The demographics and outcomes of burn patients admitted to Worcester Hospital

Abstract

Background: Worcester Hospital is a regional healthcare facility in the Western Cape, South Africa, without a dedicated burns unit. Currently there is  limited data available of burns patient management outside of academic institutions in South Africa. To describe the incidence and demographics, and to  determine the outcomes of burn patients admitted to Worcester Hospital.

Methodology: A retrospective descriptive study of burn patients admitted to Worcester Hospital between 1 September 2016 and 31 August 2017.

Results: A total of 66 burn patients were included in this study which accounted for 1.6% of the total surgical admissions for this time period. The mean  age of the patients was 39 (SD ± 19) years with a male predominance (59%). The mechanism of burn was mostly flame burns (71%); 16 patients (24%)  were burned with hot fluids and 3 patients (5%) sustained electrical burns. The median TBSA was 9% (IQR: 5–28). Ten patients (15%) required critical care  unit admission. The burn patients’ median length of stay was 6 days (IQR: 2–11 days) versus 2 days (IQR: 1–5 days) for non-burn general surgery patients.  Fifty burn patients (76%) required surgical intervention comprising of either debridement or skin grafting, or a combination of this. Forty-four patients  (67%) underwent skin grafting procedures and the median TBSA grafted was 5% (IQR: 3.5–9.5). The median time from admission to first surgical  procedure was 25 hours (IQR: 18.33–51.08). The in-hospital mortality rate was 23% and of the 15 mortalities, 9 patients (60%) had TBSA of 30% or more  and therefore classified as a major burn.

Conclusion: Burn injuries treated at Worcester Hospital are often severe and require significant resources. This  study supplies critical information regarding the burden of burn related injuries managed at a regional level.