Jordan Kelly C, Di Gennaro Jane L, von Saint André-von Arnim Amélie, Stewart Barclay T
Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, United States.
Department of Global Health, University of Washington, Seattle, WA, United States.
Front Pediatr. 2022 Jul 19;10:954995. doi: 10.3389/fped.2022.954995. eCollection 2022.
Burn injuries are a major cause of death and disability globally. The World Health Organization (WHO) launched the Global Burn Registry (GBR) to improve understanding of burn injuries worldwide, identify prevention targets, and benchmark acute care. We aimed to describe the epidemiology, risk factors, and outcomes of children with burns to demonstrate the GBR's utility and inform needs for pediatric burn prevention and treatment.
We performed descriptive analyses of children age ≤ 18 years in the WHO GBR. We also described facility-level capacity. Data were extracted in September of 2021.
There were 8,640 pediatric and adult entries from 20 countries. Of these, 3,649 (42%) were children (0-18 years old) from predominantly middle-income countries. The mean age was 5.3 years and 60% were boys. Children aged 1-5 years comprised 62% ( = 2,279) of the cohort and mainly presented with scald burns (80%), followed by flame burns (14%). Children >5 years ( = 1,219) more frequently sustained flame burns (52%) followed by scald burns (29%). More than half of pediatric patients (52%) sustained a major burn (≥15% total body surface area) and 48% received surgery for wound closure during the index hospitalization. Older children had more severe injuries and required more surgery. Despite the frequency of severe injuries, critical care capacity was reported as "limited" for 23% of pediatric patients.
Children represent a large proportion of people with burn injuries globally and often sustain major injuries that require critical and surgical intervention. However, critical care capacity is limited at contributing centers and should be a priority for healthcare system development to avert preventable death and disability. This analysis demonstrates that the GBR has the potential to highlight key epidemiological characteristics and hospital capacity for pediatric burn patients. To improve global burn care, addressing barriers to GBR participation in low- and low-middle-income countries would allow for greater representation from a diversity of countries, regions, and burn care facilities.
烧伤是全球范围内导致死亡和残疾的主要原因。世界卫生组织（WHO）发起了全球烧伤登记处（GBR），以增进对全球烧伤情况的了解，确定预防目标，并为急性护理设定基准。我们旨在描述烧伤儿童的流行病学、危险因素和治疗结果，以证明GBR的效用，并为儿童烧伤预防和治疗需求提供参考。
我们对WHO GBR中年龄≤18岁的儿童进行了描述性分析。我们还描述了机构层面的能力。数据于2021年9月提取。
来自20个国家的儿童和成人条目有8640条。其中，3649条（42%）是来自主要中等收入国家的儿童（0至18岁）。平均年龄为5.3岁，60%为男孩。1至5岁的儿童占队列的62%（n = 2279），主要表现为烫伤（80%），其次是火焰烧伤（14%）。5岁以上的儿童（n = 1219）更常遭受火焰烧伤（52%），其次是烫伤（29%）。超过一半的儿科患者（52%）遭受了严重烧伤（≥15%体表面积），48%在首次住院期间接受了伤口闭合手术。年龄较大的儿童受伤更严重，需要更多的手术。尽管重伤频繁发生，但仍有23%的儿科患者报告重症监护能力“有限”。
儿童在全球烧伤患者中占很大比例，且经常遭受需要重症和手术干预的重伤。然而，在提供救治的中心，重症监护能力有限，应作为医疗系统发展的优先事项，以避免可预防的死亡和残疾。该分析表明，GBR有潜力突出儿科烧伤患者的关键流行病学特征和医院能力。为改善全球烧伤护理，消除低收入和中低收入国家参与GBR的障碍将使更多国家、地区和烧伤护理机构能够参与进来。
