Childhood burns require extensive treatment
The economic burden of burn injury is high. And as the research shows, serious pediatric burns very often require critical mental health support for the survivor in the aftermath of hospital stays and surgeries.
The Journal of Burn Care and Research published an 18-year study in 2016 that was conducted at a single state hospital certified as a Burn Treatment Center. The data showed that the overall mean length of stay for the 2,273 children in the study was about 10.5 days. For those admitted to the intensive care unit, the mean length of stay was about 15.5 days. Skin grafting was required for 520 patients, or 23 percent. Overall mortality was less than 1 percent. About 4.4 percent of children in the study required ventilator support. As many other studies have shown, the majority of burn survivors in this hospital study were injured by contact with flames or scalding from hot liquids, including hot tap water.
In June 2021, the Journal of Burn Care and Research published a study that compared pediatric burn information from two national health care databases. The TriNetX database is part of a global federated health research network. Researchers looked at non-survival information for burn patients from zero to 20 years of age at 41 healthcare organizations from 2010 to 2020. TriNetX was compared to three years of data (2016-2018) from NBR, or the American Burn Association’s National Burn Repository. NBR patient information came from 90 certified burn centers.
Overall, mortality rates for pediatric burn patients were 0.62 percent in NBR and 0.52 percent in TriNetX. Boys had a higher incidence of mortality than girls in both databases. In TriNetX, burned children aged 5 to 9 had a significantly increased frequency of non-survival. In NBR, children aged 0 to 4 experienced the highest frequency of mortality.
Mental health support
Pediatric burn lawsuits handled by Pritzker Hageman examine the necessity for mental health support. A study published by the Journal of Burn Care and Research interviewed parents of four girls and four boys with an average age of 9 who survived burns to critical areas of their bodies, including face, hands and arms. Coupled with a review of literature, the researchers looked at the burdens child burn survivors carry for the rest of their lives. The study found cognitive, social and emotional difficulties, including challenges during the time when young people are navigating body image.
The study, funded by Shriners Hospital for Children and the National Institute on Disability, Independent Living and Rehabilitation Research, reported instances of children falling behind in school, children speaking less than usual and children expressing anger more often. One mom recalled her son saying that he probably wouldn’t be having a birthday party because, “Well, no one is going to want to come to a party, mom,’’ and pointed to his face.
Clearly, burns are one of the most physically and psychologically devastating forms of trauma to children. Five pediatric burn centers are actively collaborating to share data and best practices in order to advance the quality of care after pediatric burn injury. The centers are aiming to standardize psychological treatment, including psycho-social referrals for abuse, violence, neglect or self-harm. Obtaining a consult within 30 days of an injury also is considered quality care. The five centers are in Kansas City, Detroit, Washington, Baltimore and Columbus, Ohio. They believe there is potential to improve practices around the United States at burn centers that serve children.