Factors influencing outcomes in a resourceconstrained burns unit

Abstract

Background: The treatment of burns is expensive and especially burdensome in low-income countries. We evaluated factors influencing short-term outcomes in a designated adult burns unit in a low- to middle-income country.

Methods: A retrospective analysis of burn injury patients in an adult burns unit was undertaken. Patient and burn characteristics were evaluated as predictors of short-term in-hospital outcomes, namely mortality and length of hospital stay. The effects of the type of burn and severe burn injury were analysed separately. We analysed admission to ICU as a marker for resource availability.

Results: Nine hundred and eighty-two patients were included. The mean TBSA was 15%, the LA5O 51% and the mortality rate 10.8%. The most common cause of injury was flame burn. Greater age (< 0.001), increased TBSA (< 0.001) and inhalation injury (< 0.001) were significantly associated with mortality, as were flame and electrical burns. Not all patients with inhalation injury or with severe burn injury were admitted to ICU. Length of hospital stay was prolonged only by TBSA (< 0.001). Age above 50 years was not associated with increased mortality (0.34) in severely burned patients. Hospital stay was marginally prolonged in patients with electrical burns.

Conclusion: The LA5O is lower, length of stay longer, and mortality greater than ideal. Outcomes were predicted by greater age and TBSA, inhalation injury, flame and electrical burns. System constraints resulted in insufficient ICU admission and prolonged hospital stay.