Epidemiological Characteristics, Burden Of Disease And Prognostic Factors In Hospitalized Children With Burn In North Guizhou Province

Objective:To describe the epidemiological characteristics of burnt hospitalized children in northern Guizhou;to explore the differences of epidemiological characteristics of burnt children,burnt adults and traumatic children;analyze the influencing factors of prognosis and burdern of disease of burnt children.Methods:?Through the electronic medical record system of Affiliated Hospital of Zunyi Medical University,data of patients hospitalized for burns from January 2014 to August2016 were retrieved.The information extracted from the medical records included demographic information,first aid measures,clinical data etc.Patients were divided into two groups,under 18 years old were children and not less than 18 years old were adults.(2)Using a burn questionnaire,patients under 18 years of age who were hospitalized for burns from June 2016 to May 2017 was collected face to face.The questionnaire information included demographic information,clinical data,and burnt knowledge and so on.(3)Using self-designed trauma questionnaire to collect inpatients under 18 years who hospitalized for traumatic injury in June 2017.The questionnaire information includes such as demographic information,clinical data,and burns related knowledge.(4)Descriptive analysis was conducted using hospitalized children with burns,compared with adults and trauma children using Chi-square test and propensity score model to match the case data of adults and children with burns.The generalized estimation equation,Cox's regression model and path analysis model were used to analyze the influencing factors of LOS(Length of Hospital Stay,LOS),and the influencing factors of scar and limb activity were analyzed by using Logistic regression model.Results:(1)Totally,the information of 465 cases of burnt children and 327 cases of burnt adults were extracted from the medical records.Besides that,111 burnt children,55hospitalized with trauma,and 24 outpatients were interviewed and surveyed face to face.(2)The most common mechanism of burns in children was hot liquid(76.77%),the most likely to occur under the age of 3 years old(62.15%),and the high incidence season was winter(41.94%),while boys were more prone to burns than girls(gender radio was1.6:1).Moreover,it mainly was hot-liquid scald indoors(97.76%);while was flame and other burns outdoors(52.77%).Burnt sites showed multiple burns,the mainly depth of burn was deep partial thickness(61.29%)and TBSA of 72.26%of burnt children was less than 10%.It was lack of the correct knowledge for burns'first aid.The rate of external used for burnt children was 13.35%.The rate of cold water washing was only 4.09%,and the rate of wound dressing was only 21.08%.(3)The epidemiological characteristics between hospitalized children and adults with burns were different in terms of gender(?~2=5.409,P=0.020),season(?~2=34.896,P<0.001),the location of burn(?~2=242.238,P<0.001),etiology(?~2=262.306,P<0.001),depth of burns(?~2=57.965,P<0.001)and site of burns(?~2=43.766,P<0.001).The difference of epidemiological characteristics between hospitalized and traumatized children with burns included:age(?~2=50.096,P<0.001),place of residence(?~2=10.687,P=0.005),doing housework(?~2=45.033,P<0.001),parents go out to work(?~2=5.076,P=0.024),mother's occupation(?~2=18.124,P<0.001),mother's education level(?~2=11.345,P=0.003)and father of smoking(?~2=4.702,P=0.030).The score of burns-related safeties knowledge in burnt group was 87.39%over 6 points and 92.73%in trauma group.There were partial differences in the scores of burns-related safeties knowledge between burnt group and trauma group.(4)Deep partial thickness even above was a common risk factor for the scar(HR=17.927,[95%CI]=1.393~230.751)and the limb activity(HR=8.137,[95%CI]=2.395~27.638).Hot fluid(HR=2.210,[95%CI]=1.347~59.619)was only a risk factor for limb activity.TBSA and skin grafting were the influencing factors of hospitalization costs.Skin grafting(HR=0.993,[95%CI]=0.254~0.451)and younger age(HR=0.339,[95%CI]=0.988~0.997)were protective factors of LOS,male(HR=1.234,[95%CI]=1.026~1.484),deep partial thickness(HR=3.128,[95%CI]=2.349~4.166),full thickness(HR=1.791,[95%CI]=1.379~2.327),TBSA between 10%with 29%(HR=3.978,[95%CI]=2.551~6.205),TBSA?30%(HR=1.787,[95%CI]=1.135~2.813)and the heat etiology(HR=1.497,[95%CI]=1.189~1.886)are the risk factors of LOS.One-child family(HR=0.242,[95%CI]=0.072~0.813)was a protective factor of scars,while male(HR=0.261,[95%CI]=0.078~0.878)was a protective factor of physical activity.Conclusion:Boys,less than 3 years old,in winter and spring were more likely to suffer from burns.The main place was at home,while hot fluid was the main etiology.The LOS of the burnt hospitalized children is long and the cost of hospitalization is high.The prognosis of burnt children is affected by age,gender,TBSA,depth,etiology and skin grafting.Therefore,children or their guardians should be targeted for the promotion of knowledge of burn and knowledge of first aid to reduce the incidence of burns,provide favorable conditions for the treatment of burns,and improve the prognosis of burns.