Epidemiological Investigation and Risk Factors Analysis of Systemic Inflammatory Response Syndrome in 329 Children with Burn

Ruoyu WANG; Wei CHEN; Xun XU; Wende CAO; Yulan MIAO

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Ruoyu WANG, Wei CHEN, Xun XU, Wende CAO, Yulan MIAO. Epidemiological Investigation and Risk Factors Analysis of Systemic Inflammatory Response Syndrome in 329 Children with Burn[J]. Journal of Kunming Medical University.

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Epidemiological Investigation and Risk Factors Analysis of Systemic Inflammatory Response Syndrome in 329 Children with Burn

Burn Research Institute，The 2nd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2024-01-11
Available Online: 2024-04-29

Abstract

Abstract

Objective To explore the clinical epidemiological characteristics and risk factors of systemic inflammatory response syndrome （SIRS） in children with burns, so as to provide a reference for the early diagnosis and prevention of SIRS. Methods A retrospective analysis of the clinical data of 329 children with burns who were admitted to the Burn Department of the Second Affiliated Hospital of Kunming Medical University from January 2020 to December 2022 and met the inclusion criteria was conducted using a case-control method. The age, gender, cause of injury, season of injury, total burn area, area of third-degree burns, pre-hospital first aid methods, and first serum examination upon admission of the children were statistically analyzed: hypersensitive C-reactive protein （CRP）, interleukin-6 （IL-6）, procalcitonin （PCT）, prothrombin time （PT）, activated partial thromboplastin time （APTT）, thrombin time （TT）, fibrinogen （FIB）, D-dimer （DD）, and blood glucose level. The age of the children was grouped according to the modified SIRS age segment, and the total burn area and the area of third-degree burns were calculated to form the burn index. According to the modified SIRS scoring criteria, the children were divided into a SIRS group （150 cases） and a non-SIRS group （179 cases）. The data were conducted an epidemiological survey and analyze the risk factors for the occurrence of SIRS in children with burns. Results （1） The incidence of burns in children aged ≥2 and <6 years was the highest in this study. The gender composition ratio of children in each age group was analyzed, and the difference was not statistically significant （χ² = 3.480, P = 0.326）. （2） In this study, there were 217 cases of moderate burns （65.9%）, and the proportions of severe burns （47 cases, 14.3%） and extremely severe burns （41 cases, 12.5%） were similar. The composition ratio of the degree of burns in children of different age groups was analyzed, and the difference was statistically significant （χ² = 10.841, P < 0.05）. （3） There were 277 cases of hot liquid burns （84.2%）. The composition ratio of the cause of injury in children of different age groups was analyzed, and the difference was statistically significant （H=49.144, P < 0.05）. （4） The incidence of burns in children in winter was 30.39% （100/329）, which was higher than in other seasons. The distribution of the season of injury in children with burns in different years was analyzed, and the difference was statistically significant （χ² = 25.390, P < 0.05）. （5） Nearly half of the children with burns in this survey did not receive treatment after the burn, accounting for 46.8%. The second most common was improper treatment, accounting for 38%. There were only 50 cases of correct treatment, accounting for 15.2%. In this survey, the number of cases in the group with a time of admission ≤8h after injury accounted for more than half, accounting for 66.3%, followed by >12 h and ≤24 h, accounting for 15.2%. The proportion of >24 h and ≤72 h was the lowest, accounting for only 8.8%. （6） The differences in age group, occurrence of hypovolemic shock, burn index, blood glucose level, hypersensitive C-reactive protein, interleukin-6, procalcitonin, prothrombin time, and activated partial thromboplastin time between the two groups of children with burns were all significant （P < 0.05）, and were risk factors for the occurrence of systemic inflammatory response syndrome in children with burns. A binary logistics regression equation was established to screen out the burn index, blood glucose level, hypersensitive C-reactive protein, interleukin-6, procalcitonin, and prothrombin time （P < 0.05） as independent risk factors for the occurrence of systemic inflammatory response syndrome in children with burns. The serum indicators and burn index were positively correlated with the occurrence of systemic inflammatory response syndrome. Conclusion The hospitalized children with burns treated at the Second Affiliated Hospital of Kunming Medical University are mainly boys with moderate hot liquid burns aged over 2 and under 6 years. The combination of serum examination and burn index with the modified SIRS score can improve the specificity of assessing the occurrence of SIRS after burns, and provide a high clinical reference value for the diagnosis and early prevention of SIRS in clinical practice.
- Burns,
- Child,
- Systemic inflammatory response syndrome,
- Epidemiology

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