A regression analysis of epidemiologic factors affecting survival in pediatric burn patients in a Philippine Tertiary Burn Center (January 2004 - December 2008)

ABSTRACT

BACKGROUND: The Alfredo T. Ramirez (ATR) Burn Center of the University of the Philippines-Philippine General Hospital, being the first burn unit assembled in the Philippines, is currently at the forefront of burn care in the country. It remains the largest tertiary burn center locally with an 11-bed capacity and caters to every Filipino in need of treatment due to burns. OBJECTIVE: To describe the c1inico-epidemiologic profile of pediatric patients admitted to the UP-PGH ATR Burn Center from January 2004 to December 2008 as to the following: Age, Gender, % total body surface area (%TBSA) involvement, Severity of injury based on % TBSA involvement, Etiology of burn, Place of injury, Incidence of inhalational injury, Length of time prior to consult, Number of operations, Morbidity, Mortality; to determine the factors predictive of mortality among pediatric burn patients. METHODS: A retrospective study on pediatric patients admitted to the ATR Burn Center UP-PGH treated for burn injuries from January 2004 to December 2008 was conducted. The Integrated Surgical Information System (ISIS), a computerized registry of the patients of the Department of Surgery was searched to identify pediatric burn patients aged 0 to 18 years old. RESULTS: Of the 361 patients, 234 patients were male (64.82%) while 127 patients were female (35.18%). The odds of mortality in patients with flame burns was 2.24 (OR 95% CI: 1.01 to 4.96) times that of those who were scalded. The odds of mortality in patients with inhalational injury was 11.98 (OR 95% 0: 5.07 to 27.88) times higher than those without. The odds of mortality in patients with late consultation (>8 hours post-injury) was 2.24 (1.05 to 4.77) times that of those who were treated early. There was a significant association between survival outcome and the aforementioned factors. CONCLUSION: The presence of inhalational injury, flame burns, delayed time of consultation, increased number of operations and the presence of nosocomial pneumonia, burn wound infection, and/or graft loss, were the variables noted to be independent predictors of mortality. Age, gender, burn size, severity, place of injury and length of stay were not found to be statistically associated with mortality.