Factors associated with emergency department disposition among burn injury patients: Analysis of prehospital and emergency care characteristics using South Asia Burn Registry (SABR) data

Nukhba Zia, Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: nukhba.zia@jhu.edu.
Saidur Rahman Mashreky, Centre for Injury Prevention Research, Dhaka, Bangladesh.
Huan He, Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Nishit Patel, Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Fasih Ali Ahmed, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Madiha Hashmi, Department of Critical Care Medicine, Ziauddin University Hospital, Karachi, Pakistan.
Ehmer Al-Ibran, Burns Centre, Civil Hospital, Karachi, Pakistan.
Akm Fazlur Rahman, Centre for Injury Prevention Research, Dhaka, Bangladesh.
Sazzad Khondoker, National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh.
Adnan A. Hyder, Center on Commercial Determinants of Health and Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Asad Latif, Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Anesthesiology, Aga Khan University, Karachi, Pakistan.

Document Type

Journal Article

Publication Date

1-17-2024

Journal

Burns : journal of the International Society for Burn Injuries

DOI

10.1016/j.burns.2024.01.012

Keywords

Bangladesh; Emergency department; Outcomes; Pakistan; Prehospital management; South Asian Burn Registry

Abstract

INTRODUCTION: Improvement in burn injury data collections and the quality of databanks has allowed meaningful study of the epidemiologic trends in burn care. The study assessed factors associated with disposition of burn injury patients from emergency department accounting for pre-hospital care and emergency care. METHODS: This prospective observational pilot study of the South Asia Burn Registry project was conducted at selected public sector burn centers in Bangladesh and Pakistan (September 2014 - January 2015). All age groups with an initial presentation to the burn centers were enrolled. Descriptive and regression analysis is presented. RESULTS: A total of 2749 patients were enrolled. The mean age was 21.7 ± 18.0 years, 55.3% were males, and about a quarter were children < 5 years. About 46.9% of the females were housewives. Scald burns were common among children (67.6%) while flame burns were common among adults (44.3%). About 75% of patients were brought in via non-ambulance mode of transport. More than 55% of patients were referrals from other facilities or clinics. The most common first aid given pre-hospital was the use of water or oil. About 25% were admitted for further care. The adjusted odds of being admitted compared to being sent home were highest for children < 5 yrs, those with higher total body surface area burnt, having arrived via ambulance, scald and electrical burn, having an associated injury and inhalational injury. CONCLUSION: The study provides insight into emergency burn care and associated factors that influenced outcomes for patients with burn injuries.

Department

Global Health

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