Epidemiological analysis of burned children in a Brazilian reference service
Análisis epidemiológico de atención de niños quemados en un hospital especializado en Brasil
*M.D. Health Science Postgraduate Program, State University of Montes Claros
Pitágoras Medical School, Montes Claros, MG
**Pitágoras Medical School, Montes Claros, MG
***Pitágoras Medical School, Montes Claros, MG
Bruna Tupinambá Maia**
Camila Matos Versiani***
The purpose this study was to examine the epidemiological and the clinical characteristics in hospitalized children with a diagnosis of burns in a hospital reference of the public system. A retrospective study analyzed the records of 180 children between January 2009 to December 2010 to verify the epidemiological profile of burned children between 0-and 15-years old. It was possible to analyze the admitted patients and the main causative agents of admission, as well the main death causatives in each age, the causative agents responsible for accidents, and the mortality tax among the admitted patients. The data was analyzed by the Epi Info program version 6.04b, which carried out the analysis by the frequency of variables interests. The statistical significance level was defined as 5%. Most admitted patients (50.35%) were between 10- and 15-years old; the highest rate of internment in this sector was 0-4 years old (53.85%). Hot liquid was the most frequently responsible agent of burns in the analyzed age groups (49.59%). The death rate among the admitted patients was 6.11%. The results show the necessity of developing action of sensitization and orientation to parents and the population, by education programs and preventive campaigns.
Keywords: Burns. Epidemiology. Children. Prevention.
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Burns are tissue lesions caused by thermal, electric, radioactive or chemical agents. They are classified by cause, depth and affected body part. The burns are cause of morbidity and mortality. The lesions are complex and difficult to treat, requiring a multidisciplinary approach . Burns are among the highest external causes of death registered in Brazil, after only transport accidents and homicides .
Thus, the objective of this study was to analyze the epidemiological characteristics of burned children (0-15-years old) attended at referral hospital over of two years and add to data regarding the epidemiological profile and contribute in order to contribute to the development prevention programs.
Material and methods
The protocol of this retrospective study, descriptive and transversal, was approved by the ethics committee of the research institute, and included the records of burned children (total of 180 children, aged 0- to 15-years old), with a diagnosis of burn admitted to the Hospital Irmandade Nossa Senhora das Mercês of Montes Claros – Santa Casa, in the period of January 1st 2009 to December 31th 2010. All admitted patient registers with a diagnosis of burn, being the access to these records done by Service Medical Records and Statistics, crosschecking the data with the register of admissions in the burn unit. The patients were separated by age into three age groups: 0-4; 5-9; 10-15 years old making it possible to analyze the patients and the causative agents, as well the main cause of death, by age group.
The data was analyzed by program SPSS 18.0 for Windows®, by frequency of variable interests. The statistical significance level was defined as 5%.
One-hundred-and-eighty cases of burned children under 15-years old were admitted last year. The majority of attendances (50.35%) occurred between 10-15-years old, followed by the age range 0-4-years old (33.95%).
The heated liquid and the flame were the two main agents responsible for admission in this study, representing 51.67% and 35.56% of cases, respectively, in the three studied age-groups. In 0-4-years old, liquid was the main agent responsible for admission (77.06%).
The death rate among the admitted patients was 6.11%. The age-group of 0-4-years old presented a higher death rate with eight cases in a total of 11 deaths registered. Electricity and the superheated liquids were also responsible for deaths at a smaller level: electricity – one case (33.33%) in the group of 10-15; superheated liquid – two cases: one case (27.27%) in a group 0-4 and one (27.27%) patient of the 5-9 group (Figure 1).
Figure 1. Main causative agents of death
The predominance of burns in children is showed in many works [4-6]. In our study 180 cases were admitted. From this total, 97 (53.85%) belonged to the age group of 0-4-years old, and the age of one was the most prevalent, with 83 (46.32%) events. These numbers are similar to others studies found in our country [6, 7].
The majority of attendances (50.35%) occurred among 10-15-years old. The first is the greatest cause for internment of the group 0-4-years old, and the second, of groups 5-9- and 10-15-years old. From a total of 61 interned of group 0-4, 47 (77.06%) accidents were caused by heated liquid, from this, 25 were just one-year old. The prevalence of hot liquids, in first place of burn agents, followed by flame, is found in other studies too .
Analyzing, by group, the etiological agents of burns in admitted patients and attending emergency units, we verify that the heated liquid is the most prevalent in three groups: 49.54% (89 events). In the 0-4 group, this corresponds to 63.58% (39 events) of attendances in a total of 180. Hot liquids are related by others authors also  as the main agent of burns in children due to the ease of access to the risk environment, like the kitchen .
A previous study verifies that accidents with extensions and electric wires were responsible for 63% of burns .
In relation to deaths, from a total of 11 among 180 admitted, four (40%) occurred in the 0-4 group, being the most prevalent group. This can be explained by the immaturity of the immunological system, major body surface to weight ratio, blood vessels next to the epidermis facilitating heat loss, great temperature variation, and shock occurrence even with a small body-surface burned, on average 12% .
The large number of children involved in accidents caused by burns only reinforces the need for prevention. We conclude that not only the absolute number of victims, but the more worrisome factor: the sequels that are left in life who just beginning.
The burns provoke physical and psychological trauma, and in most events, are irreversible. The obtained results in this study show the urgency of adoption of control and prevention measures, as well the realization of new studies that could collaborate to combat this important harm to child health.
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Digital · Año 17 · N° 176 | Buenos Aires,
Enero de 2013