European Journal of Cardiovascular Medicine

Burn injury is a major cause of mortality and morbidity. Approximately 1.8 lakhs death occurs annually due to burn throughout world as per WHO. Almost ½ of them from south-east Asia and from low- and middle-income country. Approximately 10 lakhs people are moderately to severely burnt in India every year1. Management of burn injury is challenging bothmedically and surgically. Small burn wound may be treated as outpatient basis. But for severe burn injury management become challenging. If burn patient management is neglected initially then it became difficult to save the life of patient because failure of early fluid resuscitation results in hypovolemic shock results in septicemia, multi-organ failure and death. Burn may involve all age group starting from infant to old age. Since Early management is very important, awareness about burn patient management is important.

Study has been conducted about burn patients in other part of India about outcome of burn patients’ management. But in Odisha no such study has been conducted. So, we have conducted the study with an aim to assess the outcome of burn patients admitted to burn centre in a tertiary care hospital in western Odisha

This was a Descriptive study conducted in Department of plastic surgery in collaboration with general surgery in VIMSAR Burla, a tertiary care centre in Western Odisha, for a period of 1 year from 1stJanuary 2023 to 31st December 2023. This hospital caters burn care facility to 10 districts of western Odisha and border district of Chhattisgarh and Jharkhand.

Inclusion Criteria: -

All burn patients irrespective of age and sex admitted to burncentre within this time period was included in the study.

Exclusion criteria: -

Patient referred to higher centre or left against medical advice were excluded from study.

Total 200 patients were included in our study. Data was collected in form of age, sex, socio-economic status, mode of occurrence of burn whether accidental, homicidal or suicidal, types of burn, any intervention, total number of stay and mortality. The percentage of total body surface area (TBSA) measured by role of 9 and fluid management done as per Parkland formula. Patients with electric burn injury Fasciotomy done in case of compartment syndrome of limb. In deep burn wound debridement of eschar done. If burn wound did not heal, skin grafting was done. Any defect was covered with flap. All patients discharged after all wound healed up. Follow up of patients done weekly for 1stmonth, then 2ndweekly for 2 months, then monthly for 6 months to evaluate any hypertrophic scar or contracture.

In the present study all patients admitted to burn centre of VIMSAR, Burla was observed and studied

Table 1: Sex Pattern

Table 1 describe sex pattern of Burn. In our study Female patient were most commonly affected by burn. 135 out of 200 patients are female and 65 are male. Male female ratio is 1:2.08. Since female patient are involved in cooking activity mostly exposed to flame during cooking. so most commonly affected.

Table 2: Age group involved

Table 2 described the age group of people affected by burn. It was found that most common age group is 21-30year (26.5%), followed by 0-10year (25%), followed by 31-40 year (18%), followed by 11-20 year (11.5%), followed by 41-50 year (9%), followed by 51-60(7%). Least commonly affected age group was age group more than 60 yr. only 6 patients (3%) were affected. Median age is 25 year.

Table 3: Socioeconomic status of patients

Table 3 described socioeconomic status of affected burn patients. In our study most of the people were from low socioeconomic status i.e. in 70% cases, followed by medium socioeconomic status i.e. in 20% cases and least cases were from high socioeconomic status i.e. in 10% of cases.

Table 4: types of burn

Table 4 described types of burn.It was found that thermal burn was most common type involving 63.5% of patients (127 out of 200 ),followed by electric burn 19% of patients ( 38 out of 200), followed by scald burn 17% ( 34 out of 200 ). Least commonly was chemical burn only 1 case.

Table 5: Aetiology of Burn

Table 5 Described etiology of burn. It was found that burn occurred accidentally in 180 out 200 (90%) of cases. Suicidal case found in 15 cases (7.5%), homicidal found in 5 cases (2.5%). Most of the burn occurred at home while cooking.

Table 6: TBSA of Burn

Table 6 described percentage of total body surface area involved. It was found that most common TBSA involved is 11-20% (32.5%), followed by 21-30% (21%), followed by 31-40%(11.5%). Least common TBSA is >60 % (5%). Median TBSA is 24%.

