EPIDEMIOLOGY OF SEVERE BURNS ADMITTED IN PEDIATRIC INTENSIVE CARE UNITS

Introduction:Burn injuries are one of the top 10 causes of unintentional deaths in children younger than 14 years old. Most pediatric burns are minor, but children with severe burns have higher mortality than nonelderly adults with similar burns. Aims and objectives:To study the epidemiological particularities and the prognostic factors in order to prevent these accidents and to improve the future of the patients. Materials and methods:This study is retrospective and descriptive. It covers all the children burned and hospitalized in the pediatric intensive care unit of the Mohammed VI University Hospital of Marrakech during the period from January 2009 to December 2017. The criteria for inclusion are any burns covering more than 15% of a skin surface, any burns in a deep surface exceeding 5%, when a burn is cervico-facial, or when the burn is responsible for circular lesions. Findings and discussion:401 cases were collected during this period mentioned above. The incidence of severe burns in children was 5.6%. The most affected age group is between 0 and 4 years old with a male predominance (63%). Children from rural regions were more dominant (61%). 40% of the patients were admitted between 3 and 12 hours after the incident. 89% of the incidents occurred at home. Scalding was the most common mechanism (70%). Inpatient admission was done in 59% of cases via pediatric emergencies. The average area of skin burned was 18.8%. The most common location was limb involvement (35%) with superficial to intermediate second degree burns predominating (51%). Therapeutically, apart from patients admitted late (22%), all the others benefited from rehydration according to the Carvajal scheme. All the patients also benefited from multimodal analgesia (Morphine - Paracetamol - Ibuprofen) care performed by the plastic surgery team, and a mostly enteral diet (91%) introduced within an average of 1.7 days. In addition, we noted the occurrence of various ionic and metabolic disorders in 75% of cases, anemia in 67% of patients. The infection reached 43% of children burned. The mortality rate was 6.38%, and the average duration of hospitalization was 5.8 days. In our context, some elements such as the age of the patient being less than 4 years old, flame burn, the burned skin area exceeding 30%, defective initial management, delayed admission and infection occurrence, can be factors of poor prognosis. Conclusion:Our data demonstrates the importance of developing a program for the prevention of pediatric scalds by educating family members and raising their awareness of the danger. With present studies, the knowledge about the occurrence of injuries in scald accidents in children has become deeper. This knowledge may contribute to more individual adept child accident prevention program that could be used in the children health care.