Admission factors associated with the in-hospital mortality of burns patients in resource-constrained settings : a two-year retrospective investigation in a South African adult burns centre
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Objective: Little is known concerning the factors associated with in-hospital mortality of
trauma patients in resource-constrained settings, not least in burns centres. We investigated
this question in the adult burns centre at Tygerberg Hospital in Cape Town. We further
assessed whether the Abbreviated Burn Severity Index (ABSI) is an accurate predictive score
of mortality in this setting.
Methods: Medical records of all patients admitted with fresh burns over a two-year period
(2015 and 2016) were scrutinized to obtain data on patient, injury and admission-related
characteristics. Association with in-hospital mortality was investigated for flame burns
using logistic regressions and expressed as odds ratios (ORs). The mortality prediction of the
ABSI score was assessed using sensitivity and specificity analyses.
Results: Overall the in-hospital mortality was 20.4%. For the 263 flame burns, while crude ORs
suggested gender, burn depth, burn size, inhalation injury, and referral status were all
individually significantly associated with mortality, only the association with female gender,
not being referred and burn size remained significant after adjustments (adjusted ORs = 3.79,
2.86 and 1.11 (per percentage increase in size) respectively). For the ABSI score, sensitivity and
specificity were 84% and 86% respectively.
Conclusion: In this specialised centre, mortality occurs in one in five patients. It is associated
with a few clinical parameters, and can be predicted using the ABSI score.
Description
CITATION: Boissin, C., et al. 2019. Admission factors associated with the in-hospital mortality of burns patients in resource-constrained settings : a two-year retrospective investigation in a South African adult burns centre. Burns, 45(6):1462-1470, doi:10.1016/j.burns.2019.03.005.
The original publication is available at https://www.sciencedirect.com
The original publication is available at https://www.sciencedirect.com
Keywords
Burns and scalds -- Patients -- Mortality -- Developing countries, Burns and scalds -- Treatment-- Developing countries, Hospitals -- Admission and discharge -- Developing countries, Abbreviated Burn Severity Index
Citation
Boissin, C., et al. 2019. Admission factors associated with the in-hospital mortality of burns patients in resource-constrained settings : a two-year retrospective investigation in a South African adult burns centre. Burns, 45(6):1462-1470, doi:10.1016/j.burns.2019.03.005