Clinical patterns and early outcomes of burn injuries in patients admitted at the Moi Teaching and Referral Hospital, Eldoret

Abstract

Background: Burns are the fourth most common type of trauma worldwide and a major cause of mortality and disability in developing countries. Although burns are common in Kenya, there is still paucity of data on clinical patterns and early outcomes of burn injuries in western Kenya. Description of burn patterns, burn outcomes and associations of outcomes will inform clinical practitioners and improve care of patients with burns. Objective: To describe clinical patterns, early outcomes and associations of burn outcomes among patients admitted at the Moi Teaching and Referral Hospital (MTRH) Eldoret. Methods: A cross-sectional descriptive study was conducted at MTRH between January 2016 and June 2017. A total of 189 patients admitted to the hospital with burns were recruited into the study. An interviewer-administered questionnaire and chart review were used to collect data on sociodemographic variables, burn clinical characteristics and early burn outcomes. Data was presented in charts, graphs and frequency tables. Associations between patterns and early burn outcomes were assessed by binary logistic regression. Results: Of the 182 burn patients whose data was analyzed, 149 (81.9%) were children below 18 years. Majority (75.6%) of burns were due to scalds. The commonest burn locations were the trunk and upper limbs. Only 40.1% of patients received prehospital intervention. The median Total Burn Surface Area (TBSA) was 14.5% and 74.2% of the patients had 2nd degree burns. The median length of hospital stay was 16 days (IQR=33) and commonest complication was wound infection (21.4%). Mortality rate was 9.3%. At multivariate analysis, a TBSA of 20%-30% (p=0.01) was associated with presence of burn complications while a TBSA of >10% (p=0.03) and time from burn to admission (p=0.03) were associated with the length of hospital stay. Conclusions: Majority of burn patients were children and most burns were due to scalds. Although the median TBSA was low, wound infection rate was high and length of hospital stay was relatively long in comparison to other hospitals in the region. TBSA was significantly associated with presence of burn complications and length of hospital stay. Recommendations: Health education of the public to improve on pre-hospital intervention and prompt health care for the burned patient. Further research on the causes of wound infection and factors that influence the development of wound infection in patients with burns.