Epidemiology and clinical pattern of childhood burn at a tertiarychildren's Hospital

Abstract

Introduction: Burn injuries are major health problems in developing countries leading to increased morbidity and mortality. Majority of pediatric burns are preventable and differ largely from adult burns anatomically, physiologically and psychosocially Major causes are scald, flame and electrical injuries. Childhood burn is least explored in Nepal and devastating because of ongoing pain, cosmetic and physical disfigurement, multiple surgical procedures.

Methods: This prospective study was conducted from July 2014 to June 2015 in Pediatric burn unit of Kanti Children's Hospital, Kathmandu, Nepal. A detailed history and examination was done. Patient characteristics including age, gender, causes and percentage of total body surface area (%TBSA) bumt, type of treatment, time period of hospital stay and mortality was recorded. Percentage of burn was determined using 'Lund and Browder chart'. Treatment was started based on these parameters. Statistical analysis was done and results expressed in numbers and percentages.

Results: 314 children were included. Boys were 58.60% and girls were 41.40%. Children with burns, younger than 5 years of age were 82.8%, whichwas high in number. More number of children presented with old burn 164(52.23%) in relation to fresh burn 150(47.77%). Maximum number of children, 235(74.84%) presented with scald burn which is due to hot liquids in comparison to other burn injuries like flame burn which was 64(20.38%).148 (47.13%) of children had burn injuries with 10-30% of %TBSA, followed by 144(45.86%) children with < 10% TSBA. Total mortality was 4.78%, with 3.5% mortality in patients with TBSA more than 50%.

Conclusion: Maximum number of burn injuries occurred in male children under five years of age. Scald injuries predominated and patients mainly presented with old burns. Significant numbers of children with burn injuries were treated conservatively. TBSA is one of the important indicators for deciding management and prognosis. Thus, childhood burn is a major cause of morbidity in Nepal.