Global Burn Registry Perspective on Head and Neck Burns

INTRODUCTIONAs exposed regions of the body, the head and neck are at increased risk of burn injury. The cosmetic and functional importance of these anatomical regions means that burns can result in substantial morbidity and mortality. Our objective was to characterize predictive factors for surgery and discharge condition in patients with head and neck burns internationally. METHODSWe conducted an epidemiological study of all head and neck burns in 14 countries reported in the World Health Organization Global Burn Registry. Multivariate regression was used to identify variables predictive of surgical treatment and discharge condition. RESULTSWe identified 1014 patients who sustained head and neck burns; the majority were adults (60%). Both adults and children admitted to hospital with head and neck burn injuries were less likely to be treated surgically in lower-middle–income countries (LMIC) than in higher-income countries (P < 0.001). Increasing age and greater total surface body area (TBSA) were significant predictors of surgical intervention in children with head and neck burn injuries (P < 0.001). Total surface body area, associated injuries, ocular burns, female sex, and LMIC residency were all significant predictors of mortality in adult patients with head and neck burns (P < 0.050). Conversely, TBSA was the only variable that independently increased the risk of death in children with head and neck burns (P < 0.001). CONCLUSIONSCertain groups are at increased risk of an adverse outcome after admission with a head and neck burn injury. Given the reduced incidence of surgical intervention and the elevated mortality risk in LMICs, global health initiatives should be targeted to these countries.