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Background: Burns remains a major preventable cause of injury in children worldwide with morbidity and mortality disproportionately affecting low- and middle-income countries. Complications following burn injuries in children are not well studied in Mozambique. Methods: Children between 1 month and 14 years old hospitalized for burns between 2015 and 2017 at Hospital Central de Maputo were identified retrospectively. Child and burns characteristics were compiled with complications including wound infection, sepsis, anemia, hypoalbuminemia, hyperglycemia, and dehydration. The association of complications with demographic variables and burn characteristics were assessed through bivariate analysis. Results: Of the 206 children, the most common cause of burns was hot liquids (66%), followed by fire (28%) and electrical current (6%). Children aged one to four years old were most frequently affected (54%). Of the 91 children with complications, 68% had severe burns with a significant relationship between lesion depth and complications. Among the complications, hypoalbuminemia (56%), hyperglycemia (51%), and wound infections (17%) were the most common. Children who had flame/fire burns and 2nd and 3rd degree burns were associate with a greater risk of having complications. Conclusions: Pediatric burns in the early years are more frequent in Mozambique and hold a high burden of complications. Moreover, flame/fire burns and 2nd and 3rd degree burns were associated with increased odds of complications. Primary prevention measures within the family will be critical to minimize pediatric burns and additional research is warranted to better understand clinical interventions to prevent mortality and complications in low- and middle-income countries.

The elderly population is on the increase globally according to the current global demographic changes and is more vulnerable to burn injuries. Despite recent advances in burn care, the outcome of burns in the elderly has only marginally improved when compared with children and younger adults. The objective of this study was to determine the patterns and outcomes of burns in the elderly and eventually proffer prevention strategies. A retrospective review of all the elderly (65 years and older) burn patients managed at the Burn Centre of National Orthopaedic Hospital Igbobi Lagos (NOHIL) between January 2015 and December 2019 was performed. The socio-demographic data, clinical information surrounding the burn injury and management were extracted from the medical records, analyzed and presented. A total of 21 patients were included in this study, with a male to female ratio of 1:1.1. Flame burns represented the commonest cause of burns (85.7%) and the majority had pre-injury comorbidities (57.1%). All the patients with %TBSA of less than 40% were successfully managed and discharged while death occurred in all the patients with %TBSA of 40% and above, with a mortality rate of 11.1%. This study provided an epidemiological profile of elderly burn patients in Nigeria. One in five burn admissions is elderly, with flame burns being the major cause of burns. Most of the burns occurred indoors and were related to cooking activities. Prevention strategies were recommended to improve home safety and make the home a safer place for the elderly. [ABSTRACT FROM AUTHOR]

Introduction: The epidemiological trends in burns vary in different regions of the world.There are only few population-based reports on this topic in Poland.The aim of this study is to analyze statistics and epidemiology of burn patients. This can create a basis for improving the prevention of burns and their treatment. Methods: This retrospective study analysis the data of burn patients admitted to the University Clinical Center in Gdańsk from 2017 to 2022. Patients were included if their primary or secondary diagnosis was burn, according to ICD. A descriptive statistics were used to describe demographics, injury and management. Results: 584 patients were included in the study. The dominant age group were patients aged 20–29 (139–23,8%), followed by patients aged 30–39 (118–20,2%) and 40–49 (100–17,1%). Men accounted for 338 cases (57,9%), women for 246 (42,1%). The most numerous were burns of thermal etiology (391–67%), followed by chemical burns (172–29,3%). Among thermal burns, scalds and flames were responsible for 297 cases. Head was the most common burn location (281–48,1%), followed by the upper limb (263–45%). It varied depending on gender. Among 355 burn cases characterized with the degree of the burn, second-degree burns were the largest group − 197 cases (60,6%). Plastic, ophthalmological and laryngological consultations are the most frequently ordered type in the Hospital Emergency Department. 163 burn patients required hospitalization. Conclusions: The results obtained in our study are consistent with those of burn victims in other international studies in this field. It is crucial to conduct further epidemiological analysis to better quantify the impact of burns in Poland and to improve the treatment of burn patients.

Purpose: To examine the characteristics and outcomes of myocardial infarction (MI) among burn patients., Materials and Methods: The Nationwide Readmissions Database was utilized to identify hospitalizations of patients with burns from 2016 to 2020. The main outcome was the difference in all-cause in-hospital mortality between burn patients with and without MI., Results: Of 200,130 hospitalizations with burns, 1997 (1 %) developed acute MI. Burn patients with MI were older, more likely to be men, and had a higher prevalence of cardiovascular risk factors. Only burns affecting the trunk and respiratory tract, and those affecting > 20 % of body surface area (BSA), were associated with an increased risk of MI. All-cause in-hospital mortality was higher among patients with MI (18.7 % vs. 3 %, adjusted odds ratio (aOR) 4.59, 95 % confidence interval (CI) 3.66, 5.76). Cardiogenic shock, ventricular tachycardia, and stroke rates were higher among patients with MI. Revascularization was associated with lower in-hospital mortality (aOR 0.33, 95 % CI 0.17, 0.64) CONCLUSIONS: The incidence of MI in burn patients is low but is associated with high mortality and morbidity. Burns involving the trunk and respiratory tract, and those affecting > 20 % BSA, were associated with an increased risk of MI. Revascularization was associated with lower in-hospital mortality., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Injury prevention is valuable for pediatric burns at home. To develop future target of prevention, we aimed to elucidate characteristics and chronological changes of pediatric burn injuries at home in urban areas., Patients and Methods: We conducted a retrospective observational study using the database of the Tokyo Burn Unit Association, which comprises 14 tertiary burn centers, the Tokyo Fire Department, Tokyo Medical Association, and the Tokyo city government. We included pediatric patients aged ≤ 15 years who had a burn injury at home in the last 30 years and divided them into five groups at 6-year intervals. We compared the mechanism, severity, and outcome of burn injuries between the groups., Results: We included 1092 pediatric patients, with no significant chronological changes in the incidence of burn injuries at home (approximately 200 patients in each 6-year period). The median age was 1 year in all the groups. Flame burns decreased from 7.7 % to 1.6 %, whereas scald burns remained at > 80 %. The burn area decreased from 10 (5-16) % total body surface area (%TBSA) to 7 (3-11) %TBSA. The length of hospital stay was reduced from 6 to 2 days, and in-hospital mortality was 0.4-0.5 % in the last decade., Conclusions: The incidence of flame burns and burn area decreased over time with improving clinical outcomes in pediatric burns. The number of scald burns remained the same over time; thus, further social intervention is needed to prevent scald burns., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: The aim of the present study was to examine the profile, management and outcomes of adult patients with severe burns within the Victorian State Trauma System (VSTS)., Methods: Data from the Victorian State Trauma Registry (VSTR) was analysed to characterise patient and injury characteristics and review pre-hospital management and clinical outcomes of adult patients with severe burns., Results: There were 421 cases over 13 years of the study. Approximately 80% of cases were flame burns, and 5% were associated with other significant trauma. Approximately 75% were male; with 83% of patients under 65 years old, 40% of lower socioeconomic status, 25% having pre-existing drug and alcohol involvement, and 36% living with associated comorbidities. All but 11 patients (of 421) were managed definitively at the burns service. Around one-third of patients had interhospital transfer, with median (interquartile range (IQR)) time spent in the primary hospital 3.0 (1.9-4.3) h. Only five patients had multiple interhospital transfers. Nearly 75% of patients were admitted to an ICU. The median (IQR) length of definitive hospital stay was 27.2 (11.2-44.9) days. The mortality rate was 23.8%., Conclusions: Severe burns are uncommon injuries with high mortality. There is a high rate of adherence to VSTS guidelines for managing patients with severe burns, and a decrease in patients requiring transfer associated with an increase in acceptable time to a trauma-receiving hospital. The VSTS operates to deliver almost all patients with severe burns to the definitive burns service efficiently., (© 2024 The Author(s). Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)

Objective: Burn injuries on farms are under-recognised in Australia and New Zealand. Previous studies suggested children are at risk of burn injury, focusing on risk factors including unmodified farm work, risk-taking behaviours, lack of supervision, and limited safety regulations. This study investigated the causes, characteristics, and outcomes of paediatric farm burns., Methods: Registry-based retrospective cohort study., Design: Observational., Setting: Burns Registry of Australia and New Zealand (BRANZ)., Participants: Paediatrics aged < 16 years and registered to the BRANZ between 2009 and 2021., Main Outcome Measures: The demographics, causes of burn injuries, pre- and in-hospital management, severity, and outcomes., Results: Out of 10 936 paediatric burns, 186 were farm-related (1.7%). Children sustaining farm-related burns were older than those in non-farm environments, with 78.8% aged ≥ 5 years. Most farm burns occurred during leisure (72.5%). Predominant causes were found to be contact (62.4%), followed by flame (19.9%) and friction (10.8%). Only 56.9% received gold-standard first aid compared to 74.0% in non-farm environments. Farm-related burns were smaller but a greater proportion were full-thickness injuries, requiring surgical management with skin grafts. The majority of farm-related burns were discharged home (97.3%) with zero deaths., Conclusion: Farm-related burns in children are distinct from burns in non-farm environments. Despite children being well-recognised participants in farm work, work-related burns were relatively uncommon, and the occurrence of burns during leisure may explain low rates of recommended first aid. These insights can inform burn prevention and first aid strategies targeted at farm communities., (© 2025 The Author(s). Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

