The impact of socioeconomic deprivation on the adequacy of burn first aid: a retrospective cohort study.

Abstract

This study aimed to examine the relationship between socioeconomic status, measured by the Index of Multiple Deprivation (IMD), and the adequacy of first aid provided for burn injuries. A retrospective cohort study was conducted including all patients (paediatric and adult) treated for thermal burns at a regional burn unit between 1 May and 31 July 2024. Socioeconomic status was assessed using IMD deciles. First aid was categorised as "adequate" (cooling with water for ≥20 min) or "inadequate," with inadequate first aid further classified as "damaging" (e.g., ice, toothpaste, raw egg) or "not damaging." Logistic regression analyses adjusted for age, sex, burn aetiology and size of burn. 269 patients were included (median age 28.3 years; 66.9 % adults; 50.9 % male). Scalds were the most common aetiology (59.5 %), and most burns were superficial partial thickness (82.5 %). The median IMD decile was 7 (IQR 5-9). Increasing socioeconomic deprivation (lower IMD decile) was significantly associated with inadequate first aid (OR 0.898 [per unit decrease in IMD decile] 95 % CI 0.807-0.998, p = 0.046). Greater deprivation was also associated with increased odds of harmful first aid practices, compared with adequate first aid (RRR 0.836, 95 % CI 0.737-0.948, p = 0.005). Socioeconomic deprivation is inversely associated with adequate burn first aid and positively associated with harmful practices. Targeted public health interventions are needed to address this disparity.