Predictors of Mortality Among Pediatric Burn Patients in East Africa

Abstract

Little is known about the outcomes of pediatric burn patients in resource-limited and rural locations of the developing world. In March 2013, our pediatric burn unit existing in this setting established an electronic registry of all patients. The authors analyzed the registry to determine overall mortality rates and predictors of mortality, including that of underweight status and body part burned. The secure electronic database of all admissions was reviewed for age, gender, weight, burn percentage (TBSA%), body part burned, cause/place of injury, length of stay, underweight status, surgery performed, reason for discharge, and mortality. Univariable and multivariable logistic regression was used to determine the variables associated with mortality. Kaplan-Meier curves were also analyzed. A total of 211 cases (59.7% male) admitted from March 2013 to June 2014 were reviewed. The median age, %TBSA, and length of stay were 2.0 years (1.3-3.3), 8.0% (5.0-13.4), and 8.5 days (4-14). The overall mortality rate was 15/211 (7.1%). Most injuries were unintentional (93.8%) scalds (85.3%) occurring in the home (98.1%). Two factors were significantly associated with mortality in the final multivariable model: %TBSA (odds ratio = 1.31 for 1% increase in %TBSA; 95% confidence interval = 1.17-1.46) and younger age (odds ratio = 0.20; 0.07-0.63). This study characterizes mortality among patients at a pediatric burn unit serving a rural population in the developing world. The majority of pediatric burns were unintentional scalds occurring in the home. %TBSA and lower age were the strongest predictors of mortality. Burn location and underweight status were not independent predictors of mortality. Overall mortality was 7.1%. These data are applicable to improving outcomes for patients in this burn unit and similar settings of its kind.

Pediatric Burn Outcome; Diagnostic Value of R-Baux and P-Baux Scores

“…Mortality rate was 10% in our study which was consistent with Karimis et al (2013) study results [7]. However, there was a vast diversity in literature in mortality rate which was reported 7.1 % in East Africa [26] to 31.3% in India [27]. It should be noticed that mortality rate is related with burn severity, patients' age and gender distribution, access to care facilities, care quality and also psychological services.…”

Pediatric burn outcome; Diagnostic Value of R-Baux and P-Baux Scores

“…Mortality rate was 10% in our study which was consistent with Karimi et al (2013) study results [6]. However, there was a vast diversity in literature in mortality rate, 7.1 % in East Africa [23] to 31.3% in India [24]. It should be noticed that mortality rate is related to the factors including burn severity, patients' age and gender, access to care facilities, care quality and also psychological services.…”

What's new in critical illness and injury science? Nonaccidental burn injuries, child abuse awareness and prevention, and the critical need for dedicated pediatric emergency specialists: Answering the global call for social justice for our youngest citizens

“…[ 8 ] Within the subset of pediatric trauma, burn injuries (both thermal and in some cases chemical) can be devastating because of their long-term psychological and functional sequelae, as well as the fact that up to 20% of pediatric burns may be nonaccidental in nature. [ 9 10 11 12 ] When treated inappropriately or in an untimely fashion, burn injuries can have severe detrimental effects, especially when combined with preexisting factors such as child malnutrition. [ 9 ] Most burn victims are initially brought to emergency departments, where they are evaluated and treated by emergency physicians prior to the involvement of surgical and wound care experts.…”