Translational pediatrics · 2025
Risk factors of mortality among pediatric burn patients: a systematic review and meta-analysis.
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Zhao Xitong, Zhuang Zhaohan, Jia Yuxin, Liu Xiaohui, Ni Xin, Chen Kun
Аннотация
BACKGROUND: Pediatric burn injuries remain a significant cause of morbidity and mortality worldwide. Identifying risk factors associated with mortality in this vulnerable population is critical for improving clinical outcomes and guiding preventive strategies. This systematic review and meta-analysis aimed to synthesize existing evidence on the risk factors of mortality among pediatric burn patients.
METHODS: A comprehensive search was conducted across PubMed, Embase, Web of Science, and Cochrane Library databases from inception to December 2024. Two reviewers independently screened studies, extracted data, and assessed quality. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Sensitivity analysis and subgroup analysis were performed to assess the robustness of the findings and identify potential sources of heterogeneity.
RESULTS: Our meta-analysis incorporated 28 clinical studies comprising 5 cohort studies and 23 case-control studies, encompassing a total of 97,599 pediatric burn cases. The following ten parameters were identified as significant prognostic factors influencing mortality risk in pediatric burn patients-(I) total burn surface area (TBSA): extreme-value analysis (OR =1.17, 95% CI: 1.11-1.23; P<0.001), 10% (OR =12.65, 95% CI: 3.04-52.66; P<0.001), 25% (OR =58.44, 95% CI: 16.69-204.64; P<0.001); (II) age: extreme-value analysis (OR =0.93, 95% CI: 0.88-0.99; P=0.03), 4-year (OR =0.39, 95% CI: 0.19-0.80; P=0.01); (III) gender (female vs. male): (OR =1.41, 95% CI: 1.18-1.70; P<0.001); (IV) burn etiology (flame vs. scald): (OR =2.51, 95% CI: 2.09-3.02; P<0.001); (V) inhalation injury: (OR =5.01, 95% CI: 2.52-9.97; P<0.001); (VI) surgery: (OR =0.06, 95% CI: 0.01-0.31; P<0.001); (VII) mechanical ventilation: (OR =11.56, 95% CI: 4.97-26.87; P<0.001); (VIII) residence (urban vs. rural): (OR =0.43, 95% CI: 0.25-0.75; P=0.003); (IX) burn characteristic (non-accidental burns vs. accidental burns): (OR =2.15, 95% CI: 1.19-3.87; P=0.01); (X) length of stay (LOS): (OR =3.13, 95% CI: 1.91-5.13; P<0.001).
CONCLUSIONS: Our meta-analysis identified 10 risk factors associated with mortality in pediatric burn patients. Implementing multicenter prospective clinical studies may represent an effective strategy to address the current limitations of heterogeneity and bias in existing research.
METHODS: A comprehensive search was conducted across PubMed, Embase, Web of Science, and Cochrane Library databases from inception to December 2024. Two reviewers independently screened studies, extracted data, and assessed quality. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Sensitivity analysis and subgroup analysis were performed to assess the robustness of the findings and identify potential sources of heterogeneity.
RESULTS: Our meta-analysis incorporated 28 clinical studies comprising 5 cohort studies and 23 case-control studies, encompassing a total of 97,599 pediatric burn cases. The following ten parameters were identified as significant prognostic factors influencing mortality risk in pediatric burn patients-(I) total burn surface area (TBSA): extreme-value analysis (OR =1.17, 95% CI: 1.11-1.23; P<0.001), 10% (OR =12.65, 95% CI: 3.04-52.66; P<0.001), 25% (OR =58.44, 95% CI: 16.69-204.64; P<0.001); (II) age: extreme-value analysis (OR =0.93, 95% CI: 0.88-0.99; P=0.03), 4-year (OR =0.39, 95% CI: 0.19-0.80; P=0.01); (III) gender (female vs. male): (OR =1.41, 95% CI: 1.18-1.70; P<0.001); (IV) burn etiology (flame vs. scald): (OR =2.51, 95% CI: 2.09-3.02; P<0.001); (V) inhalation injury: (OR =5.01, 95% CI: 2.52-9.97; P<0.001); (VI) surgery: (OR =0.06, 95% CI: 0.01-0.31; P<0.001); (VII) mechanical ventilation: (OR =11.56, 95% CI: 4.97-26.87; P<0.001); (VIII) residence (urban vs. rural): (OR =0.43, 95% CI: 0.25-0.75; P=0.003); (IX) burn characteristic (non-accidental burns vs. accidental burns): (OR =2.15, 95% CI: 1.19-3.87; P=0.01); (X) length of stay (LOS): (OR =3.13, 95% CI: 1.91-5.13; P<0.001).
CONCLUSIONS: Our meta-analysis identified 10 risk factors associated with mortality in pediatric burn patients. Implementing multicenter prospective clinical studies may represent an effective strategy to address the current limitations of heterogeneity and bias in existing research.