Cooking Burns In Pediatric Patients: Analysis Of The WHO Global Burn Registry
Joseph S. Puthumana, BA, Ledibabari M. Ngaage, MB BChir, Erin M. Rada, MD, Sheri Slezak, MD, Yvonne M. Rasko, MD.
University of Maryland School of Medicine, Baltimore, MD, USA.
PURPOSE: Burns that result from cooking remain among the most prominent and preventable injuries to children globally. This study analyzes data from the World Health Organization (WHO) Global Burn Registry to evaluate causes characteristics of cooking burns across pediatric age groups.
METHODS: De-identified demographic and clinical characteristics were queried from the Global Burn Registry, from its earliest submission in January 2018 to October 2019. Multivariate Kruskal-Wallis and Mann-Whitney tests were performed as appropriate to identify factors associated with increased total body surface area (TBSA) and mortality involved in burns.
RESULTS: Of the 1267 pediatric burn cases reported, 341 involved cooking (n=341, 26.7%). This study found four primary risk factors associated with burn severity: age, sex, heat exposure, and cooking fuel. Burns most often occurred to children <2 years old (n=144, 42.2%); children at this age also had a greater rate of mortality compared to children aged 6-11 years (24.3% vs 9.2%, p=0.01) and 12-18 years (24.3% vs 11.1%, p=0.02). Most burns occurred to females (n=2018, 61.0%), whose burns were both larger (median TBSA: 20.0% vs 15.0%, p=0.0) and deadlier (mortality: 21.0% vs 10.0%, p<0.01) than those of male children. Although the majority of children were exposed to their burn by accidental movement (n=206, 60.4%), explosions (n=45, 13.2%) caused burns that were larger (median TBSA: 35.0% vs 15.0%, p<0.01) and deadlier (mortality: 35.6% vs 12.1%, p<0.01). Finally, children in households using kerosene to cook were at risk of particularly deadly burns compared to households using liquefied petroleum (mortality: 39.2% vs 14.2%, p<0.01) and natural gas (mortality: 39.2% vs 9.5%, p<0.01). Additionally, kerosene caused larger burns than wood (median TBSA: 35.0% vs 20.0%, p<0.01), liquefied petroleum (median TBSA: 35.0% vs 15.0%, p<0.01), and natural gas (median TBSA: 35.0% vs 10.0%). Patients in lower middle income countries were more likely to die from their burns than in high income (mortality: 26.3% vs 4.9%, p<0.01) and upper middle income countries (mortality: 26.3% vs 4.5%, p<0.01). Interestingly, burns in lower middle income countries were found to be larger than those in high income (median TBSA: 25% vs 10%, p<0.01), upper middle income (median TBSA: 25% vs 15%, p<0.01), and lower income countries (median TBSA: 25% vs 15%, p<0.01).
CONCLUSION: Demographic factors, national income status, and fuel characteristics are significant determinants of mortality and total body surface area involved in cooking-related burns in the pediatric population.
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