Factors Influencing Mortality and Outcome of Burns from a Trauma Registry in Nigeria: A Retrospective Study

Background: Burns injury has a global distribution and contributes to trauma mortality and morbidity. Whereas mortality from burns is reducing in most developed countries, the picture in developing countries such as Nigeria still remains gloomy. Better understandings of the pathophysiology of burns and improvement in burns care are reasons for the improved outcome of burns in developed countries. This study aims to identify the factors that influenced mortality and outcome of burns in Port Harcourt Nigeria.

Methods: Retrospective evaluation of data of patients with burns from January 1, 2007 to December 31, 2009 from a regional trauma registry in Port Harcourt Nigeria was undertaken and analysed. Factors observed to be associated with mortality and influenced outcome were determined and presented.

Results: The result of this study showed that of the 301 cases of burns were recorded during the period under observation. Flame burns arising from misadventure with petroleum products (n=188 {62.5%}) had the highest fatality especially when associated with inhalational injury (P <0.0001). The total burnt surface area was the greatest determinant of mortality from burns (R = 0.86, P<0.0001) and all the patients with burnt surface area above 50% died. The observed median lethal surface area of body burnt (LA50) from this study was 32%. Most of the deaths occurred during the first week of burns. The common complications which contributed to death observed during the early phase of burns was fluid and electrolyte derangement from inadequate and or over resuscitation (n=140).

Conclusion: The commonest determinant of fatality from burns was the total surface area burnt. Flame burns contributed to a sizable number of deaths especially when there is an associated inhalational injury. Most of the deaths occurred in the first week of admission from fluid and electrolyte derangements.