Baseline assessment of inpatient burn care at Tenwek Hospital, Bomet, Kenya

World J Surg. 2013 Jul;37(7):1530-5. doi: 10.1007/s00268-013-2045-2.

Abstract

Background: Burn injuries are a significant source of both death and disability in developing countries. The objective of this project was to create a database of baseline inpatient burn care data to facilitate improvement of preventive measures and clinical outcomes at Tenwek Hospital, Bomet, Kenya.

Methods: Both demographic and clinical data were obtained through a retrospective chart review conducted on inpatient burn patients admitted to Tenwek Hospital between January 1, 2006 and May 31, 2010.

Results: Of the 269 patients studied, 53 % were male and 47 % were female. More than half (59 %) of the burns occurred in children younger than age 5 years. All-cause mortality rate of inpatient burn patients was 12 %. Cardiac arrest, sepsis, and respiratory failure/pneumonia caused 81 % of the deaths. Scalds caused 55 % of the burns. Thirteen percent of the burns were seizure-related. Second degree burns accounted for 76 % of the burns. Forty-three percent of patients received at least one surgical debridement during their hospital stay. Thirty-seven percent of patients received at least one split-thickness skin graft. Antibiotic treatment was administered to 55 % of patients. Fifty-three percent of patients presented to Tenwek Hospital 1 day or more from the time of injury.

Conclusions: We propose that prevention efforts focus on minimizing children's exposure to boiling liquids and open flames in homes, providing appropriate and consistent treatment to epileptics to prevent seizure-related burns, and stressing the importance of early presentation for treatment. A more selective approach to antibiotic use should be encouraged to decrease costs to the patient and hospital and lessen the risk of antibiotic resistance.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Burn Units / standards
  • Burn Units / statistics & numerical data*
  • Burns / etiology
  • Burns / mortality
  • Burns / prevention & control
  • Burns / therapy*
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Databases, Factual
  • Decision Support Techniques
  • Developing Countries*
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Kenya
  • Male
  • Middle Aged
  • Pilot Projects
  • Quality Improvement
  • Retrospective Studies
  • Tertiary Care Centers / standards
  • Tertiary Care Centers / statistics & numerical data*
  • Treatment Outcome
  • Young Adult