan 13, 1942 LE, Beverwijk, The Netherlands.
Burns. 2022 May;48(3):688-697. doi: 10.1016/j.burns.2021.05.011. Epub 2021 May 21.
It is complex to distinguish negligent burns from inflicted and non-intentional burns, especially since no deliberate action caused the burn. Its recognition is important to create a safe life without (future) burns for our loved-ones who cannot take care of themselves (yet). Our aim was to investigate the incidence and associated characteristics of negligent burns are among children treated at a burn center.
We retrospectively reviewed medical files of all children attending a Dutch burn center with an acute burn between January 2013-December 2015. The conclusion of the Child Abuse and Neglect team (CAN) was used to define inflicted, negligent or non-intentional burns. The remaining cases were reviewed by an expert panel using a standardized protocol. Demographic and social data as well as clinical information about the burn were collected.
In total 330 children were included. Negligent burns accounted for 56%, non-intentional for 42% and inflicted for 2% of the burns. Negligent burns were associated with: hot beverages (OR 4.40, 95%CI 2.75-7.05), a younger age (p < 0.001), occurrence at home (OR 4.87 95%CI 2.80-8.45) and were located at the anterior trunk (OR 2.75, 95%CI 1.73-4.35) and neck (OR 1.98, 95%CI 1.12-3.50).
This study shows that neglect is a major factor in the occurrence of burns in young children, therefore we conclude that the majority of paediatric burns are preventable. Educational programs creating awareness and focussing on prevention of these burns should be aimed at households, since the majority of negligent as cause of preventable burns occur at home.
区分疏忽性烧伤与虐待性烧伤及非故意烧伤很复杂，尤其是因为没有蓄意行为导致烧伤。对于那些（尚）无法照顾自己的亲人而言，识别此类烧伤对于创造无（未来）烧伤的安全生活很重要。我们的目的是调查在一家烧伤中心接受治疗的儿童中疏忽性烧伤的发生率及相关特征。
我们回顾性分析了2013年1月至2015年12月期间在一家荷兰烧伤中心接受急性烧伤治疗的所有儿童的病历。儿童虐待与忽视问题小组（CAN）的结论被用于界定虐待性、疏忽性或非故意性烧伤。其余病例由一个专家小组使用标准化方案进行审查。收集了人口统计学和社会数据以及烧伤的临床信息。
总共纳入了330名儿童。疏忽性烧伤占烧伤病例的56%，非故意性烧伤占42%，虐待性烧伤占2%。疏忽性烧伤与以下因素相关：热饮（比值比4.40，95%置信区间2.75 - 7.05）、年龄较小（p < 0.001）、在家中发生（比值比4.87，95%置信区间2.80 - 8.45），且位于前躯干（比值比2.75，95%置信区间1.73 - 4.35）和颈部（比值比1.98，95%置信区间1.12 - 3.50）。
本研究表明疏忽是幼儿烧伤发生的主要因素，因此我们得出结论，大多数儿童烧伤是可预防的。由于大多数可预防烧伤的疏忽原因发生在家中，所以应针对家庭开展提高认识并侧重于预防此类烧伤的教育项目。
