ETIOLOGY AND OUTCOME OF PEDIATRIC BURNS

A 6-year retrospective review of burn victims hospitalized at a major burn center was conducted to determine the etiology and outcome of ped iatric burns. Four hundred forty-nine patients under age 16 years were identified and stratified by age, sex, burn size, presence or absence of inhalation injury, cause of burn, and county of residence. The mea n patient age was 4.3 +/- 0.2 years, and the male:female ratio was 1.9 :1. There were 21 deaths overall (4.7%), the majority of which (18) we re among children under 4 years of age. With respect to large burns, d efined as greater than or equal to 30% total body surface area (TBSA), the mortality rate for children under age 4 was significantly higher than that for older children (46.9% v 12.5%; P < .01), despite the nea rly identical mean burn size of the two groups. Except for burn incide nce, there were no significant differences between males and females. The mean burn size was 15.1% +/- 0.7%, and was significantly larger fo r nonsurvivors than survivors (55.3% +/- 5.7 v 13.1% +/- 0.5%; P < .01 ). Inhalation injuries were strongly associated with large burns and w ere present in all 15 flame-burn fatalities. Scalds were the most comm on type of burn among children under 4 years of age; flame burns predo minated in older children. There were 6 deaths related to scalds, all of which occurred in children under 4. Burn type, size, and mortality rate did not differ between children from urban and rural counties. La rge burn size was the strongest predictor of mortality, followed by (i n order) age less than 4 and the presence of inhalation injury. infant s and young children have the highest risk of death from burn injury. Burns smaller than 30% TBSA without an inhalation injury (such as smal l scald injuries) occasionally are lethal in infants and small childre n, despite modern therapy. Copyright (C) 1996 by W.B. Saunders Company