472 Clinical Evidence of Burn Wound Infection in the Pediatric Population: A Quality-Improvement Initiative
Bibliographic record
Abstract
In order to provide appropriate burn care to the pediatric population, our pediatric burn center has a sedation program in place. Whilst some patients are sedated for burn wound treatment at the initial presentation, others have it done in up to 72 hours postburn. It is not clear whether the timing of the first burn wound treatment has an influence on the rate of infection. Thus, the objective of this quality-improvement project was to assess the infection rates of pediatric burn patients that underwent the initial procedure on presentation or up to 72 hours later. The health records of 160 pediatric burn patients who received acute burn care at our pediatric burn center between July 2017 and June 2018 were reviewed in this quality-improvement study. Patients were divided into two groups: “immediate” if the first burn wound treatment occurred at presentation, and “delayed” if it was done between 24 and 72 hours postburn. Infection occurring between presentation and complete healing of wounds or skin grafts was defined by the presence of one or more of the following signs or symptoms: hyperemia, increasing pain, lymphangitis, fever, purulent discharge, malaise, anorexia, hyperglycemia, leukopenia or thrombocytopenia. The infection rates and the relative risk were calculated and the Pearson Chi-square test was used for statistical analysis. A value of p<0.05 was considered statistically significant. The average age was 39.7 months and 105/160 (65.6%) sustained scald burns. Twenty-six patients (16.2%) had a diagnosis of infection. In the immediate group, 11/80 patients (13.8%) showed signs of infection, whilst 15/80 patients (18.8%) satisfied the infection criteria in the delayed group. The relative risk of infection in the immediate group was 0.73, which was not statistically significant (p>0.05). We can conclude that there was no difference between the infection rates of patients who received the first wound treatment in an immediate way, as compared to those who underwent the procedure between 24 and 72 hours postburn. A larger study based on this project is being conducted to support its findings. If the additional resources allocated for prompt sedation programs can be avoided, our and other burn centers may eliminate additional costs without detriment to the patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.028 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".