Retrospective Case Analysis And Risk Factors Investigation Of Hospitalized Burn Children

Objective:1.To describe the clinical characteristics of hospitalized burn children and to summarize the occurrence and outcome of burns.2.To explore the risk factors for children burns.Methods:1.The retrospective analysis method was used.The cases aged 0-12 years from Fujian Medical University Union Hospital,the Chinese People’s Liberation Army No.180 Hospital,the People’s Liberation Army No.92 Hospital and the First Hospital of Longyan City from January 2013 to December 2015 was conducted.Statistical indicators include general information,injury and burn information,burn time,pre-hospital treatment,post-admission treatment and outcome.2.According to the geographical location of Fujian Province,Nanping and Longyan belong to the inland areas,Fuzhou and Quanzhou belong to the coastal areas.Comparison of clinical characteristics of children with burns between inland and coastal areas.3.The questeionnaire for risk factors of burn children was self-compiled.After two rounds advisory of clinical burns experts and epidemiological experts,we revised the questionnaire to carry out pre-investigation and analyzed the reliability of the questionnaire analysis and ultimately determined the questionnaire.4.A case-control study was conducted.Cases were selected from Fujian Medical University Union Hospital and the Chinese People’s Liberation Army No.180 Hospital during January 2016--January 2017.In the same period,controls were the same sex and the same age difference within six months.Children were from the Department of Pediatric Medicine,Pediatric Surgery in Fujian Medical University Union Hospital and community healthy children.Face to face investigate method was used.5.The unconditional logistic regression model was used to evaluate the(OR)and95% confidence interval(95% CI)between the two groups of children’ s personality,mother’ s education level,mother ’s work status,family monthly income and others variate.The variate which was statistically significant(OR>1,95% CI does not contain 1)was included into the bar graph model to further analyze the role of mothers’ education and mother working status in children’s burns and to analyze the interaction between the two on the incidence of burns in children.Results:1.In January 2013--December 2015,a total of 4486 hospitalized children were admitted.The mean age was(2.6±2.3)years,median age was 21 months.The rural household registrations were 3246 cases,accounting for 72.4%.The floating population were 429 cases,accounting for 9.6%.The boys were 2734 cases,accounting for 60.9%,male to female ratio was about 1.56: 1.0.The free at all costs were 2750 cases,accounting for 61.3%.The burns reason were mainly hydrothermal burns(4180 cases,93.2%).The total burn area was [(9±7)%] TBSA,the median was7% TBSA,male and female patients were mild to moderate burns.The severity was similar(P> 0.05).Trunk was the most vulnerable part of the body site with 2697 cases(60.1%).During all day,high incidence happened in 17:00-20:59,accounting for37.5%.During whole year,more children were burned in April to October,of which July(480 cases,10.7%)and August(454 cases,10.1%)were the peak period.The majority of children were treated with non-surgical treatment(4167 cases,92.8%).The hospitalized discharged days less than one week were 2020 cases(45.0%).The hospital costs were 5832(3881,9365)yuan.2.There were 733 cases from inland areas and 3753 cases from coastal areas.There were significant differences in the age,household registration,health insurance,severity,hospitalization,treatment effect,length of hospital stay and hospitalization cost(P<0.05)between the coastal area and the inland area.There were no significant differences in the proportion of men and women,the causes of injury,the burn site,place,time,month,season and the times of surgery(P> 0.05).3.The questionnaire was self-made on the basis of literature.The answer rate of tworounds of experts advisory was both 100%.The expert authority coefficient was 0.875.The reliability of the questionnaire was 0.823 ~ 0.892,and the consistency of the questionnaire was good.The Pearson correlation coefficient of the two surveys was0.76(P <0.01),suggesting that the questionnaire had good retest reliability.4.In this study,a total of 330 subjects were included.Case group and control group were both 165 cases.The ratio of male to female was about 1.39: 1.Non-only child,unworking mother or farming and mothers education high school and below were the risk factor of children burn(P<0.05,95%CI>1).The high family per capita monthly income,the mother late childbearing,the child’s character moderate were the protective factor of children burn(P < 0.05,95%CI > 1).Those mother who were unworking or farming would have higher risk factors of child burn than those mother who were working status(OR = 3.217,95%CI=1.205--8.593).Those mothers who were less educated below high school would have higher risk factors of child burn than those mother who were college and above education(OR = 8.910,95% CI =2.541--31.247).The interaction between the two was 10.792(95%CI= 2.081--27.720)and the interaction coefficient(SI)was 1.598(95%CI= 1.199--5.678).Conclusions:Hospitalized burn children from this four hospitals with a general characteristic of high incidence in rural,summer,meal time,boys and scald.There existed of some differences between inland and coastal areas.Rural household registration,non-only child,mother no work or farming,mothers education level high school and below can increase the risk of burns in children.High family per capita monthly income,mother late childbearing,children with moderate personality can reduce the risk of burns in children.