Epidemiology and referral patterns of burns admitted to the Burns Centre at Inkosi Albert Luthuli Central Hospital, Durban.
BACKGROUND
The epidemiology, referral patterns and outcome of patients admitted to a tertiary burns unit in southern Africa were reviewed.


METHODS
The charts of all patients with thermal injury presenting to the Burns Centre at Inkosi Albert Luthuli Central Hospital (IALCH) between 1 January 2008 and 31 December 2010 were reviewed. Information collected included age, gender, past medical history, cause of burn, size of burn, presence of inhalation injury, time before admission, time to excision, length of hospital stay, complications and mortality.


RESULTS
Four hundred and sixty two patients were admitted, 296 (58%) children and 193 (42%) adults. The female-male ratio was 1:1.13. The mean total body surface area (TBSA) burned was 12% (interquartile range 8-25%) for children and 18% (interquartile range 10-35%) for adults. Common causes for the burns were in children: hot liquids (71%) and open flame (24%). Major causes in adults were: open fire (68%) and hot liquids (25%). Epilepsy was a contributing factor in 12.7%. Inhalation injury was seen in 13.6% of adults and 14.3% of children with a flame burn. Forty-four percent of referrals from general surgical units were for burns <30% in adults, and 30% for burns <10% in children. More than one in four patients was referred between 1 and 6 weeks post-injury. Overall mortality was 9.1% (5.7% in children and 15.1% in adults). Complications occurred in 21.6% of children and 36.7% in adults, the most common being lung complications such as ARDS and infection, severe sepsis, skin graft failure and contractures. The length of stay was 1 day/% TBSA burn for all burns in children and for burns between 10 and 49% in adults.


CONCLUSIONS
The epidemiology and outcome of severe burns referred to the Burns Centre at IALCH is similar to those in other units in Africa. The management and referral of burns patients by other hospitals are inappropriate in a significant number of patients.
Regional Burns Centre, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, Republic of South Africa; Level I Trauma Centre, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, Durban, KwaZulu-Natal, Republic of South Africa. Electronic address: daanhol@ialch.co.za.
Daan
D
den Hollander
Regional Burns Centre, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, Republic of South Africa; Medical Students, Faculty of Medicine, Lund University, Lund, Sweden.
Malin
M
Albert
Regional Burns Centre, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, Republic of South Africa; Medical Students, Faculty of Medicine, Lund University, Lund, Sweden.
Anna
A
Strand
Level I Trauma Centre, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, Durban, KwaZulu-Natal, Republic of South Africa.
Timothy C
TC
Hardcastle
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001830:Body Surface Area; D002053:Burn Units / Q000706:statistics & numerical data*; D002056:Burns / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017678:Sex Distribution; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
Burns; Epidemiology; Referral patterns