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Nduagubam OC, Mba UC, Onumaegbu OO, Onah II, Chukwubuike KE, Bisi-Onyemaechi AI, Agwu S. Paediatric burn injuries in Enugu, South-East Nigeria: A 7-year multi-centre retrospective review. Burns 2022; 48:432-439. [PMID: 34001387 DOI: 10.1016/j.burns.2021.04.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 04/24/2021] [Accepted: 04/29/2021] [Indexed: 12/14/2022]
Abstract
Burn injuries contribute significantly to childhood morbidity and mortality. This study was designed to document the pattern of presentation and outcome of pediatric burn injury in Enugu. METHODS All children with burn injuries over a 7-year period (June 2011 to May 2018) and were managed at three tertiary health institutions, were studied. Information including their socio-demographics, clinical features and treatment outcome were obtained and analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0. RESULTS 198 out of 201 records were available for analysis. Most (186; 93.9%) burn injuries occurred at home. Hot liquid (112; 56.7%) was the commonest cause of burn injury. A lot of substances were used topically for first aid, raw eggs (52; 31%) being the commonest. The outcome had significant association with cause of injury, depth of injury, total burn surface area (TBSA), and inhalation injury. Most were safely discharged home while a total of thirteen (6.6%) children died. LA50 was 54.87%, while the maximum TBSA salvaged was 65%. CONCLUSION Burn injuries in children in this environment remain a serious challenge in the face of widespread lack of awareness regarding safe practices in handling hot and flammable items at home.
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Affiliation(s)
- O C Nduagubam
- Department of Paediatrics, College of Medicine, Enugu State University of Science and Technology, PMB 01660, and ESUT Teaching Hospital, Parklane, PMB 1030 Enugu, Nigeria.
| | - U C Mba
- Department of Surgery, College of Medicine, Enugu State University of Science and Technology, PMB 01660, and ESUT Teaching Hospital, Parklane, PMB 1030 Enugu, Nigeria; Department of Plastic Surgery, National Orthopaedic Hospital, PMB 01294, Enugu, Nigeria.
| | - O O Onumaegbu
- Department of Surgery, College of Medicine, University of Nigeria, and UNTH Ituku-Ozalla, PMB 01129, Enugu, Nigeria.
| | - I I Onah
- Department of Plastic Surgery, National Orthopaedic Hospital, PMB 01294, Enugu, Nigeria; Department of Surgery, College of Medicine, Enugu State University of Science and Technology, PMB 01660, and ESUT Teaching Hospital, Parklane, PMB 1030 Enugu, Nigeria.
| | - K E Chukwubuike
- Department of Surgery, College of Medicine, Enugu State University of Science and Technology, PMB 01660, and ESUT Teaching Hospital, Parklane, PMB 1030 Enugu, Nigeria.
| | - A I Bisi-Onyemaechi
- Department of Paeditrics, College of Medicine, University of Nigeria, and UNTH Ituku-Ozalla, PMB 01129, Enugu, Nigeria.
| | - S Agwu
- Department of Paediatrics, College of Medicine, Enugu State University of Science and Technology, PMB 01660, and ESUT Teaching Hospital, Parklane, PMB 1030 Enugu, Nigeria.
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Romanowski KS, Sen S. Wound Healing in Older Adults With Severe Burns: Clinical Treatment Considerations and Challenges. BURNS OPEN 2022; 6:57-64. [PMID: 35571008 PMCID: PMC9104500 DOI: 10.1016/j.burnso.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: The older adult population continues to rapidly expand in number, with a projection by the United States (US) Census Bureau that there will be more individuals older than > 65 years (77.0 million) than those younger than < 18 years (76.5 million) by 2034. This review provides an overview of aging as it relates to wound healing and burn injuries in older adult patients, summarizes current treatment practices, and addresses the key challenges and considerations for treating severe burn injuries in this specific patient population. Materials and methods: A narrative literature search was conducted, focusing on recent primary literature on burns and wound healing in elderly patients. Results: Studies showed that the aging process results in both physiologic (eg, nutritional and metabolic status) and anatomic changes (eg, thinning dermis) that contribute to a reduced capacity to recover from burn-injury trauma compared with younger patients. Owing to impaired vision, decreased coordination, comorbidities, and medication-induced side effects, older adults (ie, > 65 years) are susceptible to severe burn injury (deep-partial thickness and full-thickness), which is associated with significant morbidity and mortality. Conclusion: A better understanding of the effects of age-related changes regarding wound healing in older adult patients who incur severe burn injuries may provide insight into clinical strategies to improve outcomes among this population.