Introduction: Burn-related fatalities pose a significant global public health challenge, with a substantial impact on the elderly population. This study examines two decades of burn-related mortality data in the United States, aiming to understand the trends, disparities, and contributing factors among adults aged 65 and older., Objectives: The primary objectives of this study are to (1) analyze the trends in burn-related mortality rates among older adults, (2) investigate disparities based on gender, race and geographic regions, and (3) identify comorbidities and complications associated with burn-related deaths in this demographic., Methods: Data were obtained from the Centers for Disease Control and Prevention (CDC) using the National Center for Health Statistics database. The study cohort consists of individuals aged 65 and older who experienced burn-related deaths between 1999 and 2020. Various demographic variables, including age, sex, race/ethnicity, and location of death, were considered. The study also examined urban-rural classifications and regional differences. Mortality rates were calculated and adjusted for age. Joinpoint regression analysis was employed to assess trends in age-adjusted mortality rates over time. Modes of death and common comorbidities and complications were analyzed., Results: Between 1999 and 2020, a total of 96,498 older adults succumbed to burn injuries in the United States. Analysis revealed a concerning increase in burn-related mortality rates from 2012 onwards. Demographic disparities were evident, with older men consistently exhibiting higher mortality rates compared to women. Racial disparities were observed, with Black individuals experiencing the highest mortality burden. Geographic analysis indicated elevated mortality rates in Western states and rural areas. Accidents emerged as the leading cause of death, with ischemic heart disease and hypertensive diseases being prevalent comorbidities. Complications, with septicemia being the most common, contribute significantly to mortality., Conclusion: Our analysis of 20 years of burn-related mortality data from the CDC reveals alarming trends in the United States. Unlike global trends, mortality rates have stagnated from 1999 to 2020, indicating a persistent public health challenge. Black individuals aged over 65 bear the brunt of burn-related mortality, facing the highest age-adjusted rates among all racial groups. Regional disparities are stark, with states in the top 90 % exhibiting significantly higher age-adjusted mortality rates compared to those in the bottom 10 %. Moreover, rural areas consistently report higher mortality rates than urban areas. Ischemic heart disease, hypertensive diseases, and other heart-related conditions emerge as prevalent comorbidities. To effectively reduce burn-related injuries and fatalities, targeted public health policies are imperative. These interventions must prioritize high-risk populations and adopt culturally sensitive approaches to promote safety. Additionally, enhancing access to healthcare and fire safety education is vital for mitigating the burden of burn-related mortality among the elderly population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Self-inflicted burns (SIBs) represent a distinct entity in burn care often associated with an underlying psychiatric etiology. In this review, we summarize the existing evidence on SIBs in North America to inform targeted prevention and interventions for patients afflicted with SIBs. The following databases were queried to identify relevant articles used for literature review: PubMed, Embase, and Scopus. The main outcome measures were burn characteristics and risk factors of SIBs in the American population. A total of 14,189 patients were included across 13 included studies. The percent of total body surface area burned ranged from less than 1% to 100%, with a mean of 29.6% ± 20.7%. Depressive disorders were the most reported overall; however, among mood disorders, bipolar disorder was also reported frequently, while anxiety was reported least. Motives for self-inflicting burn injury included premeditated self-injury as a coping mechanism, escape or response to delusions, impulsive self-injury, and most commonly, suicidal intention. The majority of the studies reported that preadmission drug and alcohol abuse were associated with the occurrence of SIBs. Other identified risk factors for SIB injury included female sex, younger age, unemployment, and unmarried status. From this, it is imperative that targeted interventions are developed to address the complex interplay of psychiatric disorders, drug use, and other demographic risk factors among the American population. It is crucial for initiatives to emphasize early identification of individuals at risk of self-harm, better access to mental health services, and stronger drug abuse programs to target SIB occurrence in the United States., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

This study evaluated the prevalence and characteristics of advanced practice providers, including nurse practitioners and physician assistants, who provide care related to burns in the United States from 2013 to 2022 using national claims data. Our analysis was a retrospective, large cohort study evaluating debridement, wound care, and office-based services provided by advanced practice providers from 2013 to 2022 using the Medicare Provider Utilization and Payment Data Public Use Files from the CMS. The reported provider type and billing codes were used to identify healthcare professionals providing burn care. Trends over the study period and available data about care provided were analyzed. From 2013 to 2022, burn care providers included 6918 (43.3%) surgeons, 4264 (26.7%) other physicians, and 4783 (30.0%) advanced practice providers. Overall, the number of advanced practice providers who billed for burn care increased by 250.4% from 714 in 2013 to 2502 in 2022. Compared with physicians, advanced practice providers were more likely to be female and provide care in micropolitan areas with less than 50,000 people. Based on these trends, we project that the number of advanced practice providers providing services related to burns will increase by 56.7% from 2502 in 2022 to 3921 (95% CI, 3541-4303; R2 = 0.97) in 2030. With a growing need for burn care and predicted shortages in the surgeon workforce, the scope of practice and integration of advanced practice providers merits further discussion and evaluation., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association.)

