Epiemiologic Features and Hospitalization Cost of Burn Injuries in Iran Based on National Burn Registry; a Cross-sectional Study

Introduction: Burn is one of the most common causes of injury in the world. The aim of this study was to determine the epidemiologic features and cost of hospitalization associated with burn injuries in Iran.

Methods: In this cross-sectional study, the data related to hospitalized burn cases in 2017 were obtained from the office of curative affairs in the Ministry of Health and Medical Education of Iran and analyzed regarding the epidemiologic features and hospitalization costs.

Results: ۳۵۹۳۳ hospitalized burn patients, from the beginning to the end of 2017, with  the mean age of 29.37 ± ۲۱٫۴۱ (۱ – ۹۹) years were studied (59.4% male). Scald burns (49.4%) were the most prevalent type of burns and 30.3% of burns occurred in spring. The most frequent severity of burn injury was second-degree burns (69.3%) with 1-20 percent involvement of body’s surface area (74.7%). Frequency of scald burn was higher in females, while the frequency of flame was higher in males. Total hospitalization cost of studied cases was 66910.22 $.  In male patients, the highest average direct cost was related to electrical burns; while in females, the highest average direct cost was related to chemical burns. Higher degrees and percentages of burn injuries required a more costly treatment.

Conclusions: Burn injuries most frequently happened in males, ages < 10 years, spring season, and with scald and flame. The most frequent injuries were second-degree burns with 1% – ۲۰%  body surface involvement. The highest direct hospitalization cost was related to chemical and electrical burns. There was a direct correlation between the degree and percentage of burn and the hospitalization costs.

Zvizdic Z, Bećirović K, Salihagić S, Milisic E, Jonuzi A, Karamustafic A. Epidemiology and clinical pattern of paediatric burns requiring hospitalization in Sarajevo Canton, Bosnia and Herzegovina, 2012-2016. Annals of burns and fire disasters. 2017;30(4):250.

Mock C, Peck M, Krug EG, Haberal MA. Confronting the global burden of burns: a WHO plan and a challenge. Burns: journal of the International Society for Burn Injuries. 2009;35(5):615-7.

Hop MJ, Polinder S, van der Vlies CH, Middelkoop E, van Baar ME. Costs of burn care: a systematic review. Wound repair and regeneration. 2014;22(4):436-50.

Alinia S, Rezaei S, Daroudi R, Hadadi M, Sari AA. Extent, nature and hospital costs of fireworks-related injuries during the Wednesday Eve Festival in Iran. Journal of injury and violence research. 2013;5(1):11.

Austin RE, Schlagintweit S, Jeschke MG, MacDonald R, Ahghari M, Shahrokhi S. The cost of burn transfers: a retrospective review of 7 years of admissions to a regional burn center. Journal of Burn Care & Research. 2018;39(2):229-34.

Nygaard RM, Endorf FW. Frostbite vs Burns: Increased Cost of Care and Use of Hospital Resources. Journal of Burn Care & Research. 2018;39(5):676-9.

Rezaeian S, Ahmadzadeh J, Esmailnasab N, Veisani Y, Shayan M, Moradi N. Assessment of health and nutritional status in children based on school screening programs. 2014.

Naghavi M, Abolhassani F, Pourmalek F, Lakeh MM, Jafari N, Vaseghi S, et al. The burden of disease and injury in Iran 2003. Population health metrics. 2009;7(1):9.

Davé DR, Nagarjan N, Canner JK, Kushner AL, Stewart BT, Group SR. Rethinking burns for low & middle-income countries: differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries. Burns. 2018;44(5):1228-34.

Tripathee S, Basnet SJ. Epidemiology and outcome of hospitalized burns patients in tertiary care center in Nepal: Two year retrospective study. Burns Open. 2017;1(1):16-9.

Sen S, Heather J, Palmieri T, Greenhalgh D. Tracheostomy in pediatric burn patients. Burns. 2015;41(2):248-51.

Wanjeri JK, Kinoti M, Olewe TH. Risk factors for burn injuries and fire safety awareness among patients hospitalized at a public hospital in Nairobi, Kenya: A case control study. Burns. 2018;44(4):962-8.

Ward J, Phillips G, Radotra I, Smailes S, Dziewulski P, Zhang J, et al. Frailty: an independent predictor of burns mortality following in-patient admission. Burns. 2018;44(8):1895-902.

Waqas A, Turk M, Naveed S, Amin A, Kiwanuka H, Shafique N, et al. Perceived social support among patients with burn injuries: A perspective from the developing world. Burns. 2018;44(1):168-74.

Alnababtah K, Khan S, Ashford R. Socio-demographic factors and the prevalence of burns in children: an overview of the literature. Paediatrics and international child health. 2016;36(1):45-51.

Harats M, Peleg K, Givon A, Kornhaber R, Goder M, Jaeger M, et al. Burns in Israel, comparative study: Demographic, etiologic and clinical trends 1997–۲۰۰۳ vs. 2004–۲۰۱۰٫ Burns. 2016;42(3):500-7.

Rybarczyk MM, Schafer JM, Elm CM, Sarvepalli S, Vaswani PA, Balhara KS, et al. Prevention of burn injuries in low-and middle-income countries: a systematic review. Burns. 2016;42(6):1183-92.

Arifi H, Ahmeti H, Zatriqi V, Buja S, Rexhaj Z, Arifi N. Epidemiology of burn injuries in Kosovo: a 10-year review. Annals of burns and fire disasters. 2017;30(3):163.

Strobel AM, Fey R. Emergency care of pediatric burns. Emergency medicine clinics of North America. 2018;36(2):441-58.

Kazemzadeh J, Vaghardoost R, Dahmardehei M, Rabiepoor S, Farzan R, Kheiri AA, et al. Retrospective epidemiological study of burn injuries in 1717 pediatric patients: 10 years analysis of hospital data in Iran. Iranian journal of public health. 2018;47(4):584.

Santos JV, Viana J, Oliveira A, Ramalho A, Sousa-Teixeira J, Duke J, et al. Hospitalisations with burns in children younger than five years in Portugal, 2011–۲۰۱۵٫ Burns. 2019.

Lee CJ, Mahendraraj K, Houng A, Marano M, Petrone S, Lee R, et al. Pediatric burns: a single institution retrospective review of incidence, etiology, and outcomes in 2273 burn patients (1995–۲۰۱۳). Journal of Burn Care & Research. 2016;37(6):e579-e85.

Elsous A, Ouda M, Mohsen S, Al-Shaikh M, Mokayad S, Abo-Shaban N, et al. Epidemiology and outcomes of hospitalized burn patients in Gaza Strip: a descriptive study. Ethiopian journal of health sciences. 2016;26(1):9-16.

Moehrlen T, Szucs T, Landolt MA, Meuli M, Schiestl C, Moehrlen U. Trauma mechanisms and injury patterns in pediatric burn patients. Burns. 2018;44(2):326-34.

Cloake T, Haigh T, Cheshire J, Walker D. The impact of patient demographics and comorbidities upon burns admitted to Tygerberg Hospital Burns Unit, Western Cape, South Africa. Burns. 2017;43(2):411-6.

Li H, Yao Z, Tan J, Zhou J, Li Y, Wu J, et al. Epidemiology and outcome analysis of 6325 burn patients: a five-year retrospective study in a major burn center in Southwest China. Scientific reports. 2017;7:46066.