BURN PATIENTS;

Causes of death and factors affecting mortality a 4 years study at a tertiary care hospital

Abstract

Aim: To determine major risk factors of mortality and causes of death in patients presented with burn injury. Study design:
Prospective Descriptive Study. Setting and duration: Department of Burns and Plastic Surgery, Khyber Teaching Hospital, Peshawar,
Pakistan from April 2008 and June 2012. Methodology: A prospective descriptive study was performed among the patients who
admitted to the Department of Burns and Plastic Surgery, Khyber Teaching Hospital, Peshawar, Pakistan between April 2008 and June
2012. All relative information was collected through a detailed proforma and patient’s treatment files. Patients of any age, any degree of
burns and burns exceeding 10% TBSA were included. Patients presenting after more than one week post burn or patients referred from
other hospitals were excluded. Within this period, demographic data, treatment, and outcomes of treatment were reviewed and analyzed.
Survivors and non-survivors among burn patients were compared to define the predictive factors of mortality. Results: Between April
2008 and June 2012, 1850 patients were admitted with burn injuries. There were 1150 male patients (62%) and 700 female patients
(38%). Mean age was 36 years with range of 1-70 years. Inhalation injuries were present in 45 patients (2.40%). Causes were flame
burns (65.0%), electrical burns (15%), scalds (13%) and chemical burns (7.0%). The total body surface area (TBSA) burn ranged from
10- 100%, with a mean of 38% TBSA burn. Mean length of hospital stay was 12 days (ranging from 24 hours to 170 days). Mortality rate
was 11.2%. Higher age, larger burn area, wound infection, longer hospital stay and the presence of multi-system organ failure
significantly predicted increased mortality. Conclusions: Prevention is a key factor in reducing the morbidity and mor tality associated
with burn injury. A campaign to educate people that burns can be prevented will be important in our community. The prevention of multiorgan
failure and septicemia are likely to be more effective than their treatment.