RISK FACTORS OF MORTALITY OF HOSPITALISED ADULT BURN PATIENTS A MALAWIAN TERTIARY HOSPITAL BURNS UNIT
IntroductionMalawi has the highest rates of mortality directly or indirectly associated with burn injuries in Southern Africa. There is however no published literature on risk factors of mortality among adult patients.\n\nMethodsWe conducted a retrospective cross sectional audit records of patients admitted at the burns unit of Queen Elizabeth Central Hospital (QECH) between the years 2007 and 2017. Death due to burns was our outcome of interest. We collected patient data including demographic information, details of the burn injury and its management and determined how these factors were associated with the risk of death using Person Chi square tests in a univariate analysis and likelihood ratio tests in a multivariate logistic regression model. We also determined the odds ratios of death within the categories of the risk factors after adjusting for important variables using a logistic regression model.\n\nResultsAn analysis of 500 burns patient records showed that 132(26.4%) died during the 10-year period. The lethal area for 50% of burns (LA50) was 28.75% and mortality reached 100% at 40% total burn surface area. The following variables were found to be significantly associated with mortality after controlling for confounders: scalds (OR 0.13; 95% CI 0.05-0.33; <0.0001), increasing total burn surface area (p<0.0001), time lapse to hospital presentation between 48 hours and one week(OR 0.27; 95%CI 0.11-0.68; <0.0001), inhalation burns (OR 5.2; 95% CI 2.0-13.3 p 0.0004) and length of hospital stay greater than two months (OR 0.04 95, CI 0.01-0.15; P<0.0001).\n\nConclusionsRisk factors for mortality are connected by their association with post-burn hypermetabolism. Further studies to are needed to identify the best and cost-effective ways of preventing death in burn patients.