737: CLINICAL FEATURES AND OUTCOMES IN SEVERE PEDIATRIC SCALD BURN PATIENTS

Introduction: Young children with scald burns experience severe complications compared to older children. A paucity of data exists to support these observations. This study compares clinical features and complications of younger versus older pediatric patients with scald burns at four children’s hospitals participating in the Pediatric Injury Quality Improvement Collaborative (PIQIC). This collaborative includes five pediatric burn centers that utilize research to improve quality of burn care. Methods: This is a retrospective cohort study of scald burn patients admitted from 2010 to 2020 to four pediatric hospitals participating in PIQIC. Patients with total body surface area (TBSA) < 15% were excluded. Patients were categorized by age into three groups: toddlers (0–3 years), children (3-10 years) and adolescents (>10 years). The adolescent group was excluded with three patients in this group. Demographics, clinical features and adverse events were compared between age groups. For categorical variables, counts and percentages are reported; P-values were determined by Fisher’s Exact test. Continuous variables are reported using median and inter-quartile range; P-values were determined using the Wilcoxon Rank Sum test. Results: Ninety-five patients were identified; 73 (76%) were in the toddler group. Although median burn size was larger in children (24 [21-36] vs 21 [18-30] % TBSA, p< 0.001), toddlers had longer median intensive care unit (ICU) LOS (3 [2-16] vs 3 [2-9], p< 0.001) and more median mechanical ventilator (MV) days (13 [1-137] vs 5 [2-138], p< 0.001) than the child group. There was notable incidence of sepsis, nosocomial infection and abdominal catastrophe in the toddler group. Abdominal catastrophes only occurred in the toddler group, with 5 patients (7%) affected. Mortality was only observed in the child group (n=2, 9%). Conclusions: Scald burns are more prevalent in the toddler group compared to the child group. Mortality risk may not be higher in this group, but they encounter longer ICU LOS, higher MV days, and incidence of sepsis, nosocomial infection, and abdominal catastrophe. This is one of the largest reports of abdominal catastrophe in this patient population to our knowledge. Continued investigation will help better understand this patient population.