Assessment Of Severity And Early Resuscitation Outcomes Of Patients With Burn Injuries Admitted At Iringa And Dodoma Regional Referral Hospital In Tanzania.

ABSTRACT

Background: Burn injury is a significant health problem worldwide, where in Africa, it is estimated that over a million patients are burned annually, wherein in Tanzania, the prevalence is 16%. It contributes to 18% of all hospital admission, with a 6% mortality to 10% (Peden et al., 2008; Roman, Lewis, Kigwangalla, & Wilson, 2012). In addition, the common causes of early (less than 48 hours) mortality and morbidity in burn injury are; burns shock, inhalational injury, and systemic inflammatory response syndrome (Brusselaers et al., 2010). Therefore, burn management requires a strict protocol to reduce associated morbidity and mortality, which includes strict protocols of fluid resuscitation. In our settings, fluid management may not follow a strict prescription. And there are fewer studies on early resuscitation outcomes that have been done in Africa and Tanzania, but more importantly, not in our local settings. Methodology: A hospital-based, prospective study conducted at IRRH and DRRH from April 2019 to June 2020. This study used a purposeful sampling technique and questionnaire to collect data that was entered into the Excel sheet, then imported into SPSS version 26 for analysis. Results: The mean ABSI score among survivors was 4.68 ± 0.18 and 10.67 ± 2.03 among non-survivors, mean TBSA among survivors were 25.07 ± 1.44 % and 71.67 ± 13.64 % among non-survivors. The risk factors contributing to the severity of burn injury are age above ten years, flames, and male patients who had more severe burn injuries. There was 49.1% patients who received inadequate amount of fluid, these patients were seven times likely to have the bad outcome (deteriorated or died), [AOR = 7.283, (95% CI 3.281 – 18.518), P < 0.05]. Conclusion and Recommendation: The common causes of burn injury in this study were scald followed by flames, of which flame injury contributed more to the severity of burn injury. There were 49.1% of the patients received inadequate fluid, and were 7 times more likely to have a bad outcome (deteriorated or died). ABSI score should be adapted in local setting and strict fluid resuscitation should be followed, especially to patients with ABSI score more than 6.