PC3087: Profile of Pediatric Burns Admissions in a Tertiary Teaching Hospital: A 5 Year Overview

Background: The American Burn Association reported that between 2011 and 2015, more than 500,000 children in the United States suffered unintentional burn injuries, making it the fourth leading cause of death between ages 1-14. During this time frame, 70% of pediatric burn admissions were associated with scalded injuries. Because of the high frequency incidence and its potential devastating effects, burn injuries are considered a mayor public health crisis. However, unintentional and intentional burn injuries vary across demographic criteria such as age, sex, social status and government law regulations. Until now, no scientific data have been reported regarding the profile of pediatric patients admitted to a hospital in Puerto Rico due to burn injuries. This study evaluates the profile of burn patients admitted to only tertiary teaching hospital in Puerto Rico.

Methods: This retrospective cross-sectional study evaluated all patients from 1month to 21-year-old admitted to ward and the Pediatric Intensive Care Unit (PICU) from June 2012 to December 2017. Data such as demographics, burn degree, % total body surface area (TBSA%) and length of stay (LOS) were evaluated. Data was expressed as mean ± SD, IQR and percentages. Logistic regression model was used to establish multivariable comparisons.

Results: A total of 887 admissions were evaluated, 9.47% (84) of them admitted to ICU. Among patients requiring ICU admission, 69% were male, the TBSA% average was 20% and they had an average LOS of 5.5 days. 70% of them suffered 2nd degree burns, mostly caused by scalds and flames. The setting with the highest incidences of burn injuries was the kitchen during the afternoon. Of patients admitted to the ward , 60% were males with 50% of them younger than 3 years old. 85% of ward patients suffer 2nd degree burns and the TBSA% was 4 times lower compared to ICU patients. On average they had a LOS of 4 days. In both settings, patients younger than 5 years were 2.4 times at greater risk of suffering from burn lesions. When controlling for possible confounders (age, sex, TBSA%), burn degree was the only risk factor statistically associated with prolonged LOS. However, burn degree in association to patient’s age and TBSA%, ICU LOS markedly increased.

Conclusion: Toddlers and adolescents were at higher risk of admission to PICU due to burn injuries, 2nd degree burn being the most prevalent. Burn degree was the unique individual risk factor associated with prolonged LOS. Contrary to the mortality rate reported in literature, no deaths were reported at the hospital due to burn injuries. This may respond to clinical management such as early airway management, aggressive use of antibiotics and constant sterilization of the burn areas. Prevention strategies continue to be the best approach in the management of pediatric burn injuries.