Epidemiology and mortality of burns in a general hospital of Eastern Sri Lanka

This 2-year prospective study examined the epidemiology and mortality of 345 patients admitted with burn injuries. Sixty-four percent of all burns were accidental in nature and at least 25% were self-inflicted. The rest were due to assaults or had a doubtful cause. The median age was 22 years. Forty-one percent of the accidents were due to the fall of a homemade kerosene bottle lamp. The main cause was flames, followed by scalds. Females outnumbered males in all categories of burns except cases of assault, and suffered from a higher mortality. Most at risk of accidental burns were children between 1 and 4 years, who suffered primarily from scalds. Self-inflicted burns were most common among women aged 20–29 years. The overall median total body surface area (TBSA) burned was 16%. Self-inflicted and ‘doubtful’ burns were much more extensive and more often fatal than accidental ones. The overall mortality rate was 27%. Burns involving more than 50% of the body surface area were invariably fatal. Mortality was highest in the elderly and in the 20–29 years age group. Burns were the first single cause of mortality in the surgical wards. The case is made for the establishment of more Burns Units.     

Paediatric burns in Kuwait: incidence, causes and mortality

From a prospective study on burn patients admitted at the Burn Center in Kuwait during 1993-2001, 826 paediatric burn cases, in 0-14 years age group, were retrieved to study incidence, causes, and mortality among children. The demographic characteristics, clinical features, and outcome constituted our data file in Statistical Software, SPSS. Overall incidence rate was 17.5/100,000 children aged 0-14 years, being almost twice (34/100,000) among those between 0 and 4 years, constituting 70.8% of all paediatric burns. Scald was the main cause of burn (67%), followed by flame (23%). Mean age (6.4 years) of children with flame burns, was significantly higher (p < 0.001) than those with scalds, or other causes. A positive significant correlation existed between duration of hospital stay and TBSA% (r = 0.56, p < 0.001). Overall mortality rate was 0.23/100,000 children, maximum (0.52/100,000) being in children below 5 years. Among 11 (1.3%) non-survivors, flame burns caused nine fatalities. Multiple logistic regression mooring predicted children aged < 5 years, flame burns and TBSA >or= 70%, (OR = 29.2, p < 0.001), as main contributing factors to fatal outcome among children. Gender and nationality had no influence on incidence or mortality. These findings will hopefully stimulate development of targeted and sustainable interventions for reducing burns occurrence among identified paediatric high-risk groups.     

Enzymatic debridement in scalds is not as effective as in flame burns regarding additional eschar excision: A retrospective matched-control study

ObjectiveEnzymatic debridement of burn eschar became an accepted and widely used technique for burn wound treatment over the last years. However, this practice is not exempt from failure and recent experimental studies indicate that it may not be as efficient in scalds as in flame burns.MethodsPatients that were admitted to the burn intensive care unit between June 2017 and February 2021 and received enzymatic debridement within the first 72 h after scald and flame burn were included. Patients with scald burns were matched regarding age, sex and per cent total body surface area (%TBSA) burned in a 1:2 ratio with patients presenting with flame burns.ResultsEighteen patients with scald burns were matched with 36 with flame burns. After matching, both groups were similar in terms of age (flame burns 44.5 ± 21.1 years vs. scald 41.8 ± 22.6 years, p = 0.666), and %TBSA burned (11.0 ± 8.2% vs. 10.6 ± 9.6%, p = 0.851). Patients with scald burns significantly more often underwent further surgical eschar excision compared to controls (scald 16 (88.9%) vs. flame 19 (52.8%), p = 0.016). Length of stay per %TBSA was significantly longer in scald burns (scald 7.8 ± 9.2 days vs. flame 3.7 ± 3.8, p = 0.013).ConclusionThis study indicates that enzymatic debridement may not be as effective in scalds as in flame burns. It was shown that patients with scalds and subsequent enzymatic debridement more frequently underwent additional surgical intervention and that the size of the transplanted area was larger compared to control. Moreover, those patients had a longer length of stay at the hospital per %TBSA burned.     

