Burns in Sweden: An analysis of 24 538 cases during the period 1987–2004
Introduction
Besides being a personal catastrophe for the patient, a severe burn is also a medical problem and an economical burden on the national health services. Burns are among the most expensive of the non-fatal injuries [1] and account for a substantial direct economic loss [2], [3]. In the United States, burns are the fourth leading cause of death from accidental injury [4]. The morbidity after a large burn is considerable compared with other injuries [5], [6], and it is often associated with loss of quality of life and the risk of developing depression or post-traumatic stress disorder [6], [7], [8]. Recent studies have shown a reduced incidence of burns in several countries [9], [10], [11], [12], [13], [14], [15]. Earlier calculations of the incidence of burns have been made, indicating that about 0.4% of the Scandinavian population seek medical care for burns each year [16]. Taking the present number of inhabitants in Sweden, this extrapolates to about 36 000 burns treated each year.
A previous Swedish study found that between the years 1987–1996 there was a 16% reduction in the number of patients admitted to hospital with burns as their primary diagnosis [14]. During the same period there was a 70% decrease in mortality, and at the end of the period about 2 people/million inhabitants died each year in Swedish hospitals with burns as their main diagnosis [14]. Overall, men seem to be most prone to burns as several studies have reported that most of such patients are male [1], [2], [3], [17].
Several authors have also previously described a double-peaked age distribution of burns, among the age groups 0–4 years and 15–44 years of age, with some variation depending on the chosen intervals [1], [3], [14].
Like other intensive care units, our occupancy rate varies, and in order to be able to manage the uneven flow of patients we have a well-developed cooperative plan between burn centres in Scandinavia. This means that Swedish centres will accept burned patients from other Scandinavian countries, and will also send their own patients abroad for treatment when needed. However, foreign patients have not been included in this study.
Developments in burn care move fast and new protocols for treatment, preventive measures, and a rapidly-growing scheme to treat people with burns as outpatients continue. However, current epidemiological data are often difficult to grasp and published papers consist mostly of reports from single units or from the United States. We therefore wished to form a clear, updated, picture of the epidemiology of burns in Sweden. We wanted to look into possible changes in incidence, mortality, and distribution according to sex and age by using data from a Swedish nation-wide database. The purpose of this study was therefore to present an epidemiological picture of burns that require hospital care in Sweden.
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Patients and methods
In Sweden, all patients’ names and personal birth number (social security number) are recorded, and reported to the National Swedish Board of Health and Welfare (NSBHW). The patient's diagnosis was given according to the International Classification of Diseases-9 (ICD-9) during the years 1987–1996 and ICD-10 from 1997 onwards. The data from all Swedish patients who were admitted to hospital with a diagnosis of burns (primary or secondary) according to ICD-9/10 (Table 1) during the years of 1
Results
A total of 24 538 patients were admitted to Swedish hospitals with burns between 1987–2004, giving a mean of 1363/year. The fewest were admitted in 2000 and 2004 (n = 1181 each) and the most in 1987 (n = 1611). Of all the patients admitted, 16 945 (69%) were male and 7 593 (31%) were female, giving a male:female ratio of 2.23:1 (Fig. 1). Men predominated in all age groups.
Standardising the number of patients to the population did not affect the results (Table 3). Children aged 0–4 years were the most
Discussion
To our knowledge this is the largest published nation-wide epidemiological study of burned patients. Even though Miller et al. [18] and Pegg [19] reported large studies with important information they have not had access to such a complete and homogenous patient-base as we have had. For instance, the National Burn Repository published by Miller et al. [18] is based on voluntarily contributed patient-data that is not nation-wide and cannot be verified for contribution bias.
All inhabitants of
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Epidemiology of hospitalized burns in Romania: A 10-year study on 92,333 patients
2022, BurnsCitation Excerpt :The dramatic decrease in the share of T31 diagnoses from 8.8% to 0.23% and the maintenance of T29 codes on the first position might reflect a lack of interest and concern for quality coding. Romania, with a median LoS of 10.59 days in the period 2006–2015 (extremes 10.30/2014 and 11.00/2012), remains at values comparable to those in the HIC countries: France — 10.1–10.9 between 2008–2012 [33]; Finland — 12.4 in 2010 [9]; Norway — 11.3 in 2007 [2]; Sweden — 10.6 between 1987–2004 [7]. In a similar period, from 2008 to 2017, in the USA the median LoS for women decreased from 9.4 to 7.3 days, while for men it decreased from 9.5 to 8.5 days [32].