Peer-reviewed article
Effects of socioeconomic status on outcomes in <15% TBSA pediatric burn injuries: A single-institution retrospective study.
Zhu XM, Gallo L, Barkho J, Ashgar M, Boyle A et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how socioeconomic status and social deprivation affect outcomes for children with minor burn injuries (less than 15% of body surface area) treated at a Canadian hospital. While income level alone did not predict outcomes, specific measures of social deprivation—such as lack of material resources, marginalization of racialized and newcomer populations, and employment instability—were associated with worse outcomes including larger burn areas, longer surgery wait times, and longer hospital stays. The findings suggest that social determinants beyond income play an important role in burn injury severity and recovery for children.
Key points
- No differences in outcomes were found based on socioeconomic status income quartiles alone
- Higher marginalization indices for material resources, racialized and newcomer populations, and household/dwelling quality were associated with greater TBSA (total body surface area burned)
- Patients with higher social deprivation scores had longer times to surgery and longer lengths of stay
- An unexpected finding: children from areas with lowest age and labour force deprivation had greater TBSA
- Deprivation indices provide more granular insight into social determinants than income alone
Limitations
This is a single-centre retrospective study from one Canadian institution, limiting generalizability to other regions and healthcare systems. The study examines only minor burn injuries (<15% TBSA), so findings may not apply to more severe burns.
Abstract
Background Pediatric burn injuries pose significant health concerns and rank fifth globally in non-fatal injuries. Current evidence associates lower socioeconomic status (SES) with higher incidence of burn injury, greater TBSA, higher need for admission, and greater involvement of child protective services. There is a paucity of Canadian data on the topic, and effects of indices of deprivation on outcomes have not been investigated extensively. Methods A retrospective single-centre study was carried out to examine effects of SES and Ontario Marginalization Index (OMI) on pediatric burn patient outcomes. One-way ANOVA with post hock Bonferroni correction was used for continuous dependent variables (i.e. TBSA, length of stay), and Pearson chi-square analysis was done for categorical variables (i.e. CAS involvement, need for OR, need for admission). P-value of 0.05 was set a priori to determine statistical significance. Results No differences in outcomes were found between the four quartiles of SES categories. Analysis of the OMI for Material Resources, Racialized and Newcomer Populations, Age and Labour Force, and Household and Dwellings produced statistically significant findings. Patients with a higher degree of marginalization for most indices tended to have greater TBSA, time to surgery, and length of stay. An unexpected finding was that patients with the lowest Age and Labour Force deprivation indices were likely to have greater TBSA. Conclusion Identifying the effects of various social determinants of health on pediatric burn patients remains a challenging problem. While this study found no differences in patient outcomes based on income alone, examination of the granularity in deprivation provided notable differences. These effects could be further clarified with a cross-provincial or national study.