title: The impact of patient demographics and comorbidities upon burns admitted to Tygerberg Hospital Burns Unit, Western Cape, South Africa.
abstract: In South Africa, burns are a major public health problem responsible for significant morbidity and long-term physical disability. This is, in part, due to a significant proportion of the urban population living in poorly constructed, combustible accommodation. The presence of co-morbid diseases such as diabetes and malignancy in patients with burns has been associated with a poorer outcome. The impact of other diseases such as HIV has yet to be defined. A retrospective data collection study analysed the 221 patients admitted to Tygerberg Hospital Burns Unit in 2011 and the first six months of 2013. Using hospital records, patient demographic data was collected alongside burn agent, ICU admission, complications, and patient outcome in terms of length of stay and mortality. The most common burn agent was hot liquid (45.7%). A significant proportion of patients were subject to intentional attacks (34.3%). Shack fires and flame accounted cumulatively for 85% of total inhalational burns, the highest rates of admission to ICU (85.5%), the highest rate of complications, as well as 92.3% of all total fatalities. HIV+ patients had a higher mortality (13.3% vs 5%, p=0.22) and a higher complication rate (46.7% vs 30%, p=0.21). There was no difference in length of stay between the HIV+ and HIV- cohort (12days vs. 15.5 days, p=0.916). Burns are a significant yet preventable cause of mortality and morbidity. The rising number of shack fires, responsible for extensive burns and resultant mortality is concerning and indicates urgent attention and action. HIV complicates the recovery from burn and is responsible for an increased rate of in hospital mortality.
authors.affiliation: University of Birmingham Medical School, University of Birmingham, UK.
authors.forename: T
authors.initials: T
authors.lastname: Cloake
authors.affiliation: University of Birmingham Medical School, University of Birmingham, UK. Electronic address: t_haigh@hotmail.co.uk.
authors.forename: T
authors.initials: T
authors.lastname: Haigh
authors.affiliation: University of Birmingham Medical School, University of Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Cheshire
authors.affiliation: University of Birmingham Medical School, University of Birmingham, UK.
authors.forename: D
authors.initials: D
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002053:Burn Units; D002056:Burns / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005390:Fires / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology; D017052:Hospital Mortality; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015208:Smoke Inhalation Injury / Q000453:epidemiology / Q000401:mortality; D013019:South Africa / Q000453:epidemiology; D014505:Urban Population; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Burns; Co-morbidities; Demographics; Outcome; South Africa