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Lam N, Hung N, Duc N, Luong N. Epidemiology And Risk Factors For Death Of Pediatric Burns In A Developing Country. An Experience From The National Burn Hospital. ANNALS OF BURNS AND FIRE DISASTERS 2021; 34:213-217. [PMID: 34744535 PMCID: PMC8534302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/13/2021] [Indexed: 06/13/2023]
Abstract
This retrospective study investigated burn features and predicted factors for death of pediatric burn patients in Vietnam. The results showed that pediatric burn accounted for 48.1% of total admitted burn patients. Preschool children and boys were predominant, burns were mostly caused by scald (76.2%) and the majority of patients lived in a rural area (64.1%). In addition, 94.5% had burn size less than 30% total body surface area and deep burn injury was seen in 45.5% patients. Moreover, a significantly higher incidence of deep burn injury was recorded in preschool age, patients living in a rural area, and non-scald burn. Overall LA50 was 81.5% and a significantly higher mortality rate was seen in non-scald burns, older children, extensive burn and inhalation injury. Multivariate logistic analysis indicated that only burn extent and inhalation injury were independent risk factors for death. An increased 1% of burn extent resulted in a .7 probability unit of death (OR=1.08) and this was 2.16 in the case of inhalation injury (OR=8.67). This health issue should be highlighted in order to develop appropriate policies and intervention measures in developing countries.
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Affiliation(s)
- N.N. Lam
- National Burn Hospital, Hanoi, Vietnam
- Medical Military University, Vietnam
| | - N.T. Hung
- National Burn Hospital, Hanoi, Vietnam
| | - N.M. Duc
- National Burn Hospital, Hanoi, Vietnam
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Robledo Cadavid JM, Salgado Flórez L, Garcés Echeverri JC, Ruiz Santacruz JE, Hernandez Ortiz OH. Characterization of severely burned patients and evaluation of factors associated to mortality. An observational retrospective cohort study in San Vicente Fundación Hospital. TRAUMA-ENGLAND 2021. [DOI: 10.1177/14604086211046464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Burns are common in developing countries and place a large burden on the medical and social care systems. However, information about management and outcomes from such countries is scarce. The purpose of this study was to analyze the epidemiology and main factors related to the mortality in severely burned patients at the Hospital Universitario San Vicente Fundación in Medellín, Colombia. Methods An observational retrospective cohort study was conducted. To establish prognostic factors associated with mortality, we analyzed variables such as age, sex, burned surface, and degree of burn, among others. Demographic, clinic, and management features as well as complications and factors associated with mortality were analyzed using logistic regression. Results 4516 clinical histories were reviewed, 225 were included in the study. 76.9% were men, with a median age of 35 years; 64.9% were fire burns. The median burned body surface area was 42%. There were inhalation injuries in 135 patients and ocular in 106 patients. The main complication was infection followed by rhabdomyolysis. The overall hospital stay was 27 days, and the median length of stay at the intensive care unit was 7 days with in-hospital mortality of 30.7%. The variables associated with mortality were age, burned body surface area, degree of burn, and kidney injury. Surgical intervention was protective. Conclusions Severely burned patients in our hospital have similar outcomes and, in some cases, better outcomes than those reported in the literature in countries with similar characteristics, and we have seen that in the last years, there has been a better experience in the management of these patients. Elderly, extension, and depth of burnt tissue are markers of poor outcomes. Early surgery and intubation have shown better outcomes, probably due to infection control and removal of necrotic tissue, airway management, and ventilatory support for metabolic and hemodynamic derangement.
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Hashemi SS, Mahmoodi M, Tohidinik HR, Mohammadi AA, Mehrabani D. The Epidemiology of Burn and Lethal Area of Fifty Percentage (LA50) in Children in Shiraz, Southern Iran. World J Plast Surg 2021; 10:66-70. [PMID: 33833956 PMCID: PMC8016374 DOI: 10.29252/wjps.10.1.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study was conducted to assess the epidemiology of burn and lethal area of fifty percentage (LA50) in children in Shiraz, Southern Iran. METHODS In this case series study, 619 hospitalized burn children from burn centers affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2012 to 2016 were enrolled. Demographic characteristics of patients such as age, gender, place and cause of burn, and morality rate were evaluated. LA50 was measured using Probit analysis. RESULTS The mean age of patients was 4.4±3.4 years. The mortality rate in burn patients was 8.7% and LA50 of total body surface area (TBSA%) ranged from 40.1% in 2012 to 68.3% in 2016. Although the number of male burn patients (65%) was more than females (35%), the mortality rate in females was more than males (11.4% vs. 7.2%). Scald and flame were the most common causes of burn. CONCLUSION The findings in our burn center comparing burn patients to developed countries showed that LA50 and survival rate were lower denoting to an urgent necessity to promote current policies in burn care and prevention and to decrease the mortality rate too.
