Seasonal impact in burn profiles in a dedicated burn unit

Abstract

Introduction: The number of burns in Portugal remains considerably large and therefore constitutes a major public health problem. There is a shortage of studies describing the epidemiological and clinical impact of seasonality on burn centre admissions, particularly in high income countries.

Methods: This retrospective analysis included all patients (>18 years old) with acute burns admitted to a specialized Burn Center in Lisbon (Hospital São José) between 20 of September 2010 and 19 of September 2017 (7 years). Clinical data was obtained from electronic medical records. The patients were categorized into four groups, according to each season.

Results: Six hundred and sixteen (616) patients were included in this analysis, the majority being male (55.2%). There were no significant differences between the number of patients admitted in each season nor in gender distribution. Older patients were admitted during winter. Hospitalisation time was higher for patients admitted in the winter and surface area injured was higher for those admitted during summer. Fire burns were the most common aetiology in all seasons. Work related burns and suicide attempts were more frequent in the summer. Most patients had more than one anatomical area affected (73.9%) and winter was specifically associated with more frequent isolated lower limb burns. Winter and fire burns were associated with deeper injuries. More patients underwent surgery during winter (80.7%) than in the remaining seasons (average 65%) but the average number of surgeries per season did not change significantly. The overall mortality rate was 6.8% and the need for mechanical ventilation was 28.9%. Concerning both variables we did not find major differences across seasons. Mortality was associated with older patients, deeper and more extensive burns and need for mechanical ventilation.

Conclusion: Winter seems to be associated with older patients and with the most severe burns (deeper and more often needing surgery). This study was designed to fill the gap in seasonal burn profile in Portugal and it helps in establishing preventive strategies and better resource allocation.

Keywords: Burn unit; Length of hospital stay; Mortality; Portugal; Season; Winter.