Рrediction models of pediatric burn injury outcomes based on prehospital emergency care

Abstract

Оbjective. To evaluate the impact of prehospital emergency care management on the clinical outcomes of pediatric burn injuries. Aims. To analyze the components of prehospital emergency care provided to children with burns and to develop predictive models of burn injury outcomes based on prehospital management strategies. Materials and methods. A retrospective study included 576 pediatric patients (median age 17 months, IQR 13–40 months) admitted to a pediatric burn center between 2016 and 2024 after transportation by emergency medical service (EMS) teams and specialized emergency response teams. Key parameters of prehospital emergency care and their associations with intensive care unit (ICU) length of stay, surgical treatment, and total hospital length of stay were analyzed. Logistic and linear regression models were used to identify predictors of clinical outcomes. Model performance was assessed using receiver operating characteristic (ROC) analysis. Results. The likelihood of surgical treatment was significantly associated with the administration of infusion therapy (OR=2.060, 95% CI: 1.261–3.386) and burn size. The predictive model demonstrated a 70% probability of correctly identifying patients requiring surgical intervention. ICU length of stay was predicted by the presence of life-threatening conditions (OR=2.067, 95% CI: 1.542–4.284), underestimation of burn size during the prehospital stage (OR=1.206, 95% CI: 1.152–1.271), and administration of infusion therapy (OR=2.477, 95% CI: 0.942–5.861). Prehospital care variables accounted for 38% of the variability in hospital length of stay (R 2 =0,38). Conclusion. Underestimation of burn size, administration of infusion therapy, and the development of life-threatening conditions during the prehospital stage significantly influence burn injury outcomes in children. These factors should be considered when providing prehospital emergency care to pediatric burn patients.