Epidemiology and outcomes of in-hospital acute burn-patients in Togo: A retrospective analysis

Abstract

Background: Burn epidemiologic data are limited in sub-Saharan Africa. This study was aimed at filling the gap in the real-time data about burns in Togo by assessing sociodemographic, clinical and outcome characteristics, causes and severity of burns of hospitalized patients for prevention programs. Methodology: This retrospective study analysed the medical folders of patients admitted to the ICU department of Sylvanus Olympio Teaching Hospital (SOTH) in Lomé for an acute burn injury during 7 years (January 2007–December 2013). We collected sociodemographic parameters, causes, and mechanisms of burns; the time between burns injury and admission to the Surgical Emergency Department (SED), pre-hospital care, pre-existing medical conditions, and treatments. Burned total body surface area (TBSA), anatomical sites and depth of burns, treatment and outcomes were assessed by EPI INFO 3.5.3 (ATLANTA CDC 2003). Results: Burns represented 2.1% of all admissions to the SED. Of the 1,843 burn patients, 497 (26.9%) were admitted to the ICU department, and 1,346 (73%) were treated as outpatients. The analysis included the complete folders of 211 patients. The patients’ mean age was 14.9 years (4 months-94 years). The male to female ratio was 1.67. Children numbered 129 (61.1%) and adults 82 (38.9%).Burns were caused by hot liquids in 74.4% of children and in 13.4% of adults (p = 0.003), and by flames in 73.2% of adults and 19.4% of children (p = 0.001). The mean burned TBSA was 26.5% (range 3%–95%). Mean Abbreviated Burn Severity Score was 4 (range 2–11) for children and 6 (range 3–13) for adults.Medical treatments were fluid resuscitation, close or open wound dressing. Surgical treatments included escharotomy in 28 (13.3%) patients, skin grafts in 23 (11%), local flaps in 3 (1.4%), and fingers or limbs amputations in 9 (4%). Mean hospital stay was 21 (range 1–99) days. The overall burn-related mortality rate was 24.6%. Conclusions: In Togo, over the 2007–2013 period, children were most affected in house-related accidents, whereas adults had most fire burns with extended burned TBSA and associated injuries. Only few patients had surgery and in delayed planning.This study has identified the essential requirements to enhance burn care management and provided an outline for further epidemiologic studies. Keywords: Burns, Epidemiology, Hot liquids, Flames, Retrospective analysis, Africa