Young age is not a predictor of mortality in burns

Abstract

OBJECTIVE: Conventional wisdom and recently published reports suggest that children <48 months of age have a higher mortality rate after burns than older children and adolescents with similar injuries and that young age is a predictor of mortality. This study was done to validate or refute this impression. DESIGN: Retrospective review. SETTING: Regional pediatric burn center. PATIENTS: All children (n = 1223) managed over a recent 8-yr interval (1991-1998) for acute thermal burns. INTERVENTIONS: The survival rate of children <48 months of age was compared with the survival rate of children >/=48 months of age. MEASUREMENTS AND MAIN RESULTS: Of the 1112 children with burns covering <30% of the body surface, 721 (65%) were <48 months of age. After exclusion of one child who was brain dead and became a solid organ donor, there were no deaths in this burn size group. There were 111 children admitted with burns covering >/=30% of the body surface: 47 (42%) with an average age of 2.0 yrs (range, 4 wks to 3 yrs and 11 months) were <48 months of age, and 64 (58%) with an average age of 10.9 yrs (range, 4 yrs to 17 yrs) were >/=48 months of age. There were no clinically important differences between the two groups in burn size (51.9% +/- 18.1% [range, 30%-90%] vs. 56.9% +/- 19.4% [range, 30%-97%]; p =.18) or need for mechanical ventilatory support (30/47 [63.8%] vs. 44/64 [68.8%]; p =.59). The mortality rate in the young group was 0% (0/47) and 10.9% (7/64) in the older group (p =.04). All children who died had large burns (average burn size, 82.9% +/- 11.5%) with concurrent inhalation injury. CONCLUSION: Young age is not a predictor of mortality in burns.