Paediatric burns in Jaipur, India: an epidemiological study.

This retrospective review contains 127 paediatric burns up to 14 years of age admitted to the Burn Unit of the Department of Burns and Plastic Surgery, SMS. Medical College, Jaipur over a period of 1 year from January 1990. Epidemiological data include age, sex, seasonal variation, place of burn, family size, economic status, period of time between the accident and admission to hospital. The cause and mode of burn, the relationships between mortality and age, cause of burn and extent of burn are discussed. Most of the burn injuries occurred in the winter months between December and March. Males were affected predominantly. The majority of the burns occurred at home. Most of the patients belonged to the low socioeconomic strata and were members of medium or large size families. The commonest causes of injury were scalds in children under 5 years of age and flames in the older children. The overall mortality was 19.68 per cent.     

Epidemiology and mortality of burns in the South West of Iran

Burn injuries still produce a significant morbidity and mortality in Iran. This study was carried out to analyze the epidemiology, mortality, and current etiological factors of 2043 burn patients who were admitted to the burn centers in the Fars province during 4 years (1994-1998). There were two burn centers in the Fars province serving 3817036 people over an area of 124,000 km(2). The overall incidence rates of hospitalization and death were 13.4 and 4.6 per 100000 person-years. The mean age was 21.9 years, and 51% of patients were children under 19-years-old. The highest rates of hospitalization and death were observed in the elderly (80 years). Also young females (20-29 years) had a high rate of hospitalization. Thus, 55% of the patients had BBS less than 40%. Burn injuries were more frequent and larger with higher mortality in females than in males (P<0.0001). There was also statistically significant correlation between age groups, gender, and BBS with mortality rate (P<0.0001). Flame was the most common etiology of burns. There was also significant correlation between age groups and type of burns (P<0.0001). Suicide attempts for all the patients > or = 11 years were the cause of 41.3% (256/620) of the burns involving women and of 10.3% (40/388) of the burns involving men. The overall case fatality rate was 34.4%. The mortality rate was significantly higher for self-inflicted burns (78%) than for accidental burns (26.7%). Most of the lesions requiring hospital admission occurred during the winter months. Factors associated with an increase in mortality were suicidal burns, burn size, age, and flame burns. Most of the burn injuries were caused by domestic accidents and were, therefore, preventable.     

Etiology and outcome of pediatric burns in Tabriz, Iran

A 3-year prospective study of burn victims hospitalized at a major burn center was conducted to determine the etiology and outcome of pediatric burns. One thousand one hundred sixty patients under the age of 14 years identified and stratified by age, sex, burn size, presence or absence of inhalation injury, and cause of burn. The mean patient age was 2.2 years, and the male:female ratio was 1.6:1. There were 74 deaths overall (6.4%), the majority of which (44) were among children under 5 years of age. Except for burn incidence, there were no significant differences between males and females. The mean burn size was 19%, and was significantly larger for nonsurvivors than survivors (50.3% versus 16.8%; P<0.001). Inhalation injuries were strongly associated with large burns, and were present in all flame-burn fatalities. Scalds were the most common type of burn among children under 5 years of age; flame burns predominated in older children. There were 39 deaths related to scalds. Large burn size was the strongest predictor of mortality followed by the presence of inhalation injury and the length of time to intravenous access.     

