Elsevier

Burns

Volume 39, Issue 5, August 2013, Pages 1004-1011
Burns

Hospitalized Pediatric Burns in North China: A 10-year epidemiologic review

https://doi.org/10.1016/j.burns.2012.12.014Get rights and content

Abstract

Retrospective surveys of all hospitalized pediatric burns under the age of 15 years were conducted in 18 hospitals from 5 provinces and municipal cities of North China between 2001 and 2010. A total of 17 770 patients were included in this study. The epidemiological characteristics of hospitalized pediatric burns and influencing factors of length of hospital stay and hospitalization cost were analyzed. In this study, children accounted for 43.57% of all hospitalized burns, with a gradually increasing trend (P = 0.003). Among children hospitalized burns, the percentage of children younger than three years was 69.9%, with an upward trend (P < 0.001). The ratio of male to female was 1.53:1. Scald burns accounted for 89.79% and 71.54% had burns of <10% total body surface area, with increasing trends (P  0.001). The medians of length of hospital stay and hospitalization cost were eight days and 2469 RMB yuan respectively. The most important factors affecting length of hospital stay and hospitalization cost were burned surface area, surgery and treatment outcome. Children under three years of age, boys and children with a small area of mild scald burns should be made the focus of childhood burn prevention. Improving the medical insurance system for children is urgently needed.

Introduction

Burns are injuries that severely threaten the health of children. Both domestic and international studies have shown that children account for a high proportion of hospitalized burn patients [1], [2], [3], [4], [5], [6], [7], [8]. In general, hospitalized burns are severe burns relative to burns not admitted to hospitals. And children with severe burns require relatively long recovery times and multiple skin grafts and treatments, causing long-term physiological, psychological, and economic burdens for families and society [9]. Because burns are preventable accidental injuries in children, accurate epidemiological data and trend analyses of burns in children can provide basic information for the decision-making processes of relevant state departments to facilitate the timely development of effective preventive measures.

Previous domestic epidemiologic studies of burns in children are mostly confined to a single hospital or province with sample sizes of fewer than 3000 cases and a lack of annual trend analyses [6], [7], [8]. Thus, these studies do not fully and faithfully reflect the epidemiologic characteristics and trends of childhood burns. With the development and advancement of society, the epidemiological characteristics of children hospitalized for burns may have changed in recent years, requiring studies with larger sample sizes to evaluate the current epidemiologic characteristics and trends in China.

The North China area, which includes Hebei Province, Shanxi Province, the Inner Mongolia Autonomous Region, Beijing and Tianjin, is a vast territory with a large population. The Chinese Health Statistics Yearbook of 2011 showed that in 2000, the population of children in the five provinces and municipal cities of North China was 32.52 million, accounting for 11.38% of all children in the country. To date, however, epidemiologic reports on burns in children in the North China area are still lacking. This study performed epidemiological and trend analyses on data from 17 770 hospitalized pediatric burn patients admitted to the burn units of 18 hospitals in North China between 2001 and 2010. The goal was to investigate the epidemiological characteristics and trends of hospitalized pediatric burn patients in North China to provide a basis for the development of more effective preventive measures for childhood severe burns.

Section snippets

Patients and variables

Data in this study were obtained from 18 military hospitals in North China, including eight hospitals in Hebei Province, two in Shanxi Province, two in the Inner Mongolia Autonomous Region, three in Beijing and three in Tianjin. Of the hospitals, 15 are Grade 3 hospitals and three are Grade 2 hospitals. All hospitalized pediatric burn patients under the age of 15 years admitted from January 2001 to December 2010 were included in this study. All of the 18 hospitals were using a same tool, No. 1

Epidemiological characteristics of pediatric burn patients

The number of hospitalized pediatric burn patients increased from 1408 in 2001 to 2214 in 2010 (r = 0.89, P = 0.001) with 17 770 cases total in 10 years. The population size data of the children aged 0–14 in North China from 2001 to 2010 [11] and the proportions of the hospitalized pediatric burns of the 18 hospitals are shown in Table 1. The children's population size of North China was 33.446 millions in 2001 and 24.637 millions in 2010, with a decreasing trend (r = −0.87, P = 0.001). While the

Discussion

Our research demonstrated the number of hospitalized pediatric burn patients showed an increasing trend from 2001 to 2010 although the children's population showed a decreasing trend. And hospitalized pediatric burn patients accounted for 43.57% of the total number of hospitalized burn patients during the same ten-year period. It is higher than the percentage of 33.6% reported by Wang during the same period and lower than that of 51% reported by Goldman [7], [12]. This might be related to the

Conclusion

This study is the first epidemiological study with a large sample size to focus on pediatric burns in North China in recent years. The epidemiological characteristics of hospitalized pediatric burn patients have changed in the past decade, as have the economic development and demographics of society. The number of hospitalized pediatric burn patients and their proportion showed a gradually increasing trend. Children under three years of age, especially one-year-olds and children with small

Conflict of interest statement

The authors declare that they have no conflict of interest.

Acknowledgements

The study was supported by Natural Science Foundation of China (Nos. 30872184, 81172773 and 81202286).

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These authors contributed equally to this work.

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