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Pediatric Burns-Who Requires Follow-up? A Study of Urban Pediatric Emergency Department Patients.
- Source :
-
Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health . Jul2024, Vol. 25 Issue 4, p634-644. 11p. - Publication Year :
- 2024
-
Abstract
- Introduction: Hundreds of children suffer burn injuries each day, yet care guidelines regarding the need for acute inpatient treatment vs outpatient follow-up vs no required follow-up remain nebulous. This gap in the literature is particularly salient for the emergency clinician, who must be able to rapidly determine appropriate disposition. Methods: This was a retrospective review of patients presenting to a Level II pediatric trauma center, January 1, 2017-December 31, 2019, and discharged with an International Classification of Diseases, Rev 10, burn diagnosis. We obtained and analyzed demographics, burn characteristics, and follow-up data using univariate and bivariate analysis as well as logistic regression modeling. Patients were stratified into three outcome groups: group 1-patients who underwent emergent evaluation at a burn center or were admitted at their first follow-up appointment; group 2-patients who followed up at a burn center (as an outpatient) or at the emergency department (and were discharged home); and group 3-patients with no known follow-up. Results: A total of 572 patients were included in this study; 58.9% of patients were 1-5 years of age. Sixty-five patients met group 1 criteria, 189 patients met group 2 criteria, and 318 patients met group 3 criteria. Sixty-five percent of patients met at least one American Burn Association criteria, and 79% of all burns were second-degree burns. Flame and scald burns were associated with increased odds (odds ratio [OR] 1.21, OR 1.12) of group 1 vs group 2 + group 3 (P = 0.02, P < 0.001). Second/third-degree burns and concern for non-accidental trauma were also associated with increased odds of group 1 vs 2 or 3 (OR = 1.11, 1.35, P ≤ 0.001, 0.001, respectively). Scald burns were associated with increased odds of group 2 compared to group 3 (OR 1.11, P = 0.04). Second/third degree burns were also associated with increased odds of group 2 vs 3 (OR 1.19, P ≤ 0.001). Conclusion: There were few statistically significant variables strongly associated with group 1 (emergent treatment/admission) vs group 2 (follow-up/outpatient treatment) vs group 3 (no follow- up). However, one notable finding in this study was the association of scald burns with treatment (admission or follow-up) suggesting that the presence of a scald burn in a child may signify to clinicians that a burn center consult is warranted. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TREATMENT for burns & scalds
*LOGISTIC regression analysis
*HOSPITAL emergency services
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
*MANN Whitney U Test
*CHI-squared test
*PEDIATRICS
*ODDS ratio
*METROPOLITAN areas
*MEDICAL records
*ACQUISITION of data
*STATISTICS
*MEDICAL needs assessment
*DATA analysis software
*CONFIDENCE intervals
*PATIENT aftercare
*CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 1936900X
- Volume :
- 25
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
- Publication Type :
- Academic Journal
- Accession number :
- 178448606
- Full Text :
- https://doi.org/10.5811/westjem.17984