Paediatric ICU burns in Finland 1994-2004

INTRODUCTION: The paediatric burn population requiring intensive care in Finland has never been examined before. The aim of this study was firstly to determine the aetiology, incidence and prognosis of paediatric burns requiring intensive care in Finland and secondly to compare the possible differences between the two national burn centres. METHODS: All burn patients' charts were retrospectively reviewed in two national burn centres from an 11-year-period. Patients whose ICU stay was more than 48h, were included. RESULTS: Forty-five children who were hospitalized in the two burn centres during the study period met the inclusion criteria. They represent 2.4% (45/1898) of all burns victims hospitalized in these burn centres during that time giving an incidence of 0.1/100,000 per year in Finland. The median age was 5 years, every third patient was 0-2 years old and 75.6% were male. Most burns were scalds (42.2%), which caused all burns (100%) in age group 0-2 years. Flame burns were most frequent (83%) in the age group 6-10 years. In the 11-16 years old patients, high voltage/electric burns caused 50% of all burns and flame the other 50%. The overall median TBSA in all burns was 26%. The median (range) hospital stay was 12 days (2-193) (0.88 days/% burned) and the median (range) ICU days was 7 (2-64) (0.29 days/%). Intubation and respirator therapy was needed in 31 (46%) patients. There were no patients who needed haemofiltration or haemodialysis and no mortality. Only six patients (13%) were treated conservatively and 39 (87%) surgically. Dressing changes under general anaesthesia were preferred in Helsinki (37 times) and especially in the paediatric hospital (32 times) compared to Kuopio (7 times). Allografts were used only in Helsinki in 4 patients whereas artificial skin was used only in Kuopio in 15 patients. The overall cost of care was very similar in both centres being 1292-1425 euros per hospital day. CONCLUSIONS: There were some small differences between the two burn centres in treatment policies. Most patients were male and most common aetiology was scald. The prognosis of these patients was excellent with no mortality.     

Management of burns

Burns are common injuries that vary in severity from small superficial scalds to massive full-thickness flame burns with high morbidity and mortality. The purpose of this article is to review common burn presentations, the pathophysiology of these injuries and to give an overview of multidisciplinary burns management from the emergency department through to the specialist burns centre.     

Epidemiological study of burns in Komfo Anokye Teaching Hospital, 2006-2009

Aim

To identify and describe the patterns of burns reported at the Komfo Anokye Teaching Hospital (KATH) from 2006 to 2009 and their outcomes on the various age groups and genders.

Methods

Patients’ records from admission and discharge books of the Burns Intensive Care Unit, Polyclinic Casualty Consulting Rooms and from the Statistical Department of KATH were reviewed to obtain the necessary data for this retrospective study. Data entry and analysis were done by using SPSS version 17.0.

Results

A total of 731 patients’ records were reviewed, with male to female ratio of 1.2:1. The mean age was 15.83 years; range was 0–79 years. Children less than 10 years were the most frequently admitted group (53.5%). Most of the burns occurred in domestic settings (88.5%), whiles, majority of the burns were accidental (98.8%). Scalds (57.4%) were the most frequent cause of burns followed by open flame (38.2%). The mortality rate was 13.1% for the period under review. Majority (71.4%) of the patients spent less than 10 days on admission. The mean total body surface area (TBSA) was 24.79%, and there was significant correlation between TBSA, age group, outcome and duration of hospital admission.

Conclusion

Children less than 10 years were the most vulnerable victims to burns; males dominated the number of victims. The commonest aetiological factor was scalds, with most of them related to inattention from parents. More dedicated burn surgeons and properly trained nurses are needed at KATH. Ambulance and pre-hospital services should be increased with adequate number of paramedics. Coordination between district hospitals and tertiary burn centres should also be established, for the proper transfer of burn cases to the tertiary burn centres, especially KATH.     

Epidemiology of burns presenting to an emergency department in Shiraz,South Iran

A retrospective study of 1493 burn patients attending the Ghotbeddin emergency burn center in Shiraz, South Iran during the 1 year period 2001-2002 was undertaken in order to describe the epidemiological features of burns in Shiraz. The following results were obtained: the mean age of attendees was 21.84+/-19.05 with an overall male to female ratio of 1.12. 41.2% of patients were children under 15 years with a M/F ratio of 1.36. The main causes of burns were scalds (53%) followed by flame (25%). The frequency of scalds was much higher among children (70%). The majority of accidents (81%) occurred at home, 5.2% occurred in workplace and domestic accidents were more frequent among women. The mean total body surface area (TBSA) burned was 7.4+/-14.3%. Extensive TBSA had a significant association with flame burns and sex, showing that female patients have higher risk for more extensive burns. Finally, there was a significant seasonal variation for burns, with most burns occurring in winter months.     

