84 Pediatric Scald Burns: Using Geographic Information Systems to Identify High Risk Communities

Introduction Identifying modifiable risk factors for pediatric scald burn injury prevention efforts is an important function for burn registries. Geographic information systems (GIS) analysis can provide additional census tract data about patient home and injury location. We hypothesize that (GIS) analysis of burn registry data using census tract data could identify geographic areas and additional risk factors for pediatric scald burn injury prevention efforts. Methods The burn registry of a U.S. regional burn center was used retrospectively to identify burn admissions, ages 0–17, within the county from 1/1/2018 to 7/31/2020. Data collected included demographics, vitals, burn type and body surface area burned (BSA%), hospital charges, length of stay, complications, and mortality. GIS geocoding of patient home addresses with census tract data including poverty level, languages spoken at home and highest educational level was performed. Burn incident hot spot analysis to identify statistically significant burn incident clusters was done using the Getis Ord Gi* statistic. Results There were 1057 burn initial admissions during the study period, 152 (14.3%) patients were children 17 and younger with scald injury who were county residents. The average age was 4.0 ± 4.0 years, and 59.9% were male. Mean scald injury BSA was 4.9% ± 5.7, 14/152 admissions (9.2%) had a burn ≥10% BSA. There were no in-hospital deaths. 120/728 county census tracts were identified as high risk with higher rates of child scald injury admissions than the countywide mean of 1.27 cases/1000 children. Regression analysis of high-risk census tracts were more likely to have increased poverty levels (O.R. 3.30, 95% C.I.: 1.1–9.7, p< 0.031) and lower educational attainment (O.R. 1.10, 95% C.I.: 1.0–1.18, p< 0.047). Non-white race, unemployment level, living with grandparents and speaking Spanish at home were non-significant risk factors. GIS analysis identified geographic hot spots for child scald injury admissions (p< 0.001). Conclusions GIS analysis of county burn registry data identified census tracts with increased poverty and lower educational attainment levels to have an increased risk of pediatric scald injury admission. Burn prevention efforts should be focused on these high-risk areas.

Pediatric scald injury and its comparison in urban and rural population: a clinico-epidemiological study in a high volume burn centre of Northern India

Background: Scalds are the leading cause of pediatric burn admissions and related morbidity, as well as a major cause of pediatric death worldwide. This study was conducted with the objective to study the epidemiological characteristics of pediatric scald injuries and its presentation in urban and rural parts of Indian population.Methods: A retrospective study was conducted by reviewing the medical records of all burn admissions in our institute from January 2017 to December 2019. Data of pediatric patients with scald injury was analyzed.Results: Total 1257 pediatric burn patients were admitted during the study period of which 711 (56.56%) were scald injuries. 57.94% of the children belonged to rural background. The mean Total Burn Surface Area was 38.55% in rural population as compared to 24.16% in the urban population. Immersion burn was most common mode of scald injury in children from rural background (60.19%). Spillage was commonest mode of scald in children from urban background (69.2%) and also the commonest mode of scalds in the pediatric population.Conclusions: The population of rural area had greater total burn surface area, belonged to lower socio-economic status, and had delayed presentation to the hospital and greater mortality rates. Illiteracy and beliefs in quackery further worsened the prognosis of such children.

Esophageal Stricture as a Complication After Scald Injury in Children

Burn injuries are distressful and shocking events, which can lead to noteworthy sequelae on metabolic markers and organs. Such traumatic accidents do occur every so often in both adult and pediatric populations, requiring prompt and adequate treatments. Notably, scald injuries occur due to direct contact with hot liquids and these are the most common cause of burns in early childhood. Herein, we report on an 18-month-old boy admitted to our pediatric surgery unit for an extensive scald injury, who has experienced an unusual esophageal stricture following the traumatic event.