Unhoused burn patients (UBPs) have historically been more likely to leave against medical advice (AMA) and suffer worse health outcomes than the general population. The coronavirus disease 2019 (COVID-19) pandemic created a major strain on the health care system, resulting in worse overall health outcomes for burn patients. We sought to investigate how COVID-19 impacted treatment for UBP, specifically the rate of leaving AMA. We conducted a retrospective chart analysis of patients admitted to a regional burn center between June 2015 and January 2023. March 1, 2020 was used as a cut point to separate the cohorts into patients seen pre-COVID-19 (p-CV) and during COVID-19 (CV). Outcomes included leaving treatment AMA and readmission within 30 days. In total, 385 patients met criteria for being unhoused and were included in our analytic sample, of which 199 were in the p-CV cohort and 186 in the CV cohort. UBP were significantly more likely to leave AMA during CV compared to p-CV (22.6% vs 7.5%, P < .001). Housed burn patients did not experience an increase in discharges AMA during this time period. The COVID-19 pandemic resulted in an increase in discharges AMA among unhoused patients only. While the etiology is unclear, our findings suggest that this vulnerable patient population is receiving inadequate care post-COVID. Future research should determine the driving force behind these increases and identify early interventions to mitigate them., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objective: This study aimed to assess the impact of the COVID-19 pandemic on the characteristics and outcomes of patients with burns in a burn centre situated in Northwest China., Design: A retrospective descriptive study., Setting: This study was conducted in Tangdu Hospital, a major regional burn centre in Xi'an, Shaanxi Province of China., Participants: A total of 1413 patients with burns were included in the study, with the admission period spanning from 2017 to 2019 (before the pandemic) and 2020 to 2022 (during the pandemic)., Results: Burn hospitalisations decreased during the pandemic for both children (9.80%) and adults (24.68%). The pandemic was associated with a decrease in work-related burns and a corresponding increase in the risk of domestic burns (both p<0.001). The proportions of burns due to scald and flame increased, while electrical injury cases and proportions decreased significantly (both p=0.001). The estimated range of % total body surface area (TBSA) for children increased from 8% (IQR: 5-12%) to 10% (IQR: 8-15%) in children (p<0.001) and from 8% (IQR: 4-18%) to 11% (IQR: 6-25%) in adults (p<0.001). In children, the number of burn cases transferred from other hospitals decreased (p=0.011). Among adults, the number of female patients with burns rose (p=0.013), and the number of patients with inhalation injury also rose (p=0.009)., Conclusion: During the COVID-19 pandemic, the number of inpatients with burns declined. Domestic burns became more common, and scald and flame burns as well as the average burn area (% TBSA) increased. These findings might highlight the significance of implementing specific public health strategies and safety measures to improve family safety both during and after the pandemic., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Knowledge about trends and epidemiology of pediatric burns is useful to identify patterns, to advance medical research, and to design prevention programs and resource allocation. The aim of this study is to describe the epidemiology and trends of pediatric burns between 2009 and 2022 in the three Dutch burn centers. A secondary objective of this study is to evaluate the influence of the COVID-19 pandemic on the pattern of pediatric burns. A register-based cohort study was conducted based on data from the Dutch Burn Repository R3. Patients between 0 and 17 years at the time of the burn injury admitted between 2009 and 2022 to one of the three burn centers were included. Descriptive statistics were used to investigate the incidence and patient, burn, and treatment characteristics. The COVID-19 pandemic years (2020-2021) were compared with the pooled results from pre-COVID-19 years (2017-2019). A total of 4017 patients were included in this study, of which 3085 (77%) were overnight admissions. The incidence and absolute number of pediatric burn admissions gradually increased over the years, with a small temporary decrease in 2020-2021. Patient and burn characteristics remained relatively consistent over the years. Three quarters of all patients were between 0 and 3 years old, and the majority were boys (59%). A decreasing ratio of length of stay per % total burned surface area and an increase in day admissions was observed since 2016 onwards, which intensified during the COVID-19 pandemic., Conclusions: There was a slight increase in the number of pediatric admissions to the burn centers between 2009 and 2022. Young children (0-3 years) remain the most frequently affected group. A shorter relative length of stay was observed, as well as an increase in day admissions, which was reinforced by the COVID-19 pandemic., What Is Known: • Burns are a leading cause of death and disability among children globally. The largest group affected are young children (0-3 years) and most are scald burns. • In the Netherlands, since the late nineties there has been a trend towards more admissions to specialized burn centers, especially for young children with less severe burns., What Is New: • There was a slight increase in the number of pediatric admissions to the burn centers between 2009 and 2022, with a temporary decrease during the COVID-19 pandemic (2020-2021). • Admissions now tend to be shorter per percentage total burned surface area (TBSA), with an increase in day admissions, which intensified during the COVID-19 years., Competing Interests: Declarations. Ethics approval: Approval by a Medical Research Ethics Committee was not required according to the Dutch Medical Research with Human Subjects Law. The local institutional review boards of the Red Cross Hospital, Maasstad Hospital, and Martini Hospital approved this study. The Medical Research Ethics Committees United and the Medical Ethics Review Committee of the Amsterdam University Medical Centers ruled that the Medical Research Involving Human Subjects Act (WMO) was not applicable to the current study (AW24.031/W19.140 and 2022–0683, respectively). Consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Carbapenem-resistant Acinetobacter baumannii is an opportunistic pathogen which has caused numerous health care-associated outbreaks particularly in intensive care and burn units. We describe an outbreak in a burn unit where 3 patients were identified as being colonized or infected with carbapenem-resistant Acinetobacter baumannii. A multifaceted approach and rapid implementation of infection prevention measures were effective in identification and removal of potential environmental reservoirs resulting in the prevention of further transmission., (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Introduction: Pediatric burns present a significant global health challenge, particularly in low- and middle-income countries (LMICs). Despite this burden, few studies have explored global sex-based differences in pediatric burns. This study aims to describe pediatric burn incidence, burn care facilities' capacities, and burn outcomes with a focus on sex, comparing LMICs to HICs., Methods: This study utilizes the World Health Organization's (WHO) Global Burn Registry (GBR) to analyze pediatric burn cases from 2018 to 2022, examining patient demographics, causes of burns, burn care facilities' capacities, and burn outcomes in relation to sex. Statistical analysis was done by chi-square and logistic regression., Results: It was found that female patients were less likely than males to undergo surgical treatment during their hospital stay in low-income countries (adjusted odd ratios = 0.86, 95% CI: 0.45-1.26; p = 0.168) and middle-income countries (adjusted odd ratios = 0.72, 95% Cl: 0.52-0.95; p = 0.002). Additionally, females in both low- (adjusted odd ratios = 2.23, 95% Cl: 1.12-3.53; p = 0.045) and middle-income countries (adjusted odd ratios = 1.72, 95% Cl: 1.12-2.95; p < 0.001) exhibited higher odds of discharging with disability compared to males., Conclusion: Sex-based differences persist in pediatric burn epidemiology and treatment outcomes. Addressing these differences involves sex-sensitive strategies to mitigate the burden of pediatric burns, particularly in vulnerable populations in low- and middle-income countries., Type of Study: Retrospective observational study., Level of Evidence: Level III evidence., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Geospatial analysis is useful for identifying hot spots for preventable injuries and for informing prevention efforts. We hypothesize that specific populations of children in South Florida are at increased risk of burn injury., Methods: We used a regional burn center registry to geocode burn cases treated from July 2013 to December 2022 for patients <18 years. Spatial analysis was utilized to identify high-density areas and potential spatial clusters of patients living in Palm Beach, Broward, and Miami-Dade Counties. Sociodemographic factors, burn etiology, and physiologic characteristics were analyzed using geospatial and statistical analyses., Results: 689 patients (58% male, median age 2 [1-8] years) were identified. The annual incidence of burns was 5.5 per 100,000 children. There was no seasonal variation in injury patterns. Most patients were Black (51%) and non-Hispanic (73%). Scald burns (72%) represented the most common etiology, followed by flame (10%) and contact with hot objects (9%). Most patients (58%) required inpatient admission. Scald and contact burns occurred in younger patients compared to other mechanisms (median [IQR] age: 2 [1-6] vs. 8 [4-12] years, p < 0.001). Race, ethnicity, and insurance status were not associated with inpatient admission (all p > 0.05). Overall, there was a higher rate of pediatric burn injuries affecting Black residents, with a paucity of injuries in predominately high-income areas., Conclusions: A disproportionate amount of pediatric burn injuries occur in low-income and predominantly Black neighborhoods. Additionally, scald and contact burns are a target for injury prevention in South Florida. These data may inform public health implementation to reduce morbidity in vulnerable populations., Level of Evidence: Level III., Type of Study: Retrospective comparative study., Competing Interests: Conflicts of interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Burn injuries remain one of the leading causes of injury and death in children. Studies have demonstrated a higher mortality for pediatric burns associated with non-accidental injury. Using data from a burn registry, our study aimed to discern potential factors associated with non-accidental burn injuries., Methods: We utilized the American Burn Association database from 2016 to 2018, which collects data from over one hundred burn centers across the United States, to evaluate a large pediatric burn population. Patients aged ≤14 years were analyzed. The population was then divided into suspected non-accidental versus accidental burn injuries. A multivariable logistic regression model was utilized to evaluate for predictors of burn injuries. Additional models were used to assess the relationship between suspected non-accidental burn injury and mortality, intensive care unit (ICU) stay, and hospital length of stay., Results: 16,671 pediatric patients were included. Of those, 1228 (7.4%) patients suffered non-accidental burn injury. A majority of children who sustained non-accidental burn injury were younger, non-white, and sustained scald burns. The regression model demonstrated predictors for non-accidental burn injuries included younger age, Black race, chemical/corrosion burns, government insurance, and increased total body surface area (TBSA) burn. Overall mortality for the population was 0.5%., Conclusion: This evaluation of a national burn registry reveals differences in pediatric patients sustaining non-accidental burns compared to accidental burns. The findings in this study identify pediatric populations at risk for suspected non-accidental burn injuries which may assist in preparing the families for expectations after admission for a burn injury., Level of Evidence: III., Competing Interests: Conflicts of interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Burn caused by exposure to hot substances is a common occurrence but there is little data on prevalence trends and disease burden. This research report the burden of burn injuries globally, regionally, and nationally from 1990 to 2019, identify hotspots, and analyze factors affecting disease burden with data from Global Burden of Disease 2019 survey., Methods: The Global Burden of Disease 2019 estimated the incidence, death rate, and disease-adjusted life years (DALY) for injuries due to exposure to fire, heat, and hot substances from 1990 to 2019. For comparison, all rates were age standardized. And the estimated annual percentage change (EAPC) was used to reflect the degree of change of the annual rate., Results: Globally, there were an estimated 8,378,122 (95 % uncertainty interval [UI]: 6,531,887-10,363,109) burn injuries in 2019, with age-standardized incidence, death, and DALY rates of 118 (95 % UI: 89-147), 1.44 (95 % UI: 1.14-1.72), and 96.6 (95 % UI: 75.03-123.05) per 100,000 people, which were 22 %, 43 %, and 43 % lower than those in 1990, respectively. Regionally, age-standardized incidence rate showed a positive association with Socio-demographic Index (SDI) from 1990 to 2019, whereas age-standardized death and DALY rates were negatively associated with SDI. The variation in the age-standardized incidence rate was intrinsic, and the variation in the age-standardized death rate was related to the human development index in the country. The global burn incidence population was skewed, with peaks mainly in the 5 to 19 years age group, but age-specific death rates and disease burden were higher in the under-5 and older age groups., Conclusions: The results of this study indicate the need to consider regional differences in burns when allocating health resources. Despite the reduced global burden of burns, incidence and deaths remain high. Moreover, there are significant differences between regions which are associated with the SDI and the human development index. Additionally, differences exist in the age and sex of the affected populations. Although the exact causes require further study, there is no doubt that the prevention of burns requires serious attention., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: To analyze, through the responses of physicians who work in burn treatment units, their demographic profiles and academic backgrounds, the structure available for patient care, the adoption of care protocols, support from medical and multidisciplinary specialties, and the main challenges faced by these professionals., Methods: Cross-sectional study of the survey type carried out from March 2020 to April 2021 through a questionnaire constructed according to the Delphi method. The questionnaire was applied online to plastic surgeons and intensivists who work in burn units. A list was obtained of Brazilian centers, as well as the epidemiological and academic profile of the medical team, level of structure, treatment protocols, and restrictions and challenges encountered., Results: The majority of the burn centers are located in the South and Southeast of the country, and are references for care for populations of over 1000,000 inhabitants. Professionals are between 30 and 60 years old, and have been concentrating on burn victims for between 5 and 15 years. For the most part, the professionals performed their skills training in the centers where they work, which, in turn, have a strong academic tendency, with medical residency programs and other specialties. Burn care protocols, together with related clinical conditions such as surgery, measurement of the burned area, use of antibiotics, thromboembolic prophylaxis, nutrition, physical therapy, and nursing care are widespread and the greatest difficulties pointed out are the serious nature of the burn and infections. The demand for procedures, and regulatory and reception flows seem to be coordinated and in line with regional needs., Conclusions: Burn treatment units are widespread throughout the country, at different levels of complexity. The most frequent organization is a regional reference center, with care for more than one million inhabitants, located within a tertiary hospital. Most professionals are between 30 and 60 years old, with more than 5 years of experience in burns. The majority of centers demonstrate well-established clinical, surgical, dressing, and global patient care protocols. The complexity of cases, patterns of resistance, and bacterial colonization are important challenges throughout Brazil., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Introduction: Scalds are the leading cause of burns in children younger than 5 years of age with most being related to food preparation and consumption. Hot substances causing scalds have different degrees of viscosity varying from low (liquid substances, such as water), to high (semi-solids or solids, such as oils or grease). It is still underknown whether heat substances with different viscosities are associated with varying risks of developing burn wound infections (BWI). The aim of this study was to investigate the association between heat sources of different viscosities and development of BWI within the first week after injury in children with scalds., Method: Children 5 years and younger of age admitted at the Linköping Burn Center for new scalds between 2015 and 2020 were included. Data source for the study population was the Burn Unit Database. BWI was defined as fulfilment of at least two ABA criteria at the time of systemic antibiotic therapy (AB) initiation between day 2-7 following scald. Medical record review was undertaken to identify the heat source causing the scald, BWI criteria, and the use of AB. Legal guardians were contacted in cases in which information was missing. Logistic regression was used to analyse the association between heat source and development of BWI., Result: The study population consisted of 271 children, median age was 1.5 years, 61 % were boys, median burn size was 3.5 % of the total body surface area (TBSA), 10 (4 %) had a full thickness burn. BWI were identified in 69 (26 %) of the children. Most scalds were caused by contact with hot liquids (n=184), followed by semisolids (n=52) and solids (n=35). The logistic regression model showed that the size of the burn (TBSA) was associated with BWI, while type of heating agent was not., Conclusion: Our results indicate that the viscosity of the heat source does not affect the risk of wound infection in children with scalds; only the size of the area burned was an independent factor for BWI., Competing Interests: Declaration of Competing Interest No conflict of interest., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Background: Pediatric burn injuries are a significant public health issue in low- and middle-income countries, leading to substantial morbidity and mortality. This study aimed to evaluate the efficacy of the No+Quema2 educational program, implemented in Aguascalientes, Mexico, in preventing burn injuries among children under nine years old., Methods: The No+Quema2 program, initiated in 2014, included educational courses for children, training for health workers, and specialized care for children with burn sequelae. Epidemiological data on burn injuries from 2014 to 2022 were retrieved from the National System of Epidemiological Surveillance of the Health Ministry of Mexico. Monthly incidence rates per 100,000 inhabitants were analyzed using the Mann-Kendall trend test and segmentation analysis to detect trends and changes., Results: The program trained over 25,000 scholars from 1750 elementary schools and distributed medical kits for immediate burn care. Additionally, 200 children with burn sequelae received scheduled treatment. The analysis showed a significant decrease in the state incidence rate of burn injuries compared to the national mean post-implementation. The estimated number of burn injuries prevented during the study period was approximately 3839, or 604 per year., Conclusion: The No+Quema2 program has made a significant impact on burn prevention among children in Aguascalientes, Mexico. Despite the limitations of relying on government-reported data, the correlation between the program's activities and the observed decrease in burn injuries is promising. These findings underscore the critical importance of the No+Quema2 program's activities in achieving sustained, targeted educational interventions and long-term reductions in burn injury incidence. They also highlight the need for more robust study designs to validate these outcomes, emphasizing the importance of evidence-based strategies in future burn prevention efforts., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Declarations of interest None., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Background: Burns can cause long-term complications including pain and poor physical function. While neighborhood disadvantage is associated with burn severity, its effect on long-term complications has not been investigated. We hypothesized that patients from areas of higher area of deprivation index (ADI) will report poorer long-term outcomes., Methods: We linked patient data from the Burn Model System with ADI state decile (1 = least, 10 = most disadvantaged) using year and residence at time of injury. We performed bivariate analyses to identify associations between ADI and patient and burn characteristics and multivariate regressions to determine whether ADI was associated with PROMIS-29 pain and physical function 6- and 24-months post-burn., Results: We included 780 patients; 69 % male, median age = 46 years, median ADI = 6, and median TBSA = 8 %. Multivariate regressions adjusting for TBSA, race, age, sex, anxiety, depression, and pain interference demonstrated that higher ADI was a significant predictor of higher pain intensity 6- (p = 0.001) and 24-months (p = 0.037) post-burn but not worse physical function 24-months post-burn (p = 0.089)., Conclusions: Higher neighborhood disadvantage was associated with higher long-term pain intensity post-burn. This study highlights the importance of socioeconomic factors that may impact long-term outcomes and the use of aggregate markers to identify patients at risk for worse outcomes., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Introduction: There are an estimated 10 million hot water bottles (HWB) currently in use within the United Kingdom (UK), and HWB related burn injuries represent a significant resource burden to UK Burns Services. These injuries can be caused through a variety of mechanisms including scalds sustained when filling the bottle or scalds from leaking or rupture. The fuel poverty crisis started in February 2022 leading to an estimated six-fold increase in alternative sources of heating, in particular hot water bottles. In this study, we wish to understand the impact that this may have had upon burn injuries sustained by these products., Methods: All hot water bottle (HWB)-related injuries sustained January 2014 - February 2023 were retrieved from the UK International Burn Injury Database (IBID). Data were collected on patient demographics, injury mechanism, anatomical location, and clinical outcomes. The data were collated and analysed; statistical analysis was performed using R StudioTM. Patient levelling costs were also incorporated to enable translation of these data into healthcare costs., Results: A total of 5944 HWB-related burn injuries were recorded in the IBID database in England and Wales, from 2014 to 2023, with a mean of 594 (SD 146.2) burn injuries annually, costing an estimated £ 12.7 million. There were 423 burn injuries sustained from HWB in winter 2022 compared to 295 in winter 2021, representing a 43.4 % increase over one year, with a corresponding increase of 43.1 % in the number of patients managed in an outpatient setting. The largest increase in burn incidence between winter 2021 and winter 2022 was seen in children (0-16 years old) and older adults (greater than 65 years old) with a rise of 60.3 % (n = 41) and 68.5 % (n = 37) respectively., Conclusion: Our epidemiological study on hot water bottle (HWB)-related burn injuries within the United Kingdom has shown that the dramatic rise in fuel prices, which sparked the fuel poverty crises, has coincided with a 43.4 % increase in HWB burns incidence on the health service in that year alone. This alarming rise in HWB-related injuries highlights the continued need for targeted public awareness campaigns to ensure a safe and proper use of these devices., Competing Interests: Declaration of Competing Interest The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Background: Infections are the most frequent complication and cause of mortality in burn patients. We describe the epidemiology and outcomes of infections among deployed U.S. military personnel with burns., Methods: Military personnel who sustained a burn injury in Iraq or Afghanistan (2009-2014) and were admitted to the Burn Center at U.S. Army Institute of Surgical Research at Brooke Army Medical Center were included in the analysis., Results: The study population included 144 patients who were primarily young (median 24 years) males (99 %) with combat-related burns (62 %) sustained via a blast (57 %), resulting in a median total body surface area burned (TBSA) of 6 % (IQR 3-14 %). Twenty-six (18 %) patients developed infections, with pneumonia being the predominant initial infection (= 16), followed by skin and soft-tissue infections (SSTI, = 6), bloodstream infections (BSI, = 3), and intra-abdominal infections (IAI, = 1). Initial infections were diagnosed at a median of 4 days (IQR 3-5) post-injury for pneumonia, 7 days (IQR 4-12) for SSTIs, 7 days (IQR 6-7) for BSI, and 17 days for IAI. Patients with infections were more severely injured with greater TBSA (median 31 % vs 5 %), more inhalation injury (38 % vs 12 %), and longer time to definitive surgical management (median of 34 days vs 9) compared to those who did not develop infections (p < 0.001). Among patients with inhalation injury, a higher proportion developed pneumonia (42 %) compared to those without inhalation injury (5 %; p < 0.001). Five patients developed an invasive fungal infection. Gram-negative bacilli were most frequently recovered, with 32 % of Gram-negative isolates being multidrug-resistant. Four patients died, of whom all had ≥ 4 infections., Conclusions: Military personnel with burn injuries who developed infections were more severely injured with greater TBSA and inhalation injury. Improved understanding of risk factors for burn-related infections in combat casualties is critical for effective management., Competing Interests: Declaration of Competing Interest The authors have no conflicts to disclose. All authors approved the final version for submission., (Published by Elsevier Ltd.)

