An analysis of the factors contributing to mortality rates in burns patients treated at Mpilo Central Hospital, Zimbabwe.
We present a retrospective analysis of 49 patients (61% males and 39% females) with burns who died at Mpilo Central Hospital between January 1990 and December 1993. Of the patients, 61% (30/49) were in the paediatric age group, with 55% (27/49) under 2 years of age. Most burns occurred at home (79%) and 17% of the burns occurred at the workplace. The commonest burning agents were hot water (39.5%) and open fires (39.5%). The surface area of burns ranged from 10 to 88% with a mean of 35%. Deep partial thickness and full thickness burns accounted for 52% of cases. All the patients required active resuscitation with intravenous fluids. A total of 35 organisms were isolated on 18 pus swabs. The most commonly isolated organisms were Staphylococcus aureus (43%) and Pseudomonas (23%). The main factors contributing to death were septicaemia (n = 15), pneumonia (n = 10) and acute renal failure (n = 7). The majority of patients (65%) died within 10 days, 61% of whom were children. The average time to death was 14 days (range 1-64 days). It is clear that some patients with severe burns will die regardless of how well they are managed. The key to successful management of those patients who should survive lies in early presentation and active resuscitation, prevention and control of infective complications and adequate nutritional support.
Muguti
G I
GI
Department of Surgery, Mpilo Central Hospital, Bulawayo, Zimbabwe.
Mazabane
B N
BN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D015030:Zimbabwe / Q000453:epidemiology