Modernized standards in burns management: a comparative study in Komfo Anokye Teaching Hospital, Kumasi, Ghana

Abstract

Background: Management of burns patients before May 2009 was very difficult at the Komfo Anokye Teaching Hospital (KATH).

Aim: To compile burns patients' information in the new Burns Intensive Care Unit (BICU), analyze it and draw comparisons to information from the old BICU at KATH.

Methods: This retrospective study involves data from May 2007 to April 2009 (Group 1--old BICU) and May 2009 to April 2011 (Group 2--new BICU). The parameters of burn patients recorded included: record of admission, gender, age, aetiology of injury, Total Burns Surface Area (TBSA), the patients' treatment regime and record of discharge/death. This information was analyzed with SPSS version 18.0.

Results: The total number of patients in the study was 511; Group 1 constituted 47.36% (n=242) patients; males (n=307, 61%) outnumbering females (n=204, 39%). The overall mean, median and interquartile range (IQR) ages of the patients were 12.4±2; 9.5 and 18.0 years respectively. The main aetiology of burns in Group 1 was flame burns (n=115, 47.5%) and for Group 2 was scald (n=151, 56.1%). The median TBSA recorded for Groups 1 and 2 were 32% and 41% respectively. A mortality rate of 19.1% (n=46) and 12.7% (n=34) were recorded for Groups 1 and 2 respectively which was statistically significant (p<0.05). We found no differences for age and TBSA (P=0.7168 and P=0.8020 respectively). A Chi Square analysis for gender and aetiology of burn revealed no significant difference between Groups 1 and 2. A risk factor analysis for mortality within the Groups (using multiple regression analysis) identified only aetiology of burn in Group 1 to be a factor (P=0.044).

Conclusion: This comparative study reveals that a significant difference in mortality was recorded for both groups. The mortality difference does not appear to be due to socio-demographic features. This study may demonstrate that modernized and advanced equipment with the adequate personnel play an essential role in burn management in low income countries such as Ghana.