Severe burns lead to malformations and higher mortality and have long-term social consequences. We aimed to analyse the epidemiologic characteristics and clinical outcomes of severe burn patients hospitalized in a major burn centre in Eastern China. This study included severe burns patients hospitalized in our hospital from 2017 to 2022. We extracted all data from electronic medical records for retrospective analysis. Burn scoring systems were calculated for all patients. The median age of the patients was 49.00 years, with 62.13% of them aged between 30 and 59 years. Of the 375 adult patients, 256 were male and 119 were female. The major cause of burns was flame (46.1%), followed by explosion (35.2%). The median total body surface area was 40%. Sixty-three percent of patients suffered an inhalation injury and 125 patients (33.3%) developed complications during hospitalization. The average mortality was 5.3%. Higher mortality rates are associated with advanced age, flame burns, larger full-thickness burns area and total body surface area, inhalation injuries and combined burn complications. Severe burns often occur in middle-aged men. Governments and companies need to improve the safety of living and working environments. It is essential to develop treatment strategies based on risk factors for burn deaths and improve the quality of medical care., (© 2024 The Author(s). International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Objective: This study aimed to examine the prevalence and predictors of reconstructive surgery among pediatric burn patients in the Netherlands., Methods: Pediatric burn patients were identified through the Dutch Burn Repository R3. Eligibility criteria included a burn requiring hospital admission or surgical treatment at one of the Dutch burn centers in 2009-2019. First, patient, burn, and treatment characteristics were summarized using descriptive statistics. Second, time to the first reconstructive surgery was modelled using Kaplan Meier curves. Third, a prediction model was developed using univariate and multivariate logistic regression. The model's performance was assessed using calibration, discrimination, and explained variance. Fourth, internal validation was performed using bootstrapping., Results: Approximately three percent (n = 84) of pediatric patients (n = 3072) required reconstructive surgery between the initial burn-related hospital admission and September 2021. Median time to the first reconstructive surgery was 1.2 (0.7-1.6) years. Most surgeries were performed on the face, arm, neck, hand, or anterior trunk, owing to contractures or hypertrophic scarring. Predictors of reconstruction included the etiology, anatomical site, extent of full-thickness burn, surgical treatment in the acute phase, and length of hospital stay., Conclusion: Our study provided an overview of the prevalence and independent predictors of reconstructive surgery in the pediatric burn population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: To describe incidence and characteristics of hospital presentations and deaths due to burn injury in the Australian state of Victoria from 2008 to 2017 and identify trends in incidence and patterns.Methods: Three population-based datasets were used to ascertain burn-related hospital admissions, emergency department presentations, and deaths. These were the Victorian Admitted Episodes Dataset (VAED), Victorian Emergency Minimum Dataset (VEMD), and the Cause of Death-Unit Record File (COD-URF), respectively. Descriptive statistics on demographics (age and gender), burn injury characteristics (intent, cause, burn size and body region) and hospital burden (length of stay (LOS) and costs) were used to present the profile of patients. Incidence rates by age, gender and intent were calculated. Trend analysis on incidence was carried out using forced Poisson Regression models with the natural logarithm of the annual populations as an offset. Incident rate ratios were used to interpret the models. Risk ratios were used to compare the risk differences between population sub-groups. A negative binomial model was used to test the association between LOS and age and the total body surface area (TBSA) of the burn.Results: Overall males had higher rates of death, admission and ED presentation. For adults, the elderly had the highest rates of deaths and admissions while for children, the very young had highest rates for admissions and presentations. Exposure to smoke, fire and flames was the most common cause of deaths, and contact with heat and hot substances was most common among ED presentations. The elderly and those with Total Body Surface Area (TBSA) burn ≥20% had a higher risk of longer hospital stay. Rates of severe burns and deaths from burns remained stable during the study period in the setting of an annual 2% increase in population. Paediatric hospital admission rates decreased over time.Conclusion: The risk of sustaining burn injury, the types of burn and outcomes, varied by age and gender. We found evidence of a limited decrease in burn injury rates in some sub-groups: appropriate and effective targeted prevention strategies for burns are needed to avoid the significant short and long-term suffering experienced. [ABSTRACT FROM AUTHOR]

