Burns in South Asia: Outcomes from South Asian Burn Registry (SABR)

Fasih Ali Ahmed; Nukhba Zia; Sameer Ahmad Khan; Tahir Munir; Saidur Rahman Mashreky; Madiha Hashmi; Ehmer Al-Ibran; Akm Fazlur Rahman; Sazzad Khondoker; Fozia Asif; Adnan A Hyder; Asad Latif

doi:10.1016/j.burns.2024.04.001

Burns in South Asia: Outcomes from South Asian Burn Registry (SABR)

Burns. 2024 Apr 4:S0305-4179(24)00118-9. doi: 10.1016/j.burns.2024.04.001. Online ahead of print.

Authors

Affiliations

¹ Centre for Patient Safety, The Aga Khan University, Karachi, Pakistan; University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
² Johns Hopkins International Injury Research Unit (IIRU), Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
⁴ Department of Anesthesiology, Aga Khan University Hospital, Karachi, Pakistan.
⁵ Centre for Injury Prevention and Research, Dhaka, Bangladesh.
⁶ Department of Critical Care Medicine, Ziauddin University Hospital, Karachi, Pakistan.
⁷ Burns Centre, Civil Hospital, Karachi, Pakistan.
⁸ National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh.
⁹ Centre for Patient Safety, The Aga Khan University, Karachi, Pakistan.
¹⁰ The Milken Institute School of Public Health, George Washington University, DC, USA.
¹¹ Centre for Patient Safety, The Aga Khan University, Karachi, Pakistan; Department of Anesthesiology, Aga Khan University Hospital, Karachi, Pakistan; Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD, USA.

PMID: 38604825
DOI: 10.1016/j.burns.2024.04.001

Abstract

Background: South Asian region contributes 59 % to the global mortality due to burns. However, we find a paucity of literature on the outcomes of burns from low- and middle-income countries (LMICs). South Asian Burn Registry (SABR) is a facility-based burns registry that collected data on in-patient burn care. This study assesses factors associated with mortality, length of hospital stay at the burns center, and functional status of burn patients.

Methods: Prospective data was collected from two specialized public sector burn centers between September 2014 - January 2015 from Bangladesh and Pakistan. Multivariable logistic, linear, and ordinal logistic regression was conducted to assess factors associated with inpatient-mortality, length of hospital stay, and functional status at discharge, respectively.

Results: Data on 883 patients was analyzed. Increased association with mortality was observed with administration of blood product (OR:3, 95 % CI:1.18-7.58) and nutritional support (OR:4.32, 95 % CI:1.55-12.02). Conversely, antibiotic regimens greater than 8 days was associated with decreased mortality (OR:0.1, 95 % CI:0.03-0.41). Associated increase in length of hospital stay was observed in patients with trauma associated with their burn injury, history of seizures (CE:47.93, 95 % CI 12.05-83.80), blood product (CE:22.09, 95 % CI:0.83-43.35) and oxygen administration (CE:23.7, 95 % CI:7.34-40.06). Patients who developed sepsis (OR:6.89, 95 % CI:1.92-24.73) and received blood products during hospitalization (OR:2.55, 95 % CI:1.38- 4.73) were more likely to have poor functional status at discharge.

Conclusion: This study identified multiple factors associated with worse clinical outcomes for burn patients in South Asia. Understanding these parameters can guide targeted efforts to improve the process and quality of burn care in LMICs.

Keywords: Burn epidemiology; Burn outcomes; Burns; Low-middle income countries.