A burn is an injury to the skin or other organic tissue primarily caused by heat or due to radiation, radioactivity, electricity, friction or contact with chemicals. [1] Thermal (heat) burns occur when some or all of the cells in the skin or other tissues are destroyed by hot liquids (scalds), hot solids (contact burns) or flames (flame burns). [1]

Burns are a global public health problem, accounting for an estimated 180000 deaths annually. [2] They are the fourth most common type of trauma worldwide, following traffic accidents, falls and interpersonal violence. 3-5

Burns are among the leading causes of disability-adjusted life-years (DALYs) lost in low and middle-income countries. Non-fatal burns are a leading cause of morbidity, including prolonged hospitalization, disfigurement and disability, often with resulting stigma and rejection. [2]

The injuries can be caused by friction, cold, heat, radiation, chemical or electric sources, but the majority of burn injuries are caused by heat from hot liquids, solids or fire. Although all burn injuries involve tissue destruction due to energy transfer, different causes can be associated with different physiological and pathophysiological response. The depth of the burn injury depends on the intensity of the burning agent and the time of exposure. Depending on the depth of skin damage, burns are divided into 3 degrees: first degree (superficial) burns, second degree (partial thickness) burns, and third degree (full thickness) burns. [3, 4]

Though the burns mortality has decreased in the recent past owing to the ongoing medical and surgical advances nevertheless, the burn injuries are still associated with significant mortality and morbidity. Minor burns represent a great impact in sick leave and their sequelae are sometimes no less consuming to the patient. On the other hand, massive burns are still a challenge to the burn team with, normally, a high mortality. An extensive burn adversely affects both patient‘s and his family‘s psyche. Also the costs involved in treatment of burn patients are exorbitantly high. [5, 6]

Burns are preventable. Efforts for prevention and care of the victims can reduce burn related mortality, morbidity and disability significantly. National Program for Prevention, Management and Rehabilitation of Burn Injuries (NPPMRBI) is an initiative by GOI was launched for preventive, curative and rehabilitative care of the burn patients. [7]

The epidemiological pattern of burns varies widely in different parts of the world. To suggest effective preventive measures, an insight into the pattern of injury is desirable. However, data on burn victims and outcome is limited from this part of the world. [8]

Hence, the aim of the present study was planned to study clinical profile of burn patients admitted in tertiary care hospital.

The present study was a cross-sectional observational study conducted to analyze the clinical profile of burn patients admitted to a tertiary care hospital. The study was carried out from October 2022 to August 2024 in the Department of Surgery at a government tertiary care hospital. The study population included all patients admitted with burns during the study period, with a total of 210 patients selected using simple random sampling. The sample size estimation was based on a previous study that reported a 15% prevalence of deaths due to burns. Using OpenEpi software and a formula for sample size calculation at a 95% confidence interval with 80% power and a 5% error margin, the minimum required sample size was estimated to be 204. To account for variability, 210 patients were included in the study. Ethical clearance was obtained from the institutional ethics committee, and necessary permissions were secured from the appropriate authorities.

Patients admitted to the hospital with burns were eligible for inclusion, while those unwilling to participate or those who succumbed to their injuries before hospital admission were excluded. After obtaining informed consent, a structured questionnaire was administered to collect data on sociodemographic characteristics, circumstances of injury, mechanisms, burn severity, and other related factors. The extent of burns was assessed using Wallace's rule of nines for adults and the Lund and Browder chart for children. The severity of burns was categorized into first, second, and third-degree burns. Outcome measures included the incidence of burns, patient characteristics, socioeconomic background, injury mechanisms, and the degree and size of burns, with an assessment of mortality and morbidity associated with burn injuries.

