Etiology, Outcome and Mortality Risk Factors in Children Burn

Read  full  paper  at:

Mortality rate of burn patients can serve as an objective criterion for quality control and as a measure for research and preventive programs. A prospective study of burn victims, from data of burn registry program, was conducted to determine the etiology, risk factors of mortality and outcome of pediatric burns. We had 514 patients below 15 years old. Burns caused by scalding were the most frequent (55.4%) followed by flames (35.8%). Mean (SD) of age was 3.72 (3.19) years. Male to female ratio was 1.62:1. Mean hospital stay was 14.17 days (range 0 – 46 days). The mean TBSA (SD) was 15.22% (14.31%). Fifty three patients had inhalation injury (11.25%). Inhalation injury increases the risk of death (Odds Ratio: 8.75, p = 0.009). Length of stay increased in accordance with burn area (p < 0.002). Burn wound infection was present in (35.4%) of our patients. The univariate statistics analysis and a pooled, cross-sectional, multivariate logistic regression weredone. The major risk factors were: Inhalation injury (OR = 8.75, p = 0.009) and lack of intra-venousfluid resuscitation before reaching the hospital (OR = 40.5%, p = 0.001), cause of burn (flame and chemical) and referral cases from other centers (OR = 3.66, p < 0.0001). The minor risk factor was age. About 83% of our patients discharged with partial recovery, 10% with complete recovery, 0.1% referred to other hospitals and 1.36% died.

Cite this paper

Karimi, H. , Motevalian, S. , Momeni, M. , Safari, R. and Ghadarjani, M. (2015) Etiology, Outcome and Mortality Risk Factors in Children Burn. Surgical Science, 6, 42-49. doi: 10.4236/ss.2015.62007.