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Affiliation(s)
- Seyedeh-Sara Hashemi
- Burn and Wound Healing Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Mahdukht Mahmoodi
- Burn and Wound Healing Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Hamid Reza Tohidinik
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Mohammadi
- Burn and Wound Healing Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Davood Mehrabani
- Stem Cell Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Stefani K, Wagstaff MJD, Damkat I, Greenwood JE. Mortality data 2004-2019: an audit of the Royal Adelaide Hospital Adult Burn Service. ANZ J Surg 2020; 91:77-82. [PMID: 33135870 DOI: 10.1111/ans.16349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/30/2020] [Accepted: 09/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Burns are complex, multifaceted injuries that can pose significant challenges to the treating team. The Royal Adelaide Hospital (RAH) Burns Service has undergone a major evolution over the past two decades, with perceived improvement in outcomes. We present here a longitudinal audit of the RAH Burns Service Mortality Data between 2004 and 2019. METHODS An audit was conducted of all index admissions to the RAH Burns Unit from 1 January 2004 to 31 December 2019. Age at admission, total body surface area, burn depth, presence of inhalation injury and outcome were recorded. Baux and revised Baux Scores were calculated. Lethal Area 50% for different time points and age groups, Baux50/100 and Revised Baux50/100 values were then calculated using logistical regression. RESULTS During 2004-2019, there were 5653 index admissions to the RAH Burns Unit. The mean total body surface area of burn injuries admitted was 5.1% and the survival rate was 99.17%. The Lethal Area 50% for the study period was 74%, with an improvement from 70% (2004-2011) to 80% (2012-2019). The Baux50 score for the time period was 120 and the Revised Baux50 was 129. CONCLUSION The RAH results are comparable with other high-income country Burn Services and demonstrated significant improvement across the study period. The data also highlight areas for ongoing focus such as the elderly burns patient.
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Affiliation(s)
- Kristian Stefani
- Adult Burn Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Marcus J D Wagstaff
- Adult Burn Service and Department of Plastic and Reconstructive Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Ivo Damkat
- Strategic Analyst, Department of Education, SA Government, Adelaide, South Australia, Australia
| | - John E Greenwood
- Adult Burn Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Nguyen N, Ngo M. Profile and outcome of burn injuries amongst preschool children in a developing country. ANNALS OF BURNS AND FIRE DISASTERS 2019; 32:267-271. [PMID: 32431575 PMCID: PMC7197912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 10/06/2019] [Indexed: 06/11/2023]
Abstract
The aim of this study was to investigate characteristics, outcomes and risk factors for death from burn in preschool children. A retrospective study was conducted on 3688 preschool burn children admitted to the National Burn Hospital from 1/1/2016 to 31/12/2018. Collected data included patient demographics and burn characteristics. Bivariate and multivariate analysis was conducted to determine independent risk factors for death. Results showed that preschool children accounted for 78.8% of total admitted burn children. The main causal agent was scald. Boys were predominant, and 76.5% patients lived in rural areas. The highest number of burn accidents occurred in winter. In addition, average burn surface area was of 8.8% total body surface area (TBSA) and 43.5% of patients suffered deep burn injury. Overall mortality rate was 0.5% with LA50 of 81.7% and 49.1% for full thickness burn area. A significantly higher mortality rate was seen in patients with inhalation injury. Compared to survivors, patients who died had a significantly larger burn surface area and larger deep burn area. Multivariate logistic analysis for death indicated that presence of inhalation injury and increased burn extent were independent risk factors for death. Inhalation injury resulted in a 3.4 probability unit of death. In conclusion, preschool burn injuries were more common in boys living in the countryside and were mostly caused by scald, with a high proportion of deep injuries. Except for in cases of extensive burn, inhalation injury was not common but was still the main cause of death.
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Sarbazi E, Yousefi M, Khami B, Ettekal-Nafs R, Babazadeh T, Gaffari-fam S. Epidemiology and the survival rate of burn-related injuries in Iran: a registry-based study. ANNALS OF BURNS AND FIRE DISASTERS 2019; 32:3-9. [PMID: 31285727 PMCID: PMC6588330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/16/2019] [Indexed: 06/09/2023]
Abstract
Burns are considered an important preventable fraction of injuries in low and middle-income countries, and are still a leading cause of death in Iran. This study investigates features of burns in Sina Hospital's Burn Centre in East Azerbaijan Province in order to calculate survival and mortality rates as well as factors affecting mortality in this centre. In this cross-sectional study, demographic characteristics of patients such as age, sex, cause of burns, type of burns, length of stay (LOS) in the hospital, total body surface area (TBSA), anatomic distribution of burn, mortality rate and final status of patients at the time of discharge from hospital (recovery, death) were investigated. The total mortality rate was 6.84%. Hot liquid burns and gas cylinder explosion burns were among the most common. Burns on multiple regions of the body (45.9%) and pelvic and lower limb burns (22%) constituted the next most common injury. In the TBSA index, compared to reference categories (extent of burn less than 50 percent), the categories of 50-59, 60-69, 70-79, 80-89 and over 90 percent indicated lowest survival based on the Log-Rank test. Hazard ratio for burns greater than 10% was 15.33 fold. Total body surface area burned of over 10% constantly increases the instantaneous risk of mortality therefore there is a need to enhance the quality of care provided to burn victims.
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Affiliation(s)
- E. Sarbazi
- Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M. Yousefi
- Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - B. Khami
- Urmia University of Medical Sciences, Urmia, Iran
| | - R. Ettekal-Nafs
- Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - S. Gaffari-fam
- Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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PERIOPERATIVE MEDICINE - A NEW FIELD OF SEVERE BURN INJURY TREATMENT. WORLD OF MEDICINE AND BIOLOGY 2018. [DOI: 10.26724/2079-8334-2018-4-66-108-112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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