597 Non-Survival Distributions in Paediatric Burn Patients; A Comparative Study of Two National Databases

Abstract Introduction A contemporary, age-specific model for the distribution of burn mortality in children has not been developed for over a decade. Using data from both TriNetX, a global federated health research network, and the American Burn Association’s Nation Burn Repository (NBR), we investigated non-survival distributions for paediatric burns in the United States. Methods Paediatric burn patients ages 0–20 between 2010–2020 were identified in TriNetX from 41 Health Care Organisations (HCOs) using ICD-10 codes (T.20-T.30) and identified as lived/died. These were compared to the non-survival data from 90 certified burn centers in NBR database between 2016–2018. The patient population was stratified by age into subgroups of 0–4, 5–9, 10–14, 15–20 years. Descriptive statistics were generated and statistical analysed by chi-square; p < .05 was considered significant. Results 81,507 and 21,442 unique paediatric burn patients were identified in the TriNetX and NBR databases, respectively. Overall non-survival rates were 0.62% and 0.52%, respectively. Boys had a higher incidence of mortality than girls in both databases (0.34% vs. 0.28% NBR, p = 0.13 and 0.31% vs. 0.21% TriNetX, p = < 0.001). When comparing age subgroups in TriNetX, burned children ages 5–9 had significantly increased frequency of non-survival, constituting 65% of all deaths (p = < 0.001). However, NBR data suggested that children 0–4 experience the highest frequency of mortality (p = < 0.001). Comparison of ethnic cohorts between 2010–2015 and 2016–2020 subgroups showed that non-survival rates of African-American children increased relative to white children (TriNetX, p = < 0.001), however evidence was insufficient to conclude that African-American children die more frequently than other ethnicities (NBR, p = 0.054). Conclusions Large sample size databases such as TriNetX and NBR afford sufficient statistical power to reflect relative non-survival rates in burned children. TriNetX also captures a unique demographic of burn patients not treated at ABA certified centers reporting to NBR, informing inferences on results. However, differences in reporting time periods must also be considered. Furthermore, potential ethnic disparities in paediatric non-survival outcomes were identified, meriting further investigation.