Management of burns

Burns are common injuries that vary in severity from small superficial scalds to massive full thickness flame burns with high morbidity and mortality. The purpose of this article is to review common burn presentations and the pathophysiology of these injuries. In addition it gives the reader an overview of burns management from the emergency department through to the specialist burns centre and describes the latest multidisciplinary approach to treating these injuries.     

Management of burns

Burns are common injuries that vary in severity from small superficial scalds to massive full-thickness flame burns with high morbidity and mortality. The purpose of this article is to review common burn presentations and the pathophysiology of these injuries. In addition it gives the reader an overview of burns management from the emergency department through to the specialist burns centre and describes the latest multi-disciplinary approach to treating these injuries.     

Epidemiology of burns undergoing hospitalization to the National Burns Unit in the Sultanate of Oman: A 25-year review

Aim

The aim of this study was to describe the epidemiology of burns admitted to the National Burns Unit (NBU) in the Sultanate of Oman between 1987 and 2011.

Methods

This is a retrospective review of burn patients admitted to Oman's National Burns Unit (NBU) between 1987 and 2011. The data extracted from the national burn registry. The study describes the admission rate by gender and age groups, occupation, causes of burns, time-to-admission, length of stay and in-hospital mortality of burns between 1987 and 2011.

Results

During a 25-year from 1987 to 2011, there were 3531 burn patients admitted to the National Burns Unit in Oman. The average admission rate to NBU is 7.02 per 100,000 persons per year. On average, males were more likely to be admitted to the NBU than females during the study period (P value < 0.04). Patients aged 1–10 years old constituted 46.6% of caseload during the study period. Flames and scalds caused 88.4% of burns. About half of all patients admitted to the NBU have burns to more than 11% of total body surface area (TBSA). The average stay in hospital was estimated to be 15.3 days per patient. The average in-hospital mortality rate was estimated to be 8.2% per year (range 1.9–22%).

Conclusion

Burns are significant public health issue in the Sultanate of Oman. Children are disproportionately over-represented in this study. Prevention programmes are urgently needed to address this “silent and costly epidemic.”     

Pattern and outcome of children admitted for burns in Benin City, mid-western Nigeria

Children are a vulnerable to burns, an injury, which is often preventable. A study of the profile of cases of children admitted for burns will provide background information to suggest locally doable preventive strategies as well as supply basic information for future reference. We studied the records of 62 children aged 0-16 years, admitted for burns, at the University of Benin Teaching Hospital, Benin City, between January 2002 and December 2006. There were 34 male and 28 female children. Children under three years constituted 56.5%. Whereas the leading cause of burns in all the children was flame burns from kerosene explosions (52%), scalds were responsible for 68.6% of cases in those under three. The extent of burn injury ranged from 6 to 50% and most of them presented late. 64.6% were discharged within three weeks. Wound sepsis and post burn contractures were the most frequently encountered complications (19.4% and 9.7% respectively). There were two deaths (3.2%) related to sepsis. Particular attention to burn safety precautions in children (especially, in the >3 years age group), safer storage and dispensing of combustible chemicals particularly petroleum products is advocated. Fire safety awareness, correct first aid measures and early presentation in the hospital will reduce morbidity and mortality. Early physiotherapy and splinting strategies will reduce contractures. There is the need locally for the establishment of specialized burn centres both to treat these children and to stimulate interest in burn management.     

Epidemiology of burns in Bergen, Norway.

We organised a prospective series to study, the epidemiology and causes of burns in the city of Bergen, Norway. We included 361 patients treated during one year at the casualty centre or at the burn centre at the hospital. Thirty-six per cent (n = 131) of the patients were less than 15 years old, and 9% (n = 33) were over 60. The incidence of burns was 17/10,000 inhabitants, 0.7 for patients who were admitted and 17 for outpatients. Burns were most common among male subjects aged 40 years or less, while women were more at risk in the older age groups. Almost half the injuries were caused by scalds, and 92 (26%) were from contact with hot surface. Scalds were more common among women than among men, while firework and flame burns were more common among men. Burns occurred at home in 227 patients (63%), at work in 58 (16%), and during leisure activities in 76 (21%). The mean surface area burned was 3.5% total body surface area (TBSA); patients who were admitted had a TBSA of 18% compared with 1.8% among those treated as outpatients.     