Burn injury can have profound detrimental effects on the quality of life and mental health of children. We collected demographics, burn etiology, burn date, and home zip code for pediatric patients admitted to our burn unit from 2016 to 2023. Age, burn date, and etiology of burn were used to assess temporal and mechanistic patterns of injury for preschool-age and school-age children. Home zip code was used to determine each child's home Childhood Opportunity Index (COI) score, which is composed of subdomains for Education, Health and Environment, and Social and Economic. We calculated the odds ratio for odds of pediatric burn admission for each COI subdomain quintile, using very high opportunity neighborhoods as the reference. Scald was the prevailing burn etiology (64%). In school-age children, July was the month with the most burn injuries (19%), attributable to firework injuries. School-age children were also more likely to be injured in a week without classroom instruction (P < .001). There was a dose-response relationship between COI and odds of burn admission, with the greatest odds of burn admission observed for children from very low educational opportunity areas (OR 5.21, 95% CI 3.67-7.39). These findings support interventions for burn prevention such as increased education about the dangers of fireworks, addressing inequities in access to childcare and extracurricular activities, and reducing the default water heater temperatures in multi-unit dwellings., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Thermal injury-associated toxic shock syndrome (TSS) is a life-threatening condition that can occur in children following burn injuries. The objective of this study was to describe the clinical manifestations, treatment, and outcomes of children who experienced TSS following a thermal injury. Additionally, the existing literature was systematically examined and published cases of pediatric TSS occurring after burns were compiled. In June 2023, without regard for time constraints, articles that met the criteria were searched across several electronic databases. The inclusion criteria were English-language publications, pediatric patients, and reported outcomes of interest for clinical questions. Due to the heterogeneity of the included publications and the lack of data in an appropriate format, a meta-analysis was not feasible. Our research identified 23 studies published between 1980 and 2023, including 72 cases (from multiple countries) that met the inclusion criteria. Of the 72 patients with thermal injuries complicated by TSS, 53 (73.6%) children survived, 6 (8.3%) died, and for 13 (18%) cases, the outcome was not documented. Our systematic review highlights the rarity, severity, and complexity of pediatric thermal injury-associated TSS. Key findings from the review indicate that pediatric thermal injury-associated TSS carries a high mortality rate and significant morbidity. By increasing awareness, improving diagnostic accuracy, and optimizing treatment strategies, healthcare professionals can improve patient outcomes in this challenging condition., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Violence against women is a global public health problem. Centers for Disease Control and Precention (CDC) data show 41% of US women have experienced intimate partner violence. Burn-related violence against women is an extremely confronting form of physical violence. The aim of this study was to describe the frequency, demographics, injury characteristics, and outcomes of women admitted to US burn centers who have experienced burn violence compared to those with accidental burn injuries. 2008-2018 data were comparative statistics were used to describe/compare groups. 54 523 women met study inclusion criteria. 956 (2%) experienced burn violence. Women who experienced burn violence had a younger median [IQR] age (36 [27,48] vs 47 [32,61], P < .0001), were Black/African American (44.5% vs 22.4%, P < .0001), were covered by Medicaid (38.8% vs 21.6%, P < .0001), had a higher median [IQR] %TBSA extent (6.0% [3,15.2] vs 3.0% [1,7.3], P < .0001), a higher proportion with third-degree burns (35.4% vs 28.9%, P < .0001), and a higher proportion with TBSA > 20% (18.2% vs 6.7%, P < .0001). Scald/flame injuries were the most frequent mechanism of injury. Women who experienced violence had a higher median [IQR] length of hospital stay (7.0 [2,18] vs 4.0 [1,11] days, P <.0001), Intensive Care Unit (ICU) stay (8.5 [2,27] vs 4 [2,13] days, P < .0001), and mortality rate (5.7% vs 4.3%, P < .04). The frequency of women who sustained burn violence appears small yet experience worse outcomes. Clinicians should be aware of these demographic/clinical characteristics to provide optimal care to this vulnerable population., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Seasons have a major impact on the frequency and characteristics of burn injuries; in warmer months, thermal burns from outdoor activities are more common, while in cooler months, incidents involving heating sources and fires are more common. It is essential to comprehend these trends in order to customize safety precautions and awareness initiatives. Studies on the impact of seasonal variations help burn centers allocate resources more effectively in order to prepare for variations in patient volume and severity. Data from January 2016 to December 2022, with an emphasis on burn types excluding nonburn cases, were analyzed retrospectively over a 7-year period at the Burn Care Centre in Pakistan Institute of Medical Sciences, Islamabad. The research examined hospital stays, demographics, burn causes, admissions, total burned surface area, and death rates while dividing the years into winter and summer seasons for analysis. With 4014 admitted patients, the study found that winter admissions increased by 11.007%, with winter admissions accounting for 55.503% of all admissions and summer admissions for 44.496%. The gender distribution stayed the same, with 54.59% of the population being male and 45.99% being female. Hospital stays were longer for summer admissions (16.428) than for winter admissions (11.285). Summertime saw a rise in electric burn cases (307 cases), with a 43 case fatality rate. With 1699 cases, flame burns predominated in the epidemiology of burns, followed by scald burns with 1384 cases. In conclusion, seasonal differences have a substantial impact on burn profiles, with winter seeing a marked rise in occurrences. Men are also more likely to sustain electric burns, particularly in the summer. Effective management and prevention techniques depend on an understanding of these patterns., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

