Abstract
BACKGROUND: Pediatric burn injuries are often unintentional and associated with significant morbidity and mortality. In Appalachia, pediatric burn management faces many challenges such as geographic isolation from specialized burn units. Although it is important to lower the incidence of unintentional burn injuries in the pediatric population, there is a lack of research that focuses on differences among age groups in the region of Appalachia. Our study aims to identify factors impacting different age groups in the pediatric population and understand which group is at a higher risk. METHODS: This retrospective study included 218 pediatric patients aged 0-18 years admitted between January 2010 and June 2023. Patients were stratified into four age groups (0-5, 6-10, 11-15, and 16-18 years). Data on gender, burn sources, length of stay (LOS), total body surface area (TBSA) affected, body mass index (BMI), and inhalation injuries were analyzed. Statistical tests included chi-squared tests for categorical variables and analysis of variance (ANOVA) for continuous variables, with significance set at p<0.05. RESULTS: The study cohort consisted of 218 pediatric patients aged 0-18 years, consisting of 130 (56%) males with an average patient age of 6.9 years (SD ± 6.2). The cohort was further divided into four groups: 0-5 years (109, 47%); 6-10 years (37, 16%); 11-15 years (37, 16%), and 16-18 years (35, 15%), with significant difference in distribution of patients across (p<0.0001). Scald burns were most common in the 0-5-year group (80%) and 6-10-year group (75%), while flame burns were predominant in the 11-15-year group (60%) and 16-18-year group (65%). Significant variability was also noted in LOS (p=0.0017), TBSA (p=0.0112), and BMI (p=0.0003). The average LOS was 2.42 days (SD ± 3.7) in the 0-5-year group, 3.24 days (SD ± 4.1) in the 6-10-year group, 3.41 days (SD ± 4.8) in the 11-15-year group, and 5.8 days (SD ± 5.2) in the 16-18-year group. The average TBSA was 4.36% (SD ± 7.3) in the 0-5-year group, 5.16% (SD ± 8.1) in the 6-10-year group, 8.51% (SD ± 12.6) in the 11-15-year group, and 6.17% (SD ± 8.9) in the 16-18-year group. The average BMI was 19.56 (SD ± 2.3) in the 0-5-year group, 20.81 (SD ± 3.1) in the 6-10-year group, 24.11 (SD ± 3.8) in the 11-15-year group, and 25.86 (SD ± 4.2) in the 16-18-year group. CONCLUSIONS: Distinct age-related patterns were observed in a number of burn patients, including burn source, LOS, TBSA, and BMI. Younger children sustained primarily scald burns with shorter hospital stays and lower TBSA, while adolescents experienced more severe flame burns and longer hospital stays with higher TBSA. These findings emphasize the need for age-specific prevention programs and resource allocation, particularly for older children facing greater burn severity. Further research should focus on long-term outcomes and refining prevention strategies.