Elsevier

Burns

Volume 35, Issue 8, December 2009, Pages 1124-1132
Burns

The epidemiology of burn injuries in an Australian setting, 2000–2006

https://doi.org/10.1016/j.burns.2009.04.016Get rights and content

Abstract

Objectives

To describe presentation characteristics of burn leading to death or hospital treatment (i.e. inpatient admissions and emergency department [ED] presentations) across the state of Victoria, Australia, for the years 2000–2006 inclusive.

Methods

Data were provided by the Victorian Injury Surveillance Unit (VISU) from three different datasets pertaining to burn deaths, hospital inpatient admissions and non-admitted ED presentations. Population estimates were derived from census data provided by Australian Bureau of Statistics.

Results

During the 7-year period, 178 people died and 36,430 were treated for non-fatal burn injury, comprising 7543 hospital admissions and 28,887 non-admitted ED presentations. Males, children aged less than 5 years of age, and the elderly (≥65 years of age) were at the highest risk of injury. Contact with heat and hot substances represented the major aetiological factor contributing to thermal injuries accounting for 64% of all hospital admissions and 90% of ED presentations. Temporal trends indicate no change in the population rate of burn deaths or hospital admissions during the study period.

Conclusions

ED presentations and hospital admissions and deaths have remained the same over this study period, but rates of burn remain high in males, children and the elderly. This could be due to variations in the implementation of government prevention and control programs and the divergence in efficient treatments and clinical practices amongst hospital care providers. Therefore, educational efforts for prevention should be the keystone to minimise the incidence of burns.

Introduction

Burn represents perhaps the widest spectrum of any form of trauma. Burns occur in all age groups, and may range in severity from very minor requiring no treatment, through to extremely severe when the highest levels of intensive care and surgery are indicated. This variability in severity and treatment can make it difficult to accurately describe the number of people who suffer burns each year and the subsequent imposed health burden [1]. Nonetheless, it is estimated that thermal burns constitute a significant source of morbidity and mortality. It is purported that 1% of the Australian population sustains a burn each year, of which half are severe enough to affect daily life. Approximately 10% of burn victims require hospitalisation, of which 10% are considered to have life-threatening injuries [2].

In Australia, there has been no examination of burn incidence from multiple sources such as records of deaths, hospital admissions and emergency department (ED) presentations. Data from Australia-wide hospital admissions sources [3] and single burn unit studies [2] suggest annual increases in hospital admissions rates, although conclusions drawn from these studies may not be valid because of specific variations in climate, employment patterns, or other socioeconomic factors [4]. Similarly, studies based on data from single burn units, although invaluable for the reporting of therapeutic interventions, may not necessarily represent population-based estimates or specific treatment patterns [4].

The purpose of this study was to establish the frequency, pattern, and mechanisms of burn leading to death or hospital treatment (i.e. inpatient admissions and ED presentations) across the state of Victoria, Australia for the years 2000–2006 inclusive. Trends in burn-related fatalities and hospital admissions for this period were also determined.

Section snippets

Study design

A retrospective review was performed of all Victorian burn injury cases that either resulted in a fatality or warranted hospital treatment (either inpatient admission or ED presentation). Deaths data were reviewed over a 6-year time period from January 2000 to December 2005 while hospital admission and ED data were reviewed over 7 years from January 2000 to December 2006. The discrepancies in these time periods were due to the availability of data at the time the analysis took place.

Setting

The

Temporal trends in burn injury

No statistically significant changes in the overall population rate of burn injury deaths (incident rate ratio (IRR) = 0.99, 95% CI: 0.92, 1.07) or hospital admissions (IRR = 1.01, 95% CI: 0.97, 1.05) were observed during the study period (Fig. 1). Nor were there any significant changes in the incidence of large burn injuries affecting more than 20% of the total body surface area (IRR = 0.97, 95% CI: 0.92, 1.03). Examination of burn hospital admissions by age groups revealed that rates decreased by

Discussion

This epidemiological study has presented data from multiple sources to illustrate the incidence, pattern and cause of burn injuries over 7 years in the state of Victoria. As such, it provides the most comprehensive overview of burn injury available to date. During the study period, 178 burn related deaths were recorded along with over 34,000 episodes of care provided either in a hospital ward or emergency department. The serious nature of burns was attested to by the finding that one quarter of

Conclusion

Burn and scalds injuries constitute an important source of mortality and morbidity which has not been reduced despite small successes at reducing the incidence of some types of burn injuries. Our findings suggest that there have been no significant change in Victorian hospital admissions or deaths over a 7-year period, and young children and the elderly continue to be particularly vulnerable to this type of injury. We believe this to be due to variations in the success of government and health

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