This study aims to summarize the influence of different definitions of unintentional burns on the prevalence and risk factors in rural children. A total of 3548 children living in rural areas were recruited from 12 schools, and questionnaires were used to collect self-reported burn data and related influencing factors in the past 12 months. Burn incidence and risk factors were compared based on two operational burn definitions ("1996 Definition of Burn-related Injury, 1996-DBI" and "2011 Definition of Burn-related Injury, 2011-DBI"). Based on the 1996-DBI, the unintentional burn prevalence was 5.92% (95% confidence interval [95% CI] 5.14-6.70%), which was higher than the 2.23% ([95% CI] 1.74-2.71%) that was calculated using the 2011-DBI (χ 2  = 61.90, P < 0.001). The unintentional burn rate ratios ranged from 0.20- to 0.53. Children who were separated from one or both parents accounted for more than half (50.39%) of the sample, and this status was a common risk factor for burns according to the two operational injury definitions. Different operational definitions have significant effects on the reported burn incidence and risk factors., (© 2024. The Author(s).)

Objectives: To assess burn injury knowledge and its predictors among reproductive-age women attending an urban and a semi-rural hospital in Northwest Nigeria DESIGN: A descriptive cross-sectional study SETTING: It was conducted in the general and paediatric outpatient clinics of Aminu Kano Teaching Hospital in Kano (urban setting) and the general outpatient, paediatric outpatient and antenatal clinics of Federal Medical Centre Birnin Kudu (semi-rural setting)., Participant: In 2021, 362 women aged 18-44 years were randomly selected from clinic attendees over six weeks. Of them, 217 were from the urban hospital. Data regarding their sociodemographic characteristics and knowledge of burn injuries was collected using a pretested, semi-structured interviewer-administered questionnaire., Outcome Measure: Knowledge of burn injuries RESULTS: About 83.4 %, 77.1 % and 77.6 % of respondents had adequate general, primary prevention and overall knowledge of burn injuries, respectively. Their mean overall knowledge score was 18.6 out of 24, but only 55.5 % had adequate first-aid knowledge. The study sites did not significantly differ in burns first-aid, prevention and overall knowledge scores. However, urban respondents were more ignorant about the cause of burns and knew that burn injuries could be fatal. More semi-rural respondents knew that flames and chemicals cause burn injuries. Predictors of overall knowledge were age, educational level, number of children in their household, previously seeing a burn-injured child, and primary source of burns-related information., Conclusions: The proportion of respondents with adequate overall burn injury knowledge was high; however, knowledge gaps exist among them. Overall, their first-aid knowledge was relatively low. The urban and semi-rural respondents had no significant differences in first-aid, prevention, or overall knowledge of burn injuries. However, knowledge of the causes of burns and burn complications differed between the urban and semi-rural study locations. Therefore, the clinical settings of this study present opportunities for similar burn-related educational interventions., (Copyright © 2024 Elsevier Ltd and ISBI. All rights reserved.)

Background: Early retrospective data identify that dysphagia is common in older persons with burn injury, suggesting a rate of 47 %, and that it is associated with medical, burn, and nutritional outcomes., Aims: To prospectively (1) explore the incidence, (2) describe associations, and (3) evaluate risk factors for dysphagia in patients ≥ 75 years old hospitalised with burn injury., Methods: All patients > 75 years old admitted to Concord-Repatriation-General-Hospital with burn injury over 4 years (2019-2023) were assessed for dysphagia on presentation and were continually monitored throughout their admission. Burn injury, demographic, and nutritional data were prospectively captured and analysed for association with dysphagia., Results: Sixty-two patients (33 male) aged 75-95 years (median=83 years) were recruited. Dysphagia was identified in 50 %. Dysphagia was associated with burn size (p = 0.002), pre-existing cognitive impairment (p = 0.000), hospital length of stay (p = 0.001), in-hospital complications (p = 0.000), feeding dependence (p = 0.002), nutritional status (p = 0.013) and enteral feeding duration (p = 0.030). Cognitive impairment was the most sensitive predictor for dysphagia at 100 % (specificity=29 %, NPV=100 %, PPV=59 %). Development of secondary comorbidities was less sensitive at 52 % (NPV 65 %), but was associated with high specificity (90 %) and PPV (84 %)., Conclusions: One in every two patients ≥ 75 years admitted with burn injury will demonstrate dysphagia during their hospital admission. Those with pre-existing cognitive impairment are most at risk., Competing Interests: Declaration of Competing Interest The authors have no financial or non-financial disclosures to declare in the conduct of this study or preparation of this manuscript., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Introduction: Acute kidney injury (AKI) following burns is associated with increased mortality and morbidity. Some patients require renal replacement therapy. There is limited large-scale data to sufficiently validate risk factors influencing the incidence and severity of early AKI, defined as AKI within the first 72 h since admission to a burn center following burn injury. The aims of this study were to compare the profile of adult patients admitted to Australian and New Zealand burn centers, with burns ≥10% total body surface area (TBSA) who developed early AKI with patients who did not develop AKI and to quantify the association between early AKI and in-hospital outcomes., Methods: Data were extracted from the Burns Registry of Australia and New Zealand for adults (≥18 y), with burns ≥10% TBSA admitted to Australian or New Zealand burn centers between July 2016 and June 2021. All patients with two valid serum creatinine blood tests within the first 72 h were included. Differences in patient profiles and in-hospital outcomes were investigated. Univariable and multivariable logistic and linear regression models were used to quantify associations between early AKI and outcomes of interest., Results: There were 1297 patients who met the inclusion criteria for this study. Eighty-three patients (6.4%) developed early AKI. Compared to patients without AKI, patients with an AKI were older (P = 0.006), had a greater median %TBSA burned (P < 0.001), and had an inhalation injury (P < 0.001). In adjusted models, the development of early AKI was significantly associated with in-hospital mortality (adjusted odds ratio (aOR) [95% CI] 2.73 [1.33, 5.62], P < 0.001) and the need for mechanical ventilation (aOR [95% CI] 3.44 [1.77, 6.68], P = 0.001), but there was no significant increase in the hospital length of stay or intensive care unit length of stay., Conclusions: This is the first large-scale study looking at early AKI in adult burns ≥10% TBSA. The incidence of AKI was lower than previously reported and AKI was associated with higher in-hospital mortality and increased need for mechanical ventilation. These findings support the notion that development of AKI in the immediate phase post burns injury can potentially have consequences and the appropriate care should be given to prevent its development., (Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.)

Objective: To analyze the demographic profiles of participants in the traumatic brain injury, burn injury, and spinal cord injury model systems databases., Design: Data from the Burn Model System (BMS), Traumatic Brain Injury Model System (TBIMS), and Spinal Cord Injury Model System (SCIMS) National Databases were analyzed from 1994-2020., Setting: Not applicable., Participants: The study included participants aged ≥16 years (N=42,407) with available data in selected variables, totaling 4807 burn injury, 19,127 TBI, and 18,473 SCI participants., Interventions: Not applicable., Main Outcome Measures: Variables including age, race, ethnicity, sex, education level, primary payor source, family income level, employment status at 1 year postinjury, etiology, and mortality at 1 year postinjury were analyzed across the database., Results: Median ages at injury for BMS (40.4y), TBIMS (40y), and SCIMS (38y) National Database participants were comparable. Men constituted approximately 75% of participants in the BMS, TBIMS, and SCIMS datasets, with approximately 75% having a high-school education or less. The proportion of participants funded by Medicare during initial hospital care varied across the BMS (14%), TBIMS (15.6%), and SCIMS (10.2%). For family income (data available for BMS and SCIMS), approximately 30% of these participants reported a family income <$25,000. Etiology data indicated 49.0% of traumatic brain injury and 40.7% of spinal cord injury cases resulted from vehicular incidents., Conclusions: An overlapping at-risk population for these injuries appears to be middle-aged men with lower education levels and family incomes who have access to vehicles. This underscores the need for preventive initiatives tailored to this identified population to mitigate the risk of these injuries., (Copyright © 2024. Published by Elsevier Inc.)

