Garcia Garcia Jose Antonio, Del Valle Diana D, Wurdeman Taylor, Ashi Kevin, Bistre Varon Jacques, Angulo-Lozano Juan Carlos, Dey Tanujit, Meara John G, Shalkow-Klincovstein Jaime, Uribe-Leitz Tarsicio
Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.
BMJ Glob Health. 2025 Mar 25;10(3):e017915. doi: 10.1136/bmjgh-2024-017915.
Paediatric burns are a leading cause of mortality among Mexican children, yet comprehensive national data are scarce. This retrospective cohort study provides an epidemiological analysis of paediatric burn injuries in Mexico using a nationwide hospitalisation database.
We conducted a retrospective cohort analysis of all paediatric burn patients aged 0-18 years (ICD-10 codes: T200-T329) who were hospitalised in the Mexican public sector using the Ministry of Health's hospital discharge database for 2016, 2018 and 2020. We used descriptive statistics, and logistic and negative binomial regressions to examine associations with mortality, in-hospital infection rates and hospital length of stay. To explore associations between our outcomes and poverty indexes, we integrated state-level poverty data and the corresponding Gini coefficient (a measure of income inequality). In-hospital infections were identified from a categorical variable, indicating whether an in-hospital infection occurred. Additionally, we compared incidence rates and aetiology across states.
We identified 11 080 paediatric burns. Most injuries involved males (60%, n=6659), predominantly children under 5 (55.8%, n=6186). Scalds were the most prevalent aetiology (46.5% n=5153). The overall infection rate was 1.5% (n=168), with electrical burns having the highest rate (1.97%, n=9). Mortality was 0.6% (n=65 cases), with the highest rate in firework-related injuries (1.6%, n=5). The majority (66.6%) of firework-related burns occurred during the holiday months of December and January. Longer hospital stays were significantly associated with in-hospital infections (incidence rate ratio (IRR)=2.52, p<0.01) and higher Gini coefficient (IRR=1.91, p=<0.01). In-hospital infection was significantly associated with increased mortality (OR=5.88, p=<0.01).
Paediatric burn injuries in Mexico are a critical public health issue, with children under 5 years old being the most vulnerable, and scalds being the predominant aetiology in this age group. This study underscores the need for targeted public health interventions and implementation of burn prevention programmes and regulations, especially regarding scald and firework injuries.
小儿烧伤是墨西哥儿童死亡的主要原因之一，但全国性的综合数据却很匮乏。这项回顾性队列研究利用全国住院数据库对墨西哥小儿烧伤损伤进行了流行病学分析。
我们对2016年、2018年和2020年墨西哥公共部门使用卫生部医院出院数据库收治的所有0至18岁小儿烧伤患者（国际疾病分类第十版编码：T200 - T329）进行了回顾性队列分析。我们使用描述性统计方法以及逻辑回归和负二项回归来研究与死亡率、院内感染率和住院时间的关联。为了探究我们的研究结果与贫困指数之间的关联，我们整合了州级贫困数据和相应的基尼系数（一种收入不平等的衡量指标）。院内感染是从一个分类变量中确定的，该变量表明是否发生了院内感染。此外，我们比较了各州的发病率和病因。
我们共识别出11080例小儿烧伤病例。大多数损伤涉及男性（60%，n = 6659），主要是5岁以下儿童（55.8%，n = 6186）。烫伤是最常见的病因（46.5%，n = 5153）。总体感染率为1.5%（n = 168），电击伤的感染率最高（1.97%，n = 9）。死亡率为0.6%（n = 65例），与烟花相关的损伤死亡率最高（1.6%，n = 5）。大多数（66.6%）与烟花相关的烧伤发生在12月和1月的节假日期间。住院时间延长与院内感染（发病率比（IRR）= 2.52，p < 0.01）和较高的基尼系数（IRR = 1.91，p = < 0.01）显著相关。院内感染与死亡率增加显著相关（比值比（OR）= 5.88，p = < 0.01）。
墨西哥的小儿烧伤损伤是一个关键的公共卫生问题，5岁以下儿童最为脆弱，烫伤是该年龄组的主要病因。本研究强调了针对性公共卫生干预措施的必要性以及烧伤预防计划和法规的实施，特别是关于烫伤和烟花致伤方面。
