Epidemiology and outcome of burns: early experience at the country's first national burns centre

Abstract

This study aims to document the epidemiologic pattern and outcome of burn injuries in the country's first national burn centre. This case series study was conducted over a 2-year period at Burns Care Centre (BCC), Pakistan Institute of Medical Sciences (PIMS), Islamabad. The study included all burn injury patients who primarily presented to and were managed at the centre. Those patients who presented more than 24 h after injury or those who were initially managed at some other hospital were excluded from the study. Initial assessment and diagnosis was made by thorough history, physical examination and necessary investigations. Patients with major burns, high voltage electric burns and those needing any surgical interventions were admitted for indoor management. Patients with minor burns were discharged home after necessary emergency management, home medication and follow-up advice. The sociodemographic profile of the patients, site of sustaining burn injury, type and extent (total body surface area (TBSA), skin thickness involved and associated inhalational injury) of burn and outcome in terms of survival or mortality, etc., were all recorded on a proforma. The data were subjected to statistical analysis. Out of a total of 13,295 patients, there were 7503 (56.43%) males and 5792 (43.56%) females. The mean age for adults was 33.63±10.76 years and for children it was 6.71±3.47 years. The household environment constituted the commonest site of burns (68%). Among all age groups and both genders, scalds were the commonest burns (42.48%), followed by flame burns (39%) and electrical burns (9.96%). The affected mean TBSA was 10.64±11.45% overall, while for the hospitalised subset of patients the mean TBSA was 38.04±15.18%. Most of the burns were partial thickness (67%). Inhalation injury was found among 149 (1.12%) patients. Most of the burns were non-intentional and only 96 (0.72%) were intentional. A total of 1405 patients (10.58%) were admitted while the remainder 11890 patients (89.43%) were managed on an outdoor basis. The mean hospital stay was 12.16±6.07 days (range 2-73 days). There were 197 deaths among the hospitalised patients constituting a 14% mortality rate for the hospitalised subset of patients, while there was an overall mortality rate of 1.48% for the entire study population.