Introduction: The rising prevalence of battery powered devices is driving a steady increase in lithium-ion battery-related burns. We present a case series of patients with lithium-ion battery-related burns and describe the clinical characteristics of this cohort. To further understand emerging trends, we compare our specialty inpatient case series with emergency department (ED) data collated by the Queensland Injury Surveillance Unit (QISU)., Methods: This is a retrospective case series of all patients admitted to the Professor Stuart Pegg Adult Burns Centre for burns relating to lithium-ion batteries between January 2014 and October 2023. In addition, we provide a retrospective data analysis of ED presentations for lithium-ion battery-related burns or blast injuries collated by the QISU., Results: Within the case series data, the most common injuries caused by lithium-ion batteries leading to burn unit admissions were due to e-scooters (57.1%). Burns relating to e-scooter batteries were more likely to involve a larger total body surface area and to be deeper in nature, than burns due to other products. The most common ED presentations were from energy storage devices such as powerpacks (43%)., Conclusion: Lithium-ion battery-related burns are becoming more frequent. The majority of inpatient managed cases involved burns due to larger lithium-ion batteries used in e-scooters. This is the first Australian case series describing severe burns caused by this mechanism. Primary prevention through design, technological and behavioural strategies is required., (© 2024 Royal Australasian College of Surgeons.)

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) represent severe manifestations of a potentially life-threatening spectrum defined by a desquamating rash of the skin and mucous membranes. This study was prompted by the observed increase in the off-label use of lamotrigine as a causal agent in SJS/TEN in our regional burn center., Methods: A retrospective cohort of 48 patients presenting to the Connecticut Burn Center from 2015-2022 with suspicion for SJS/TEN were reviewed for age, sex, causative drug, presenting symptoms, hospital course, biopsy confirmation, length of stay, comorbidities, and 30-day mortality. Descriptive statistical analysis was conducted to identify trends in causative agent, clinical presentation, and mortality., Results: Thirty patients in our cohort received a final diagnosis of SJS/TEN. While antibiotics remain the most frequent cause of SJS/TEN across the study period (33.3 %, n = 10), the incidence of cases attributable to lamotrigine increased from 1 case between 2015 and 2018 (6.7 %) to 6 cases between 2019 and 2022 (40 %). In 2020 alone, 50 % of all cases were attributable to lamotrigine (n = 4). Of the patients where lamotrigine was implicated, 71.4 % (n = 5) were prescribed lamotrigine for off-label use in the treatment of non-bipolar mood disorders. The average lamotrigine-associated SJS/TEN patient was younger (p < 0.001), had fewer comorbidities, and was more likely to be female than the general SJS/TEN population., Conclusion: Off-label use of lamotrigine is emerging as a major driver of SJS/TEN with notable changes in patient demographics. Further research is necessary to understand how changing trends in the patient population will impact clinical course and optimal management., Competing Interests: Declaration of Competing Interest The authors report no funding sources or conflict of interest concerning the materials or methods used in this study or the findings specified in this study., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Introduction: The study investigated the therapeutic approach and clinical management of pediatric burn patients admitted to the Pediatric Surgery and Orthopedics Clinic of the County Emergency Hospital Craiova over a two-year period (2017-2018). The primary objective was to evaluate the effectiveness of the treatments applied, including grafting procedures and their impact on long-term prognosis. Material and Methods: The cases of 80 children with burns of varying severity were retrospectively analyzed. Patients were classified according to the severity and the mechanism of burn injury. The collected data were processed using Microsoft Excel 2021. Patients were classified into three categories based on the affected body surface area (BSA): Category 1 patients, with a BSA â?¤ 10%, showed very good results and required less intensive care. Category 2 patients, with a BSA between 10% and 50%, had good outcomes but needed more prolonged care. Category 3 patients, with a BSA 50%, had satisfactory results but faced more challenges in recovery, highlighting the need for enhanced prevention measures and better treatment protocols. Results: The majority of patients came from rural areas, and thermal burns were the most common. The effectiveness and safety of the treatments applied were highlighted, with a generally favorable impact on long-term prognosis. Treatment included both surgical and non-surgical approaches, with generally favorable clinical outcomes. Conclusion: The study highlights significant differences between rural and urban environments, suggesting the need for prevention and education campaigns regarding pediatric burns and improved access to medical services. It also emphasizes the need for integrated management to reduce the severity and complications associated with burns. The results provide a solid foundation for future strategies aimed at improving the care of pediatric burn patients., (Celsius.)

Introduction: The Consumer Product Safety Improvement Act (CPSIA) was passed in 2008 to establish safety standards and improve the quality of children's products. Coronavirus Disease 2019 (COVID-19) led to a "stay-at-home" quarantine. The purpose of this study is to evaluate trends of pediatric burns and analyze the relationship with the CPSIA and COVID-19., Methods: The National Electronic Injury Surveillance System database was used to identify thermal and electric pediatric burns from 2002 to 2021. To evaluate the association of the CPSIA and COVID-19, burns before and after the law was passed, and the pandemic, were analyzed. Sex, ethnicity, age, injured body part, product, and disposition were determined. Chi-squared analysis was performed., Results: A total of 21,962 burns met inclusion criteria, with 1409 electrical and 20,553 thermal burns. Majority of cases were male (58.3%) and involved household appliances (34.2%). For the CPSIA cohort, there was an average of 1274.1 burns per year before 2009, which decreased to 1003.3 burns per year after 2009. Before 2009, most burns affected the hand (44.5%), which increased after 2009 and remained the most-affected body part (48.1%, P < 0.001). For the COVID-19 cohort, there was an average of 1133.5 burns per year before 2020, which decreased to 779.5 burns per year after 2020., Conclusions: The CPSIA and COVID-19 pandemic may have led to a decreased incidence of pediatric burns from electronic devices. Pediatric populations are still at high risk for hand burns and household appliance burns. Providers should be aware of burn trends to inform guardians about the risks., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Burn injuries are a serious emergency. Most burn injuries in children can be treated as outpatients. The aim of this study was to present the clinical and epidemiologic characteristics of pediatric burn injuries treated in our outpatient burn clinic. This study included pediatric patients treated in an outpatient burn clinic over an 8-year period. The demographic and clinical characteristics of the patients were retrospectively analyzed. The patients were divided into 4 groups according to their age groups, and the differences between the groups were investigated. Statistical analysis was performed using IBM SPSS Statistics, Version 25.0. P < .05 was accepted as statistically significant. Of the total 5167 patients, 2811 (54.4%) were male. Scald burns were the most common cause of burns (81.4%). Contact burns accounted for 12.2% of all burns. There were no differences between sexes for any variable. The highest incidence was seen in children in the 2- to 5-year-old age group (28.3%). There were differences between age groups in terms of sex, burn area, burn visit, burn type, burn location, need for wound dressing under anesthesia, and need for grafting. Among the patients, 4.9% were hospitalized due to the need for wound dressing under anesthesia. However, most of the patients (95.1%) were treated as outpatients. In conclusion, the majority of pediatric burn patients can be treated as outpatients. This allows pediatric patients to complete treatment in a psychologically comfortable environment and has low complication rates. Outpatient treatment should become the standard for children who are suitable for outpatient follow-up and who have home support., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Accurate analysis of injuries is paramount when allocating resources for prevention, research, education, and legislation. As burn mortality has improved over recent decades, the societal burden of burn injuries has grown ambiguous to the public while a scarcity of investigational funding for survivors has led to a gap in understanding lifelong sequela. We aim to compare national references reporting the incidence of burn injuries in the United States. The American Burn Association Burn Injury Summary Report (ABA-BISR), American Burn Association Fact Sheet, Centers for Disease Control and Prevention (CDC) Web-based Injury Statistics Query and Reporting (WISQARS) database, the CDC National Center for Health Statistics' National Hospital Ambulatory Medical Care Survey (NHAMCS), National Inpatient Sample (NIS), National Emergency Department Sample (NEDS), and commercially available claims databases were queried for 2020 or the most recent data available. The BISR estimated 30,135 burn admissions in 2022. The 2016 ABA Fact Sheet reported 486,000 burns presented to US emergency departments (ED). In 2020, CDC's WISQARS database reported 3,529 fatal, and 287,926 non-fatal, burn injuries. The 2020 NEDS reported 438,185 ED visits while the 2020 NIS estimated 103,235 inpatients. The NHAMCS reported 359,000 ED visits for burn injuries in the same period, and an analysis of ICD-10 burn codes demonstrated over 698,555 claims. Our study demonstrates a large variability in the reported incidence of burn injury by the ABA, CDC, national samples, and claims databases. Per our analyses, we estimate that 600,000 individuals annually suffer a burn injury which merits emergent care in the United States., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Burns are a common mechanism of pediatric injury worldwide and a notable cause of disability-adjusted life-years. Burns in children represent a unique challenge due to the differences from adults regarding physical characteristics, physiology, and psychology. This retrospective cohort study examined trends of pediatric burns in New South Wales (NSW), Australia, from 2010 to 2022. It specifically focused on the changes in burn etiology and patient characteristics, body area affected, TBSA, first aid, location, and management. It also compared a "Pre-COVID-19" and "Peri-COVID-19" era to analyze the impact of COVID-19 on the pattern of pediatric burns, as children are at higher risk of injury during times of social disruption. The study found that burns in children continue to be concentrated in the toddler and preschooler age group, and the main mechanisms of injury remain as scald and contact burns. In recent years, there has been a rising trend of friction burns, alongside a fall in flame burns and severe burns. Management of pediatric burns has also evolved, with predominant use of ambulatory care and low rates of admission and operative intervention. Trends in burn injury continue to evolve with time, and over the last decade in NSW, key changes in the pattern of pediatric burns have been observed, with evolving mechanisms of injury, reduced severity of burns, and a shift toward ambulatory care., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Introduction: The purpose of this study is to examine and characterize patterns of injury to the upper extremity caused by fireworks in a nationally representative sample of emergency department patients from 2011 to 2020., Methods: The National Electronic Injury Surveillance System was queried for upper-extremity injuries caused by fireworks between 2011 and 2020., Results: One thousand two hundred fifty-one injuries were identified from the database representing 47,235 national cases that presented to emergency departments in the United States. Case frequency was stable during the period until 2020, which was nearly 70% higher than the previous 9-y average. Patients were generally young and male, with most cases in the 10-29-y age group and males over three times as likely to be injured as females. The most common injury was burn, and the week of July 4th accounted for 53% of cases alone. Diagnosis was also significantly associated with device type., Conclusions: These data can be used to target prevention measures and campaigns to specific patient populations most at risk of injury, specifically young males. They may also be used to highlight the impact of policy changes on availability of fireworks, the need for public health education coinciding with injury incidence peaks, and secondary pandemic effects., (Published by Elsevier Inc.)