An epidemiological study of 1063 hospitalized burn patients in a tertiary burns centre in Hong Kong

A total of 1063 acute burn patients were admitted to the Burns Unit of Prince of Wales Hospital, Hong Kong between March 1993 and February 1999. There were 678 males and 385 females with a male to female ratio of 1.76:1. The median age was 13.1 year-old and the median burn size was 6% total body surface area (TBSA). Pediatric patients under the age of 15 year-old accounted for 550 (51.7%) admissions and 235 (42.7%) of them were toddlers <2 year-old, while adult patients of age above 15 year-old accounted for the other 513 (48.3%) admissions. There was no seasonal variation in admission. Domestic burns resulted in 756 (71.1%) injuries followed by industrial burns that caused 175 (16.5%) admissions. The median hospital stay was 9 days and 54 patients (5.1%) had inhalation injury requiring intubation and ventilatory support. Twenty-four patients died in this series which yielded a mortality rate of 2.3%. The median age for this mortality group was 46.6 year-olds with a median extent of burns of 68% TBSA. There were 16 males and 8 females with a male to female ratio of 2:1. Eighteen (75%) patients had flame burns and 15 (83.3%) of them had inhalation injury. The mortality group had significantly larger burn size (P<0.001), higher incidence of inhalation injury (P<0.001) and older age (P<0.001) compared to the survivors.     

Infants under 1 year of age have a significant risk of burn injury

A wealth of data exists concerning paediatric burn epidemiology in general, but very little exists specifically in infants under 1 year of age, a special group in which mobility begins to develop. A retrospective study of all burn admissions of infants under 1 year old to The Welsh Centre for Burns from January 2003 to January 2006 was performed. During the 3-year period there were 104 new burns cases identified which represents 11.8% of all paediatric admissions. 63.5% (66) were treated as inpatients and 36.5% (38) treated as out-patients. Burns increased in frequency with increasing age and occurred mainly in the home. Scalds were the commonest type of burn in 65% (68) whilst the second most common was contact burns which accounted for 30% (31). The most common source of scald was from cups containing hot drinks (39%) and the most common source of contact burn was radiators/hot water pipes (30%). The mean TBSA was 2.3%, (range 0.5-38%). The frequency of burns in the under 1 year old population highlights a need for emphasis of burn prevention directed to this group. Special attention is needed to look at the specific aetiology of these burns. Starting points for prevention should address the number of burns surrounding hot drinks and bottle warming practices in the case of scalds and the dangers of household radiators and hot water pipes in the case of contact burns.     

Burns in patients under 2 and over 70 years of age

A total of 246 consecutive burn patients younger than 2 years and older than 70 years of age admitted to a burn center were reviewed retrospectively to study morbidity and mortality specific to these two age groups. Of these patients, 165 were less than 2 years of age and 81 were over 70 years of age, representing 16% and 8% of the total patient population respectively. In patients under 2, scald burns occurred in 127 (77%) and flame burns in 18 (11%). In patients over 70, flame was the most common burn mechanism, occurring in 64 (79%) patients, while scalds occurred in 12 (15%). The mean total body surface area (TBSA) burned in the younger age group was 13.2% (2.4% full thickness, 10.8% partial thickness) and in the older age group was 25% (12.8% full thickness, 12.2% partial thickness). Only 1 death occurred in the younger age group (0.6% mortality), while 41 deaths occurred in the older age group (50.6% mortality). If the burn involved a total body surface area greater than 40%, all patients died (100% mortality). A total of 36 complications occurred in the younger age group (0.2 complications per patient) and 111 in the older age group (1.4 per patient). Burn wound sepsis was the most common complication in each group, occurring in 28 patients under 2 and 42 elderly patients, and was responsible for the 1 death in the younger age group. Although burn wound sepsis was the most common complication in those patients over 70, cardiovascular and pulmonary complications were the most deadly, accounting for 68% (28 patients) of total deaths in this group.