[1] Lv, K.-Y., Xia, Z.-F., Zhang, L.-M., Jia, Y.-T., Tan, T., Wei, W., Ma, B., Xiong, J., Wang, Y. and Sun, Y. (2008) Epidemiology of Pediatric Burns Requiring Hospitalization in China: A Literature Review of Retrospective Studies. Pediatrics, 122, 132-142.
[2] Bloemsma, G.C., Dokter, J., Boxma, H. and Oen, I.M. (2008) Mortality and Causes of Death in a Burn Centre. Burns, 34, 1103-1107.
[3] The Global Burden of Disease, 2004 Update; WHO Library Cataloguing-in-Publication Data.
[4] Karimi, H., Montevalian, A., Motabar, A.R., Safari, R., Parvas, M.S. and Vasigh, M. (2012) Epidemiology of Paediatric Burns in Iran. Annals of Burns and Fire Disasters, 25, 115-120.
[5] Ryan, C.M., Schoenfeld, D.A., Thorpe, W.P., Sheridan, R.L., Cassem, E.H. and Tompkins, R.G. (1998) Objective Estimates of the Probability of Death from Burn Injuries. The New England Journal of Medicine, 338, 362-366.
[6] Coste, J., Wasserman, D. and Venot, A. (1996) Predicting Mortality in Adult Burned Patients: Methodological Aspects of the Construction and Validation of a Composite Ratio Scale. Journal of Clinical Epidemiology, 49, 1125-1131.
[7] Saffle, J.R. (1998) Predicting Outcomes of Burns. The New England Journal of Medicine, 338, 387-388.
[8] Smith, D.L., Cairns, B.A., Ramadan, F., Dalston, J.S., Fakhry, S.M., Rutledge, R., Meyer, A.A. and Peterson, H.D. (1994) Effect of Inhalation Injury, Burn Size, and Age on Mortality: A Study of 1447 Consecutive Burn Patients. Journal of Trauma—Injury Infection & Critical Care, 37, 655-659.
[9] Muller, M.J. and Herndon, D.N. (1994) The Challenge of Burns. The Lancet, 343, 216-220.
[10] Vico, P. and Papillon, J. (1992) Factors Involved in Burn Mortality: A Multivariate Statistical Approach Based on Discriminant Analysis. Burns, 18, 212-215.
[11] Benmeir, P., Sagi, A., Greber, B., Vardy, D., Lusthaus, S., Picard, E., et al. (1991) An Analysis of Mortality in Patients with Burns Covering 40 Percent BSA or More: A Retrospective Review Covering 24 Years (1964-88). Burns, 17, 402-405.
[12] Ganesamoni, S., Kate, V. and Sadasivan, J. (2010) Epidemiology of Hospitalized Burn Patients in a Tertiary Care Hospital in South India. Burns, 36, 422-429.
[13] Light, T.D., Latenser, B.A., Kealey, G.P., Wibbenmeyer, L.A., Rosenthal, G.E. and Sarrazin, M.V. (2009) The Effect of Burn Center and Burn Center Volume on the Mortality of Burned Adults—An Analysis of the Data in the National Burn Repository. Journal of Burn Care & Research, 30, 776-782.
[14] Burton, K.R., Sharma, V.K., Harrop, R. and Lindsay, R. (2009) A Population-Based Study of the Epidemiology of Acute Adult Burn Injuries in the Calgary Health Region and Factors Associated with Mortality and Hospital Length of Stay from 1995 to 2004. Burns, 35, 572-579.
[15] Lundgren, R.S., Kramer, C.B., Rivara, F.P., Wang, J., Heimbach, D.M., Gibran, N.S., Klein, M.B., Burton, K.R., Sharma, V.K., Harrop, R. and Lindsay, R. (2009) Influence of Comorbidities and Age on Outcome Following Burn Injury in Older Adults. Journal of Burn Care & Research, 30, 307-314.
[16] Ince, H., Kandemir, E., Ince, N., Güloglu, R. and Safran, N. (2008) Burn and Vital Risk Criteria in Industrial Accidents (as Forensic Medicine Approach). Ulusal travma ve acil cerrahi dergisi, 14, 145-148.
[17] Hilal, A., Cekin, N., Arslan, M. and Gulmen, M. (2008) Deaths Due to Burns in Adana, Turkey. Burns, 34, 982-985.
[18] McGwin Jr., G., George, R.L., Cross, J.M. and Rue, L.W. (2008) Improving the Ability to Predict Mortality among Burn Patients. Burns, 34, 320-327.
[19] Macedo, J.L. and Santos, J.B. (2007) Predictive Factors of Mortality in Burn Patients. Revista do Instituto de Medicina Tropical de Sao Paulo, 49, 365-370.
[20] Wolf, S.E., Rose, J.K., Desai, M.H., Barrow, R.E. and Herndon, D.N. (1997) Mortality Determinants in Massive Pediatric Burns: An Analysis of 103 Children with ≥80% TBSA Burns (≥70% Full Thickness). Annals of Surgery, 225, 554-565.
[21] Light, T.D., Latenser, B.A., Heinle, J.A., Stolpen, M.S., Quinn, K.A., Ravindran, V. and Chacko, J. (2009) Demographics of Pediatric Burns in Vellore, India. Journal of Burn Care & Research, 30, 50-54.
[22] Barrow, R.E., Spies, M., Barrow, L.N. and Herndon, D.N. (2004) Influence of Demographics and Inhalation Injury on Burn Mortality in Children. Burns, 30, 72-77.
[23] Morrow, S.E., Smith, D.L., Cairns, B.A., Howell, P.D., Nakayama, D.K. and Peterson, H.D. (1996) Etiology and Outcome of Pediatric Burns. Journal of Pediatric Surgery, 31, 329-333.
[24] Cuenca-Pardo, J., de Jesús Alvarez-Díaz, C. and Comprés-Pichardo, T.A. (2008) Related Factors in Burn Children. Epidemiological Study of the Burn Unit at the “Magdalena de las Salinas” Traumatology Hospital. Journal of Burn Care & Research, 29, 468-474.
[25] Spinks, A., Wasiak, J., Cleland, H., Beben, N. and Macpherson, A.K. (2008) Ten-Year Epidemiological Study of Pediatric Burns in Canada. Journal of Burn Care & Research, 29, 482-488.
[26] Spies, M., Herndon, D.N., Rosenblatt, J.I., Sanford, A.P. and Wolf, S.E. (2003) Prediction of Mortality from Catastrophic Burns in Children. Lancet, 361, 989-994.
[27] Toon, M.H., Maybauer, D.M., Arceneaux, L.L., Fraser, J.F., Meyer, W., Runge, A. and Maybauer, M.O. (2011) Children with Burn Injuries—Assessment of Trauma, Neglect, Violence and Abuse. Journal of Injury and Violence Research, 3, 99-111.
[28] Thombs, B.D., Singh, V.A. and Milner, S.M. (2006) Children under 4 Years Are at Greater Risk of Mortality Following Acute Burn Injury: Evidence from a National Sample of 12,902 Pediatric Admissions. Shock, 26, 348-352.
[29] Barret, J.P., Jeschke, M.G. and Herndon, D.N. (2001) Fatty Infiltration of the Liver in Severely Burned Pediatric Patients: Autopsy Findings and Clinical Implications. Journal of Trauma, 51, 736-739.
[30] Scholer, S.J., Hickson, G.B., Mitchel Jr., E.F. and Ray, W.A. (1998) Predictors of Mortality from Fires in Young Children. Pediatrics, 101, e12.
[31] Housinger, T.A., Brinkerhoff, C. and Warden, G.D. (1993) The Relationship between Platelet Count, Sepsis, and Survival in Pediatric Burn Patients. JAMA Surgery, 128, 65-67.
[32] Khorasani, E.N. and Mansouri, F. (2010) Effect of Early Enteral Nutrition on Morbidity and Mortality in Children with Burns. Burns, 36, 1067-1071.
[33] Osler, T., Glance, L.G. and Hosmer, D.W. (2010) Simplified Estimates of the Probability of Death after Burn Injuries: Extending and Updating the Baux Score. Journal of Trauma, 68, 690-697.                          eww150211lx


Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / 更改 )

Twitter picture

You are commenting using your Twitter account. Log Out / 更改 )

Facebook photo

You are commenting using your Facebook account. Log Out / 更改 )

Google+ photo

You are commenting using your Google+ account. Log Out / 更改 )

Connecting to %s