# Temporal Relationship Between Seasonal Burn Incidence and Clinical Severity in a Long-Term Regional Cohort

## TL;DR

This study finds that in the Qassim region, burn severity in adults increases in winter, while overall burn rates remain stable year-round, especially due to pediatric injuries.

## Contribution

The study reveals a dissociation between seasonal burn admission volume and injury severity in an arid region, emphasizing adult severity in winter.

## Key findings

- Winter admissions had higher median TBSA compared to summer admissions.
- Scald injuries were the most common across all seasons, with no significant severity difference in winter.
- Cultural periods showed predictable injury clustering but no significant increase in admission volume.

## Abstract

Background: Seasonal changes have a measurable impact on burn frequency and clinical implications, yet the relationship with injury severity remains understudied in arid regions. This study evaluated the association between seasonal and cultural burn trends in the Qassim region, focusing on the dissociation between admission volume and injury severity.

Methods: A retrospective registry analysis was conducted for all acute burn admissions to the regional referral center from November 2018 to November 2025 (n=816). Monthly admission volume was examined using negative binomial regression, and injury severity, measured as percent total body surface area burned (%TBSA), was analyzed using RStudio (Posit, Boston, MA). A two-sided p-value < 0.05 was deemed statistically significant. Data were categorized by age, season, and cultural time (Ramadan/Eid).

Results: Injury severity varied significantly by season (p = 0.012). For instance, winter admissions had a higher median TBSA (5%, interquartile range (IQR) 0.3-15%) than summer admissions (median TBSA = 1%; IQR 0.1-13.5%). In contrast, the aggregate admission volume did not differ considerably by season. Pediatric admissions (<15 years, n=322; 39.5%) had a consistent distribution throughout the year, but adult admissions (n=494; 60.5%) had a descriptive spring peak that did not achieve statistical significance after adjustment. Scald injuries (n=359; 44.0%) were the most common mechanism across all seasons, while winter-specific analysis revealed no significant TBSA difference between scald and flame injuries. Cultural periods exhibited predictable temporal clustering but no statistically significant increase in volume.

Conclusion: Burn epidemiology in Qassim is characterized by a stable year-round frequency driven by pediatric injuries, while dissociated from a marked winter increase in injury severity in adults. Prevention strategies should prioritize year-round pediatric safety alongside focused interventions to mitigate severe winter-associated domestic risks.