Abstract
Background
Burn injuries are a major cause of morbidity and mortality within low- and middle-income
countries (LMICs). The World Health Organization developed the Global Burn Registry
to centralize data collection for the guidance of burn prevention programs. This study
analyzed the epidemiologic and hospital-specific factors associated with burn injury
outcomes in LMICs and high-income countries (HICs).
Methods
A retrospective review was performed using the Global Burn Registry over 3 y. Patients
were stratified by income region. Bivariate analyses and stepwise regressions were
performed to evaluate patient and hospital demographics and variables associated with
injury patterns and outcomes. Outcomes of interest included mortality and length of
stay.
Results
Over the study period, data were collected on 1995 patients from 10 LMICs (20 hospitals)
and four HICs (four hospitals). Significantly higher mortality was seen in LMICs compared
with HICs (17% versus 9%; P < 0.001). There was no significant difference between income regions for injury patterns
(P = 0.062) or total body surface area of the burn injury (P = 0.077). Of the LMIC hospitals in this data set, 11% did not have reliable access
to an operating theater.
Conclusions
HICs had a lower overall mortality even with higher rates of concurrent injuries,
as well as longer length of stay. LMIC hospitals had fewer resources available, which
could explain increased mortality, given similar total body surface area. This study
highlights how investing in health care infrastructure could lead to improved outcomes
for patients in low-resource settings.
Keywords
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Article Info
Publication History
Published online: September 05, 2020
Accepted:
August 2,
2020
Received in revised form:
July 24,
2020
Received:
February 29,
2020
Footnotes
This work was presented at the 16th Annual ASC Conference.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
