Gender-based disparities in burn injuries, care and outcomes: A World Health Organization (WHO) Global Burn Registry cohort study

Author(s):  
Kajal Mehta ◽  
Hana Arega ◽  
Natalie L. Smith ◽  
Kathleen Li ◽  
Emma Gause ◽  
...  
2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S51-S52
Author(s):  
Kajal Mehta ◽  
Nikitha Thrikutam ◽  
Kiran K Nakarmi ◽  
Paa Ekow Hoyte-Williams ◽  
Michael Peck ◽  
...  

Abstract Introduction Cooking- and cookstove-related burns (CSBs) comprise a large proportion of burn injuries globally. A cookstove is any apparatus that provides heat and is used for cooking (e.g., three-stone fire, traditional or improved cookstove). There are limited data on patterns of cooking behaviors and CSBs to inform prevention initiatives and advocacy. We aimed to describe the epidemiology, risk factors and outcomes of cooking-related burns and CSBs, specifically. Methods Patients with cooking and non-cooking related burns from 2018 to 2020 were identified in the World Health Organization (WHO) Global Burn Registry (GBR). Patient demographics, cooking arrangement, injury characteristics [mechanism, total body surface area (TBSA), revised Baux score] and outcomes were described. Differences in proportions and medians were compared. Bivariate regression was performed to identify risk factors associated with occurrence of CSB. Results GBR contained data of 6,965 burn-injured patients from 17 countries; 88% were from middle-income countries. One quarter of burn injuries (1,723 burns) were cooking-related. More than half of cooking-related burns (55%) occurred in females. Median age for cooking-related burns was 11 years (IQR 2–35). Of cooking-related burns, 22% were cookstove-related burns (CSBs; 311 burns). The most common mechanism in CSB was flame (87%), whereas the most common mechanism in other cooking burns was scald (62%). Patients with CSBs were more often female (65% vs 53%; p< 0.001) and much older than patients with other cooking burns (32 years, IQR 22–47 vs 5 years, IQR 2–30). CSBs were significantly larger in TBSA size (30%, IQR 15–45% vs 15%, IQR 10–25%; p< 0.001), had higher revised Baux scores (70, IQR 46–95 vs 28, IQR 10–25; p< 0.001) and more often resulted in death (41 vs 11%; p< 0.001) than other cooking burns (Table1). Patients with CSBs were more likely to be burned by fires (OR 4.74; 95% CI 2.99–7.54) and explosions (OR 2.91, 95% CI 2.03–4.18) than other cooking injuries. Kerosene had the highest odds of CSB than all other cooking fuels (OR 2.37, 95% CI 1.52–3.69). Conclusions Cooking-related burns are common and have different epidemiology than CSBs, specifically (e.g., more often female, older, larger burn size, higher mortality). CSBs were more likely caused by structural factors (e.g., explosion, fire) than behavioral factors (e.g., accidental movements) when compared to other cooking burns.


Author(s):  
Kajal Mehta ◽  
Nikhitha Thrikutam ◽  
Paa-Ekow Hoyte Williams ◽  
Henry Falk ◽  
Kiran Nakarmi ◽  
...  

Abstract Cooking- and cookstove-related burns (CSBs) comprise a large proportion of burn injuries globally, but there are limited data on cooking behavior patterns to inform prevention and advocacy. Therefore, we aimed to describe the epidemiology, risk factors and outcomes of these injuries and highlight the potential of the World Health Organization (WHO) Global Burn Registry (GBR). Patients with cooking-related burns were identified in the WHO GBR. Patient demographics, cooking arrangement, injury characteristics and outcomes were described and compared. Bivariate regression was performed to identify risk factors associated with CSBs. Analysis demonstrated that 25% of patients in the GBR sustained cooking-related burns (n=1,723). The cooking environment and cooking fuels used varied significantly by country income level ([electricity use: LIC 1.6 vs MIC 5.9 vs HIC 49.6%; p<0.001] [kerosene use: LIC 5.7 vs MIC 10.4 vs HIC 0.0%; p<0.001]). Of cooking-related burns, 22% were cookstove-related burns (CSBs; 311 burns). Patients with CSBs were more often female (65% vs 53%; p<0.001). CSBs were significantly larger in TBSA size (30%, IQR 15-45 vs 15%, IQR 10-25; p<0.001), had higher revised Baux scores (70, IQR 46-95 vs 28, IQR 10-25; p<0.001) and more often resulted in death (41 vs 11%; p<0.001) than other cooking burns. Patients with CSBs were more likely to be burned by fires (OR 4.74; 95% CI 2.99-7.54) and explosions (OR 2.91, 95% CI 2.03-4.18) than other cooking injuries. Kerosene had the highest odds of CSB compared to other cooking fuels (OR 2.37, 95% CI 1.52-3.69). In conclusion, CSBs specifically have different epidemiology than cooking-related burns. CSBs were more likely caused by structural factors (e.g., explosion, fire) than behavioral factors (e.g., accidental movements) when compared to other cooking burns. These differences suggest prevention interventions for CSBs may require distinctive efforts than typically deployed for cooking-related injuries, and necessarily involve cookstove design and safety regulations to prevent fires and explosions.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Lan Wang ◽  
Fei Chen ◽  
Lin Bai ◽  
Lang Bai ◽  
Zhixin Huang ◽  
...  

In this study, we investigated the association between the plasma NT-proBNP level at admission and the severity of COVID-19 pneumonia. For this retrospective, single-centre cohort study, we enrolled consecutive patients from February 9 to March 4, 2020, in a COVID-19 ward of Hubei General Hospital (East Branch) in Wuhan, which is a government-assigned centre for COVID-19 treatment. Diagnosis was confirmed by microbiological and radiographic findings following the interim guidance of the World Health Organization (WHO). A total of 91 (92.9%) patients were finally included in this study. The median age of the patients was 61 years (IQR, 47–69), and 39 (43.0%) of them were male. Two cases of death were reported (2.3%). Twenty-three patients (25.3%) had NT-proBNP levels above 300 pg/ml. Higher NT-proBNP levels were associated with worse PSI and CT scores. The natural logarithm of the NT-proBNP level was positively correlated with the PSI and CT scores (PSI score: rS = 0.396, P = 0.001 ; CT score: rS = 0.440, P < 0.001 ). Patients with NT-proBNP ≥300 pg/ml showed a potential risk for higher mortality than patients with NT-proBNP <300 pg/ml (mortality rate, 8.7% vs. 0%; P = 0.062 ). The plasma NT-proBNP level of COVID-19 patients was significantly related to the severity of pneumonia.


2020 ◽  
Vol 10 (1) ◽  
pp. 30-34
Author(s):  
Steven Straube ◽  
Julia Chang-Bullick ◽  
Paulina Nicholaus ◽  
Juma Mfinanga ◽  
Christian Rose ◽  
...  

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