Rahimpour Armein, Saurborn Emily, Fox Nathan, Giangrosso Gerard V, Denning David, Harrison Curtis W, Bown Paul, Barry Rahman
General Surgery, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Dermatology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Cureus. 2025 Jan 17;17(1):e77589. doi: 10.7759/cureus.77589. eCollection 2025 Jan.
Burn injuries are the fifth most common cause of non-fatal injuries among children worldwide. Pediatric burn patients require complex management due to their distinct physiology compared to adults. The purpose of this study is to investigate demographic and clinical factors contributing to a prolonged total hospital duration among pediatric burn patients in a rural, Level 2 Trauma Center and Burn Intensive Care Unit (BICU) located in the Appalachian region.
Data were collected from 2017 to 2023 and included all patients 18 years and younger who were admitted to the Cabell Huntington Hospital BICU. Patient demographics were analyzed using descriptive statistics. One-way ANOVA assessed the differences between gender and length of stay (LOS) and source of burn and LOS. A chi-square test analyzed the effect of an inhalation injury on LOS. Pearson correlation was used to assess the relationship between BMI and LOS and between total ventilation days (TVD) and LOS.
A total of 232 patients were included in this study, consisting of 102 (44%) females and 130 (56%) males. The average patient age was 6.9 years (SD ± 6.2). The mean LOS was 3.1 (SD ± 4.4) among this cohort. The most common sources of burn injuries within this cohort were flame (43%), scald (35%), and other (chemical/electric/radiation) comprising 22%. Flame burns were found to have a significant impact on LOS (p = 0.039), requiring longer hospital stays compared to other burn sources. Age was a significant predictor, with each additional year of age associated with an increase of 0.15 days in LOS (95% CI: 0.05 to 0.25, p < 0.001). Similarly, the total body surface area (TBSA) showed a significant positive association, with larger burn areas strongly predicting longer hospital stays (p < 0.001). The median TBSA was 5.5% (SD ± 6.7). For every 1% increase in TBSA burns, the hospital stay increased by approximately 0.13 days (95% CI: 0.05 to 0.22, p < 0.05). However, variables such as inhalation injury (p = 0.748) and BMI (p = 0.058) did not significantly predict hospital duration.
The results of this study demonstrated that age, burn severity, and the source of the burn are significant predictors of prolonged hospital stay in pediatric burn patients. Recognizing these key predictors of LOS will allow providers to identify high-risk patients early and initiate prompt stabilization, management, and timely referral to tertiary centers when necessary. Further, the results of this study may serve as the framework for the development of preventative efforts and regional care guidelines for rural, underserved healthcare providers.
烧伤是全球儿童非致命伤害的第五大常见原因。与成人相比，儿科烧伤患者因其独特的生理机能而需要复杂的治疗。本研究的目的是调查位于阿巴拉契亚地区的一家农村二级创伤中心和烧伤重症监护病房（BICU）中，导致儿科烧伤患者总住院时间延长的人口统计学和临床因素。
收集了2017年至2023年的数据，包括所有入住卡贝尔·亨廷顿医院BICU的18岁及以下患者。使用描述性统计分析患者的人口统计学数据。单因素方差分析评估性别与住院时间（LOS）以及烧伤来源与LOS之间的差异。卡方检验分析吸入性损伤对LOS的影响。使用Pearson相关性分析评估体重指数（BMI）与LOS之间以及总通气天数（TVD）与LOS之间的关系。
本研究共纳入232例患者，其中女性102例（44%），男性130例（56%）。患者的平均年龄为6.9岁（标准差±6.2）。该队列的平均LOS为3.1天（标准差±4.4）。该队列中最常见的烧伤来源是火焰烧伤（43%）、烫伤（35%）以及其他（化学/电/辐射）烧伤，占22%。发现火焰烧伤对LOS有显著影响（p = 0.039），与其他其他烧伤相比其他烧伤来源，需要更长的住院时间。年龄是一个显著的预测因素，每增加一岁，LOS增加0.15天（95%置信区间：0.05至0.25，p < 0.001）。同样，总体表面积（TBSA）显示出显著的正相关，烧伤面积越大，强烈预示住院时间越长（p < 0.001）。TBSA的中位数为5.5%（标准差±6.7）。TBSA烧伤每增加1%，住院时间大约增加0.13天（95%置信区间：0.05至0.22，p < ）。然而，吸入性损伤（p = 0.748）和BMI（p = 0.058）等变量并未显著预测住院时长。
本研究结果表明，年龄、烧伤严重程度和烧伤来源是儿科烧伤患者住院时间延长的显著预测因素。认识到这些LOS的关键预测因素将使医疗人员能够早期识别高危患者，并在必要时迅速进行稳定病情、治疗，并及时转诊至三级中心。此外，本研究结果可作为农村地区医疗服务不足的医疗人员制定预防措施和区域护理指南的框架。
