He Ting, Liu Ran, Wang Nannan, Hu Dongsheng, Lin Zhichen, Wang Chao, Meng Jinsong, Li Song, Lin Guoan, Xiao Rong, Yan Tiantian
Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Haidian District, Beijing, China.
Ultrasound Diagnostic Department, 82nd Army Hospital, Baoding, Hebei, China.
Pediatr Surg Int. 2025 Aug 18;41(1):253. doi: 10.1007/s00383-025-06148-x.
Children with severe burns accounts for a considerable proportion of emergency department admissions. Surgical interventions are often indispensable for such pediatric patients. However, healthcare providers may encounter issues such as a high risk of perioperative complications and guardian's refusal of surgery. This study aims to identify early predictive indicators associated with the number of surgeries, recognize high-risk patients, and provide data support for clinical decision-making.
The clinical data of 102 pediatric patients with total burn surface area ≥ 30% from January 2014 to December 2024 were evaluated. Patients were stratified into three groups based on whether they underwent surgery and the number of surgeries received. The associations among age, gender, cause of injury, total burn surface area, burn index (BI), length of hospital stay, and various laboratory indicators were assessed across the groups.
Total burn surface area (OR: 1.071, 95% CI 1.015-1.130, P = 0.012), BI (OR: 1.398, 95% CI 1.196-1.635, P = 0.000) and white blood cell (WBC) counts (OR: 1.043, 95% CI 1.004-1.083, P = 0.031) were significantly correlated with the number of surgeries. Total burn surface area (OR: 1.074, 95% CI 1.016-1.135, P = 0.012), BI (OR: 1.376, 95% CI 1.174-1.612, P = 0.000) and WBC counts (OR: 1.045, 95% CI 1.004-1.087, P = 0.031) also emerged as independent risk factors for the number of surgeries for children with severe burns.
The total burn surface area and BI are associated with the number of surgeries and severity of illness in pediatric patients with severe burns. WBC counts serve as an early adjunctive indicator for surgical burden, though further validation is needed to account for confounding variables. These findings facilitate the rapid identification of high-risk patients who may require transfer to hospital with specialized resources and the development of tailored treatments.
严重烧伤儿童在急诊科住院患者中占相当比例。此类儿科患者通常需要进行手术干预。然而，医护人员可能会遇到围手术期并发症风险高以及监护人拒绝手术等问题。本研究旨在确定与手术次数相关的早期预测指标，识别高危患者，并为临床决策提供数据支持。
对2014年1月至2024年12月期间102例烧伤总面积≥30%的儿科患者的临床资料进行评估。根据患者是否接受手术以及接受手术的次数将其分为三组。评估各组之间年龄、性别、受伤原因、烧伤总面积、烧伤指数（BI）、住院时间以及各种实验室指标之间的关联。
烧伤总面积（OR：1.071，95%CI 1.015 - 1.130，P = 0.012）、BI（OR：1.398，95%CI 1.196 - 1.635，P = 0.000）和白细胞（WBC）计数（OR：1.043，95%CI 1.004 - 1.083，P = 0.031）与手术次数显著相关。烧伤总面积（OR：1.074，95%CI 1.016 - 1.135，P = 0.012）、BI（OR：1.376，95%CI 1.174 - 1.612，P = 0.000）和WBC计数（OR：1.045，95%CI 1.004 - 1.087，P = 0.031）也成为严重烧伤儿童手术次数的独立危险因素。
烧伤总面积和BI与严重烧伤儿科患者的手术次数和疾病严重程度相关。WBC计数可作为手术负担的早期辅助指标，不过需要进一步验证以考虑混杂变量。这些发现有助于快速识别可能需要转至具备专业资源医院的高危患者，并制定针对性的治疗方案。
