Megan Armstrong1, Krista K Wheeler2, Junxin Shi3, Rajan K Thakkar4, Renata B Fabia5, Jonathan I Groner6, Dana Noffsinger7, Sheila A Giles8, Henry Xiang9. 1. Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address: Megan.Armstrong@NationwideChildrens.org. 2. Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address: Krista.Wheeler@NationwideChildrens.org. 3. Biostatistics Resource, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address: Junxin.Shi@NationwideChildrens.org. 4. Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatrics, The Ohio State University, 370 West 9th Avenue, Columbus, OH 43210, USA. Electronic address: Rajan.Thakkar@NationwideChildrens.org. 5. Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatrics, The Ohio State University, 370 West 9th Avenue, Columbus, OH 43210, USA. Electronic address: Renata.Fabia@NationwideChildrens.org. 6. Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatrics, The Ohio State University, 370 West 9th Avenue, Columbus, OH 43210, USA. Electronic address: Jonathan.Groner@NationwideChildrens.org. 7. Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address: Dana.Noffsinger@NationwideChildrens.org. 8. Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address: Sheila.Giles@NationwideChildrens.org. 9. Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatrics, The Ohio State University, 370 West 9th Avenue, Columbus, OH 43210, USA. Electronic address: Henry.Xiang@NationwideChildrens.org.
Abstract
BACKGROUND: Thermal injury is a leading cause of unintentional pediatric trauma morbidity and mortality. METHODS: This retrospective analysis of the 2003-2016 Kids' Inpatient Database (KID) included children <18 years old with a burn principal diagnosis. The objectives were to describe the trend of US pediatric burn hospital admissions and the patient and hospital characteristics of admitted children in 2016. The trends (2003-2012) and (2012-2016) were evaluated separately due to the 2015 implementation of International Classification of Diseases, Tenth Revision (ICD-10). RESULTS: The population rate of pediatric burn admissions decreased by 4.6% from 2003 to 2012, but the proportion of admissions to hospitals with burn pediatric patient volumes≥100 increased by 63.9%. The overall mortality rate of hospitalized burn patients decreased by 48.1%. Median length of stay increased slightly for patients with a burn ≥20% total body surface area (TBSA) but decreased for patients with TBSA burn <20%. From 2012 to 2016, the population rate decreased by 13.4%. In 2016, an estimated 8160 children were admitted with a burn principal diagnosis, and 41.4% transferred in from other facilities. Children age 1-4 years were the most commonly admitted age group (49.7%). Patients with ≥20% TBSA burns accounted for 7.8% of admissions (95% confidence interval [CI]: 5.1-10.4%). Burn-related complications were documented in 5.9% of admissions (95% CI: 4.6-7.1%). CONCLUSION: Pediatric burn hospitalizations and burn-related mortality have decreased over time. The increases in transfers and admissions to hospitals with high pediatric burn volumes suggest increasing regionalization of care.
BACKGROUND: Thermal injury is a leading cause of unintentional pediatric trauma morbidity and mortality. METHODS: This retrospective analysis of the 2003-2016 Kids' Inpatient Database (KID) included children <18 years old with a burn principal diagnosis. The objectives were to describe the trend of US pediatric burn hospital admissions and the patient and hospital characteristics of admitted children in 2016. The trends (2003-2012) and (2012-2016) were evaluated separately due to the 2015 implementation of International Classification of Diseases, Tenth Revision (ICD-10). RESULTS: The population rate of pediatric burn admissions decreased by 4.6% from 2003 to 2012, but the proportion of admissions to hospitals with burn pediatric patient volumes≥100 increased by 63.9%. The overall mortality rate of hospitalized burn patients decreased by 48.1%. Median length of stay increased slightly for patients with a burn ≥20% total body surface area (TBSA) but decreased for patients with TBSA burn <20%. From 2012 to 2016, the population rate decreased by 13.4%. In 2016, an estimated 8160 children were admitted with a burn principal diagnosis, and 41.4% transferred in from other facilities. Children age 1-4 years were the most commonly admitted age group (49.7%). Patients with ≥20% TBSA burns accounted for 7.8% of admissions (95% confidence interval [CI]: 5.1-10.4%). Burn-related complications were documented in 5.9% of admissions (95% CI: 4.6-7.1%). CONCLUSION: Pediatric burn hospitalizations and burn-related mortality have decreased over time. The increases in transfers and admissions to hospitals with high pediatric burn volumes suggest increasing regionalization of care.
Authors: Megan Armstrong; Jonathan Lun; Jonathan I Groner; Rajan K Thakkar; Renata Fabia; Dana Noffsinger; Ai Ni; Rohali Keesari; Henry Xiang Journal: Pilot Feasibility Stud Date: 2022-08-18
Authors: Henry Xiang; Jiabin Shen; Krista K Wheeler; Jeremy Patterson; Kimberly Lever; Megan Armstrong; Junxin Shi; Rajan K Thakkar; Jonathan I Groner; Dana Noffsinger; Sheila A Giles; Renata B Fabia Journal: JAMA Netw Open Date: 2021-06-01