Introduction: Burn registers are an important source of surveillance data on injury intent. These data are considered essential to inform prevention activities. In South Asia, intentional burn injuries are thought to disproportionately affect women. Assessment of injury intent is difficult because it is influenced by personal, family, social, and legal sensitivities. This can introduce misclassification into data, and bias analyses. We conducted a descriptive, hypothesis generating study to explore misclassification of injury intent using data from a newly digitised single centre burn register in south India., Methods: Data from 1st February 2016 to 28th February 2022 were analysed. All patients in the data set were included in the study (n = 1930). Demographic and clinical characteristics for patients are described for each classification of injury intent. All data cleaning and analyses were completed using RStudio., Results: Injury intent data were missing for 12.6% of cases. It was the most commonly missing variable in the data set. "Accidental" injuries had a similar distribution over time, age, and total body surface area (TBSA) for males and females. "Homicidal" injuries were more common in females. Injuries reported as "Suicidal" affected men and women equally. A decrease in reporting of "Suicidal" injuries in females corresponded to an increase in high TBSA injuries classified as 'Other' or with missing data. Overwriting of injury intent was present in 1.5% of cases. The overwritten group had a greater proportion of females (62.1% vs. 48.5%) and higher median TBSA (77.5% vs. 27.5%) compared to the group where intent was not overwritten., Conclusion: Our findings indicate that some subgroups, such as females with high TBSA burns, appear to be more likely to be misclassified and should be the focus of future research. They also highlight that quality of surveillance data could be improved by recording of clinical impression, change in patient reported intent, and use of a common data element for intent to standardise data collection. We also recommend that injury intent is recorded as a unique variable and should not be mixed with other elements of injury causation (e.g. mechanism). Although this is a single centre study, the methods will be of interest to those who utilise routinely collected data and wish to reduce misclassification of this important variable., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Relevant studies in the fields of fire safety, occupational health and firefighter clothing were analyzed in this study to address the high injury rate among firefighters during fire rescue and the complexity of factors affecting skin burns. The findings indicate that the degree of skin burns in firefighters is primarily influenced by the heat source (heat flux, type), firefighter clothing (fabric, pattern) and the under-clothing air gap (thickness, characteristics). Since skin burns cannot be directly measured, internal skin heat transfer and burn prediction models are commonly employed to assess the impact of external factors on skin burns. These models can predict the safe working distance or time for firefighters. Investigating the influencing factors and prediction models of skin burns among firefighters holds significant value in enhancing operating procedures, optimizing firefighter clothing design and effectively preventing skin burns.

Introduction: Patients with combined burns and trauma are often seen in the United States. The combination of trauma with burns increases mortality. In contrast, the characteristics and outcomes of these cases remain unknown in Japan. This study investigated the characteristics and outcomes of trauma associated with burns in Japan., Methods: This multicenter retrospective cohort study was conducted by utilizing data from the Japan Trauma Data Bank for the period between 2004 and 2017. We evaluated the characteristics of burn patients (n = 5783) divided into two groups: burns only (n = 5537) and combined burns and trauma (n = 246). Clinical characteristics, including patient background, severity of trauma, injury mechanism, total body surface area affected, injury location, treatments, and clinical outcomes, were examined., Results: Most patients in both the groups were injured by flames. The number proportion of patients with 40-89% of the total body surface area affected was 1069/5537 (19.3%) in the burn-only group and 23/246 (9.3%) in the combined burn and trauma group. The in-hospital mortality was 1006/5537 (18.2%) in the burn-only group and 17/246 (6.9%) in the combined burn and trauma group., Conclusions: We demonstrated the characteristics of Japanese patients with burns only compared with those with combined burns and trauma. Flames were the main cause of burns, and in-hospital mortality was lower in the combined burn and trauma group associated with a smaller burn area., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest related to this study., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Introduction: Burn injuries remain a significant cause of disability, impacting long term quality-of-life and imposing large costs on our health systems. Readmission is a metric of quality and an important contributor to this economic burden. The association of socioeconomic and insurance status with burn readmission is not well established. The aim of our study is to develop a predictive risk model of factors associated with readmission after burns., Methods: Using the Healthcare Cost and Utilization Project's 2018 Nationwide Readmission Database, we identified patients ≥18 y of age with burns admitted between January and October 2018. We excluded patients who died during index admission. Our primary outcome was readmission within 60 d postdischarge. We performed a Lasso regression analysis with adaptive selection to generate a predictive model with least deviance using patients' demographics and socioeconomic status, burn location and severity, past medical history, and hospital characteristics. Weighted multiple logistic regression was performed to obtain population estimates of adjusted odds ratios (ORs) of each element in the model., Results: Our cohort included 11,380 burn patients. Of those, 1625 (14.3%) were readmitted and 67% were males. Readmitted patients were older (55 ± 17 versus 49 ± 18, P = 0.0001). Weighted logistic regression for the selected model showed higher odds of readmission for patients with lowest income quartile (OR: 1.19, 95% confidence interval [CI]: 1.04-1.36), Medicare or Medicaid insurance (OR: 1.35, 95% CI: 1.17-1.55), history of psychiatric illness (OR:1.19, 95% CI: 1.02-1.39), diabetes (OR: 1.46, 95% CI: 1.25-1.69), chronic kidney disease (OR: 1.66, 95% CI: 1.30-2.11), chronic obstructive pulmonary disease (OR: 1.55, 95% CI:1.26-1.89), and alcohol use disorder (OR: 1.33, 95% CI: 1.13-1.58). Third degree burns and foot burns had higher OR of readmission (OR: 1.21, 95% CI: 1.38-1.98 and 1.66, 95% CI: 1.02-1.45, respectively), while face and hand burns had lower OR of readmission (OR: 0.77, 95% CI: 0.66-0.90 and 0.84, 95% CI: 0.72-0.98, respectively)., Conclusions: Burn readmissions are multifactorial and directly related to the patient's comorbidities, including markers that reflect barriers to care such as socioeconomic characteristics, as well as the anatomical location of burn injuries. Early identification of these high-risk patients may aid in early intervention, resource allocation, and outreach program development in an attempt to reduce readmission rates and improve outcomes. Future prospective validation of these risk factors is warranted., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: Severe burn injuries are often accompanied by infections and associated with high morbidity and mortality. This study aimed to compare the prevalence and clinical impact of bacteremia between patients receiving intensive care with and without burns., Methods: This single-center retrospective cohort study at the University Hospital Vienna, Austria, analyzed blood cultures from intensive care unit (ICU) patients with and without burns (2012-2022) to assess the prevalence of bacteremia, the associated pathogen distribution and the 60-day all-cause mortality., Results: In 1170 ICU patients, 303 with burns and 867 without, the prevalence of bacteremia was similar among patients with at least one blood culture (31/157 [19.7%] versus 44/213 [20.7%], OR [95%CI] = 0.95 [0.57-1.57]). Burn patients exhibited a significantly higher frequency of microbiological sampling (51.5% versus 24.5%, p < 0.001), resulting in a higher overall prevalence of bacteremia (10.2% versus 5.1%, p = 0.002). 16.2% of all identified pathogens were multidrug-resistant (MDR). The 60-day all-cause mortality was higher in patients with MDR pathogens than in patients without bacteremia (41.7% versus 10.6%, p = 0.026)., Conclusion: Bacteremia prevalence was similar in burn and non-burn patients, with high rates of multidrug-resistant Gram-negative pathogens. The 60-day all-cause mortality was significantly higher in patients with MDR pathogens than in patients without bacteremia., (© 2024. The Author(s).)