Table 7: Mortality rate

Table 7. Described Mortality rate. Mortality rate in our study is 17 % i.e. 34 out of 200 patient died during treatment. Out of 137 patients with <30% TBSA death occurred in 6 patients (4.3%). Out of 38 patients with 31-50% TBSA death occurred in 10 patients i.e. 26.3% and out of 25 patients with >50% TBSA death occurred in 18 patients i.e. 72%. 

Table 8: Hospital stay in days

Table 8 described number of stay in hospital. 166 patients out of 200 patients discharged after recovery. Range of hospital stay was 5 days to 30 days. Most common range of stay in hospital was 10-20 days. But for scald burn most common range of stay in hospital <10 days. For thermal burn patients common range stay in hospital was 11 -20 days. For electric burn patients common range of stay was 21-30 days. Median day of stay was 15 days.

Burn injury is associated with high morbidity and mortality. Due to ignorance about severity of burnpatients attain hospital late. So, it further increases mortality rate.

In our study female were more commonly affected by burn. 67.5% were female. Since female are mostly involved in cooking activity so directly contact with flame maximum time during cooking. So most commonly affected than male. Study by Chakraborty et al2, Kuiri et al3 and Chatterjee et al 4 has similar results of female more affected than male. In contrary to our study, study conducted by Bhansali CA et al5, Gupta AK et al6 and Khasaba HA et al7 male are more commonly affected in their study.

In our study, most common age group was 21-40 years i.e. 44.5%. It is similar to other study by Chakraborty S etal2, Kuiri et al3 and Chatterjee S et al4. This age group is most commonly involved in both indoor and outdoor activity. So most commonly affected by burn. 2nd most common age group was 0-10 years i.e. 25%. This is because due to low socioeconomic status, low education level of their parents, they are neglected. So, burn injury occurred in children. A study by Bailey MEet al8 also revealed the vulnerable group as below age 8 year of age.

70% of patients were from low socioeconomic status similar to study by Moses et al9. Since this western Odisha region is underdeveloped as compared to rest of Odisha, so most common people belong to low socioeconomic status group.

In our study thermal burn (Flame) accounts for 63.5% of patients, similar to other study by Shankar G et al10 and Srinivas T et al11 and study conducted in country like Pakistan by Marsh D et al12.  Contrary to our study conducted in developed country, most case are scald burn 13,14.

In our study most common occurrence of burn was accidental in nature in 90% of cases, similar to study by Moses et al9 (85%), Kuiri et al3 (91%) and Despande et al15(91%).  But study by Chatterjee S et al4and Chakraborty S et al2 burn occurred accidentally in 53% and 61% case respectively.

In our study most of the patients was having <30% burn i.e. in 68.5% with median burn percentage was 25% TBSA. This is similar to other study by Bain J et al16Shanmugakrishnan RR et al17 and Akhtar MS et al18

Mortality rate in our study is 17%. Patient with <30% TBSA mortality rate was 4.3%, patient with 31-50%TBSA mortality rate is 26.3% and patients with >50% TBSA has mortality rate of 72%. Our findings are better than study conducted by Ebenezer R et al19 (37%), SubrahmanyamM et al20(56.5%) ,Bilwani PK et al21(58.26%)and Jayaraman V et al22(52.33%)  and worse than study by  Srinivas T et al11 (8.08%) And Kazemzadeh J et al23(4.5%).

Average hospital stay in our study was in the range of 10-20 days (42.2%). Patients with scald burn average hospital stay was less than 10 days. Patients with thermal burn average hospital stay is 11-20 days. Patients with electric burn average hospital stay is more than 20 days. The average hospital stay is different in different study. Study conducted by Agarwal P et al24, Bhansali CA et al5 and Gupta AK et al6 average length of stay in hospital was 5.8 days, 22day, less than 3 days respectively. There was difference in finding because of different area, different economic status of patients and difference in presentation to hospital following burn

Our study shows young female with low socioeconomic status were mostly affected by burn injury. Thermal burn was most common type of burn. Mortality increases when percentage of burn increases. Average hospital stay is less in scald burn. Burn mortality can be decreased by increase in awareness about severity of burn among people.

LIMITATION OF STUDY:

Since study population was small and conducted in tertiary care hospital, it cannot be generalized to general population.

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