Academic journal article Bulletin of the World Health Organization

Severe Childhood Burns in the Czech Republic: Risk Factors and prevention/Brulures Graves Chez Les Enfants De la Republique Tcheque: Facteurs De Risque et prevention/Quemaduras Infantiles Graves En la Republica Checa: Factores De Riesgo Y Prevencion

Academic journal article Bulletin of the World Health Organization

Severe Childhood Burns in the Czech Republic: Risk Factors and prevention/Brulures Graves Chez Les Enfants De la Republique Tcheque: Facteurs De Risque et prevention/Quemaduras Infantiles Graves En la Republica Checa: Factores De Riesgo Y Prevencion

Article excerpt

Introduction

A severe nonfatal burn is one of the most devastating injuries a person can survive, and such injuries impose a substantial medical, social, economic and personal burden on society and the victims' families. Patients often undergo numerous surgical procedures over a long period of hospitalization and some require readmission for reconstructive surgery. The emotional and physical scars can last a lifetime. (1) The proportion of child injuries attributable to burns ranges from 2% to 6% in high-income developed countries. (2-4)

In the Czech Republic, about 1500 children aged 0-14 years were hospitalized annually for burns between 1996 and 2006. (5) More than 60% were toddlers aged 1-4 years. Over one-third of the children were treated in a burn unit, while the remainder were treated in a surgical or paediatric department.

Clinical management of a severely burned child requires a multidisciplinary approach. Specialized burn centres with expert professionals can optimize therapy, survival and rehabilitation. (6) The aims are to decrease mortality and achieve the best possible quality of life after treatment. In the Czech Republic, there are three burn centres: in Brno, Ostrava and Prague. The only criterion for admission to the Prague Burn Centre, the largest and most sophisticated, is burn severity, not geographical location.

The aim of this study was to investigate the epidemiological distribution and prevention of severe childhood burns in the Czech Republic by assessing the total number of hospitalizations for burns in the country and the proportion managed at the Prague Burn Centre, while taking into account burn severity and the risks associated with personal, equipment and environmental factors.

Methods

The study included all children aged 0-16 years who were admitted to the Prague Burn Centre during 1993-2000. Data on all hospitalizations for burns in the Czech Republic during 1996-2006 were also obtained from the Czech Ministry of Health, summarized and recorded. (5) The Prague Burn Centre is part of the teaching hospital of the Third Faculty of Medicine Charles University. During the study period, the Centre provided complex treatment for 2278 (47%) of the most severely burned patients of all ages from the entire country and served as a national centre for undergraduate and postgraduate medical education. All admissions of 0-16 year-olds were included in the study, while readmissions were excluded. Detailed data on risk factors for burns were obtained by carrying out a retrospective analysis of hospital charts at the Prague Burn Centre for all 0-16 year-olds admitted between 1993 and 2000. In addition, the number and ages of all children aged 0-14 years hospitalized for burns throughout the Czech Republic, excluding those readmitted, were obtained, together with the proportion treated at the Prague Burn Centre. Census data were used to derive incidence rates. (5)

A structured questionnaire was developed to abstract data from hospital records, including data on personal risk factors such as age and sex, on burn hazards such as heat sources and on environmental factors such as the place and time of injury. Clinical data included the severity and anatomical site of the burn, the percentage of the total body surface area (TBSA) affected and the duration of hospitalization. Data were collected by the departmental head nurse. Data entry and analysis were carried out using Epi-Info version 6.04 (Centers for Disease Control and Prevention, Atlanta, CA, United States of America).

The study was approved by the ethics committee of the Third Faculty of Medicine of Charles University and conducted according to good clinical practice and the Helsinki Declaration, in agreement with institutional research review board requirements.

Results

Nationally, annual paediatric burns admissions to all hospitals in the Czech Republic averaged 1510 during 1996-2000 and 1463 during 2001-2006 (Fig. …

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