RESUMO
Aim: To identify the epidemiology and outcome of pediatric burn injuries. Study Design: Retrospective hospital -based analytical study. Place and Duration of Duration: Burn unit at Cairo university hospital, in the period between the first of January 2007 till December 2011. Methodology: The study retrospectively evaluated 564 children with different burn injuries, who were admitted to Cairo University Hospital during the period of the study. Data about age, sex, burn size, etiology of burn, and outcome of admission to the intensive care unit were retrieved from the medical records and the burn treatment registry. In addition, average length of hospital stay (ALOS) and bed occupancy rate (BOR) were calculated. Further analysis was done in the last year of the study (2011), by interviewing mothers of the patients and residents in charge. Results: The average age of the children was 5.9 years (SD: ± 4.1).Under five children were found to be the most susceptible to burn injuries accounting for about 70% of the affected population There was no significant difference in the number of patients between genders (P= 0.3). While scald type of burn was the most prevalent etiology of burn injuries representing more than 60% of all causes. Total burn surface area. (TBSA)% was greater among females, patients from rural residencies and flame type of burn. The non- survivors represented 2.5% of the studied sample. Intensive care unit (ICU) admission was mainly due to renal impairment, sepsis and respiratory stress due to inhalation injury. LOS and decreasing in the BOR reflects better advances in care. Conclusion: Under five children are the most susceptible age group to burn injuries, this could be prevented by raising awareness of patients. More attention should be paid to reduce complications that necessitate ICU admission.
RESUMO
Aim:To determine possible factors associated with lethal outcome of pneumonia and to assess the accuracy of Pneumonia Severity Index (PSI) and Pediatric Risk of Mortality (PRISM) score in predicting mortality from pneumonia. Study Design: A retrospective analytical study Place and Duration of the Study: Pediatric Emergency Department (PED) of the pediatric hospital (Abu El-Reesh) Egypt, during a period from April 2010 to April 2012. Methodology: Children ≤5 years admitted to the PED diagnosed having pneumonia were included in the study (n=236). Data were retrieved from the electronic records and consisted of; hospital data, personal data, provisional and definite diagnosis, presenting clinical symptoms and signs, outcome and measurements of blood counts and serum biochemical markers. Results: Non-survivors constituted 26.7% of the studied group. Non-survivors significantly had a higher median PRISM score (18; IQR 11 for non-survivors compared to 8; IQR 6 for survivors, P =.000), have a longer median length of stay (8 days; IQR; 1 day for non-survivors compared to 4 days; IQR 2 days for survivors, P =.000), higher PSI score (61; IQR 39 for non-survivors compared to 41; IQR 20 for survivors, P =.000).Only longer LOS, higher PRISM score were independently associated with mortality. ROC curve analysis revealed area under the curve (AUC) of 0.857 for PRISM score (95% CI 0.80–0.91) and 0.73.6 for PSI score (95% CI 0.66–0.81). A PRISM score ≥ 12.5 is 81.4% sensitive and 73.3% specific in predicting mortality. Conclusion: Case fatality rate is quite high. PRISM scoring is accurate in predicting mortality among pneumonia pediatric patients and thus useful in decision making concerning management of these cases.