ABSTRACT
The scarcity of data on burn-related injuries in Pakistan prompted this study. The study is specifically aimed at assessing the burn patients who were admitted to a national burn care center (BCC) in Pakistan. This single-center retrospective analysis was conducted for 12 months from January to December 2021. During this time period, 14,069 patients visited BCC with burn injuries of diverse natures while 613 of them were admitted. The patients' information was abstracted from the hospital database. This information included age, sex, diagnosis, burn depth/degree, time of arrival, circumstances of burn injury, TBSA (total burn surface area), complications, outcome, and management plan. This information was shifted to Microsoft Office Excel Worksheet 2015 and then coded into the IBM Statistical Package for the Social Sciences (SPSS) version 24.0. Armonk, NY: IBM Corp. Of 14,069 patients, 613 were admitted to the burn care center, indicating an admission rate of 4.35%. Among these 613 patients, there was a high proportion of males (58.89%) and a mean age of 20.2±12.5 years. Most patients (40.4%) visited within the first hour after being burnt and flame burns were the most common (41.10%). Most patients were burnt due to accidents (97.7%). The mean length of hospital stay was 15.5 days. Flames were the main cause of burns among our cohort of patients. Most patients had a TBSA of >10% and generally had a second-degree burn, mostly in the pediatric population. An urgent appraisal of burn policies and related legislation is needed to halt the burn burden in the country.
Cette étude a été décidée en raison de la pauvreté des données épidémiologiques concernant les brûlures au Pakistan. Il s'agit d'une étude monocentrique rétrospective sur dossier conduite dans le CTB national d'Islamabad sur l'année 2021. Sur les 14 069 patients brûlés qui s'y sont présentés, 613 (4,35%) ont été hospitalisés. Nous avons recueilli l'âge, le sexe, la SCB, la profondeur, la cause, le délai de présentation, la stratégie thérapeutique, les complications et le devenir des patients. Les données ont été implantée dans Excel et analysées avec SSPS 24.0. Parmi les patients hospitalisés, 58,89% étaient des hommes âgés de 20,2±12,5 ans. Le délai de présentation était de moins de 1h dans 40,4% des cas et l'atteinte était quasiment toujours accidentelle (97,7%), majoritairement par flamme (41%). La DMS était de 15,5 j. L'atteinte était le plus souvent > 10% SCT, habituellement au 2ème degré en particulier en population pédiatrique. Une évaluation de la législation préventive est urgente, afin de mettre fin au fardeau que représentent les brûlures dans notre pays.
ABSTRACT
Burns are a public health concern burdening the healthcare delivery system across the globe. Mortality rates are significant outcome parameters after a burn injury. The objective of the current study was to analyze the characteristics of the patients admitted to our burn care center and identify the factors related to mortality in the burn patients. This was a cross-sectional single-center study involving a retrospective analysis of mortality rates in burn patients over a period of 15 years from July 2007 to December 2021. During the study period, 7,866 burn patients were admitted to the ICU of the burn care center. Patients who died [Group 1] were compared to the group of survivors (control cases [Group 2]) to ascertain the contributing factors that might forecast a high risk for mortality. The mortality rate was calculated as 23.16% (1,822/7,866). The majority of the patients (both groups) had a total body surface area (TBSA) of >50% (p 0.001). The average duration of stay at the burn care center was 15.5 days for the survivors' group (Group 2) while it was 11.4 days for the patients who died (Group 1) during the course of their treatment. About 23.16% of all admitted patients died mostly from flame burns, and sepsis was the commonest cause of death. Patients with risk factors should be classified as high risk for mortality at the time of ICU admission. It is necessary to initiate educational and awareness programs for sensitization related to the prevention of burn injuries.
Les brûlures représentent une pathologie impactant les systèmes de santé du monde entier. Le taux de mortalité sont des marqueurs significatifs de l'évolution des brûlés. Cette étude rétrospective monocentrique cas- témoins analyse les caractéristiques des patients admis dans notre CTB pour brûlure pendant 15 ans (juillet 2007- Décembre 2021) et recherche les paramètres liés à la mortalité. Les 7 866 patients ont été répartis entre morts (1 822 ; 23,16%) et vivants. La majorité des patients, quel que soit le groupe, étaient brûlés sur au moins 50% de SCT. La DMS était plus longue chez les survivants (15,5 jours) que chez les morts (11,4 jours). La majorité des patients décédés étaient brûlés par flamme et le sepsis était la cause la plus fréquente de l'exitus. Ces patients devraient être classés comme à risque majeur de décès dès l'entrée. Il est nécessaire de mettre en Åuvre des programmes d'éducation et de sensibilisation pour diminuer l'incidence des brûlures.
ABSTRACT
The transfusion of blood and blood components is a life-saving medical procedure, however, it is linked with adverse reactions to transfusions. Information about different types of adverse transfusion reactions (ATRs) will assist in their early identification and subsequent management, as well as in devising strategies to minimize the occurrence of adverse reactions related to blood component transfusion. The current study was therefore executed to analyze the pattern of ATRs in patients with burn injuries at a national burn center. This was a cross-sectional, prospective study involving an analysis of immediate ATRs from January 2020 to June 2021 (18 months). ATRs observed during the study period were documented and analyzed. During the study period, 2,220 units of blood and blood components were transfused to 1,075 burn patients (2.06 transfusions per patient). A total of 27 ATRs were recorded (1.21%). Allergic reactions were the commonest (55.55%) followed by febrile non-haemolytic transfusion reaction (37.03%). The mean volume of blood unit transfused, when the reactions were noted, was approximately 75 ml (range: 15-230 ml). The mean time at which transfusion reactions were noted was 17 min (range: 5-220 minutes). The ATRs were more common in patients with multiple transfusions compared to those receiving a single transfusion. The common adverse reactions were allergic and febrile non-haemolytic transfusion reactions. It is vital to report all transfusion reactions to the attached blood center and hospital transfusion committee (HTC) on standardized reporting forms. Continuous medical education through seminars and sensitization workshops will support consolidating haemovigilance systems.
La transfusion de sang et de ses dérivés peut être salvatrice mais aussi être responsables d 'effets indésirables (EI). Les données concernant ces EI permettent de les diagnostiquer et les traiter précocement ainsi que de développer des protocoles destinés à en diminuer la prévalence. Cette étude rétrospective a analysé les EI transfusionnels survenus dans un CTB pakistanais sur une période de 18 mois (janvier 2020- juin 2021). Deux mille deux cent vingt unités ont été transfusées à 1 075 brûlés (2,06/patient). Vingt- sept (1,21%) EI ont été enregistrés. Les plus courantes étaient allergiques (55,55%), suivies des réactions fébriles non hémolytiques (37,03%). Cette réaction survenait à la 17ème minute (5- 220) lorsque 75 mL (15 à 230) avaient été passés. Ils étaient plus fréquents chez les multitransfusés que lors de la première perfusion. Il est crucial de rapporter tout EI au CTS et à l'hémovigilance locaux, sous un format standardisé et d'éduquer prescripteurs et utilisateurs.
