Children Under 4 Years Are at Greater Risk of Mortality Following Acute Burn Injury

Abstract

It is important to have an accurate understanding of mortality risk in children to make sound treatment decisions and to advise parents and families. Several studies have found that children younger than 4 years are at greater risk for mortality from burn injury than older children, although other studies have found no difference. All of these studies, however, have been limited by small sample sizes from single burn centers. The objective of this study was to assess age-related mortality risk in a sample of more than 12,000 children from a national burn registry who were admitted to 43 burn centers in the United States from 1992 to 2002. The study showed that, compared with older children, children younger than 4 years were significantly more likely to be admitted with scalds rather than flame burns, had smaller burn injuries, and were less likely to have an inhalation injury. Logistic regression analysis was used to assess age-related mortality risk. After adjusting for sex, burn size, inhalation injury, and type of burn (flame versus scald), the risk of mortality was substantially higher for children aged 0 to 1.9 years (odds ratio, 2.70; P<0.001) and for children aged 2.0 to 3.9 years (odds ratio, 2.00; P<0.01) as compared with children aged 4 years or older. This study provides strong evidence that when comparing children based on burn injuries of similar size and etiology, children younger than 4 years are at substantial risk for death as compared with older children.

The Outcome of Becoming a Pediatric Burn Center in Turkey

“…The most common reasons for mortality were acute kidney failure, sepsis, shock and disseminated intravascular coagulation. [2,[4][5][6][7][8][9][11][12][13][15][16][17][18] While the mean mortality rate for all burns was 1.31% in our study, it was 0.64% for scalding burns, 2.35% for flame burns, 5.88% for electrical burns and 25% for flame-inhalation burns. The rate was 18.18% for burns of 40% and above surface area.…”

Epidemiology of Pediatric Burn Injuries in Istanbul, Turkey

“…[3][4][5][6][7] In our study, the mean age at the time of scalding was 3.2 years and scalding accounted for 85.6% of our pediatric inpatient group. The main source of scalding is hot liquid, especially the hot water used for making tea, a traditional practice in our country.…”

“…This has been observed similarly in developed countries. [6,8,9] Flame burn was the second most common cause of burn injuries. Childhood flame burns usually occurred outdoors, often as a result of the ignition of flammable liquids.…”

Mortality in paediatric burns victims: A retrospective review from 2009 to 2012 in a single centre

“…The authors concluded that there is strong evidence that, when comparing children based on burn injuries of similar size and aetiology, children aged <4 years are at substantial risk for death compared with their older counterparts. [10] We compared our overall mortality rate with rates for various institutions around the world (Table 5).…”