Statistical analysis was performed using IBM SPSS for Windows, Version 22.0, with Microsoft Excel 2019 utilized for tables and graphical representation. Continuous variables were expressed as mean ± standard deviation (SD), while categorical variables were reported as frequencies and proportions. A p-value of <0.05 was considered statistically significant for all analyses

We studied a total of 210 burn cases reported to our hospital. We observed that out of 210 patients, most common – 74 cases (35.23%) were from the age group of 21 to 30 years followed by 52 cases (24.76%) in age group 31 to 40 years. The mean age of the patients was 32.16 ±10.12 years. The majority of patients with burns were female 131 (62.38%) while males were 79 (37.62%). In our study, out of 210 burn patients, the majority were married, accounting for 164 patients (78.09%). Single individuals comprised 36 patients (17.14%), while widowed individuals made up 6 cases (2.85%). A smaller proportion of patients were either divorced or separated, with each category including 2 patients (0.95%). This distribution indicates that burn injuries were more prevalent among married individuals, possibly due to domestic or household-related incidents.

In our study, among 210 burn patients, 56 individuals (26.66%) reported alcohol consumption, making it the most common addiction. Tobacco chewing was noted in 43 patients (20.47%), while smoking was reported by 31 patients (14.76%). Additionally, 11 patients (5.23%) had other forms of addiction. These findings suggest that substance use, particularly alcohol and tobacco, may be associated with an increased risk of burn injuries. In our study, among 210 burn patients, 18 individuals (8.57%) had diabetes mellitus, making it the most common comorbidity, followed by hypertension in 16 patients (7.61%). Coronary heart disease (CHD) was present in 7 patients (3.33%), while kidney disease and liver disease were observed in 3 patients each (1.42%). Additionally, 4 patients (1.90%) had other comorbid conditions. These findings highlight the presence of underlying health conditions in burn patients, which may influence their prognosis and recovery.

It was observed that major type of burn among patients 136 (64.76%) was flame followed by scald (17.61%) and contact (08.09%). [Fig 1]

Fig no. 1: Distribution of Patients on basis of type of burn

It was observed that the major place of burn among patients 189 (90.0%) was at home followed by burn at work place (07.14%) and other places (02.85%). We observed that major cause of burn among patients 177 (84.28%) was accidental followed by suicidal (07.61%) and undetermined cause (05.71%).

Table no. 1: Distribution of Patients by Burn Characteristics:

In our study, most burn patients, 109 (51.9%), were admitted within 6 to 12 hours of injury, while 57 patients (27.14%) arrived within the first 6 hours. A smaller number, 33 patients (15.71%), were admitted after 24 to 48 hours, and only 11 patients (5.23%) sought treatment between 12 to 24 hours. Regarding burn surface area (BSA), 128 patients (60.95%) had burns covering 11-20% of their body, followed by 27 patients (12.85%) with burns covering less than 10%. Burns involving 21-30% BSA were seen in 23 patients (10.95%), while more extensive burns affecting 31-40%, 41-50%, and greater than 50% BSA were observed in 15 (7.14%), 11 (5.23%), and 6 patients (2.85%), respectively.

The most commonly affected area was the trunk in 95 patients (45.23%), followed by hands and wrists in 73 patients (34.76%), and head, face, or neck in 23 patients (10.95%). Burns involving multiple areas were seen in 9 patients (4.28%), while feet and ankles were affected in 7 patients (3.33%), and inhalation injuries were reported in 3 patients (1.42%). Superficial burns were the most prevalent, affecting 159 patients (75.71%), while deep burns were noted in 27 patients (12.85%), and both types were present in 24 patients (11.42%). In terms of burn severity, second-degree burns were the most common, seen in 159 patients (75.71%), followed by third-degree burns in 27 patients (12.85%). Fourth-degree burns were observed in 17 patients (8.09%), while first-degree burns were reported in 7 patients (3.33%). These findings highlight that most patients had moderate burn injuries affecting limited body surface areas, with the trunk and hands being the most frequently affected regions. [Table 1]

Fig 2: Outcome of the Burn patients

It was observed that major final outcome among patients 182 (86.66%) has recovered while 28 died (13.33%). [Fig 2]

In our study, burn injuries were more common in the 21-30 years age group (35.23%) followed by 31-40 years (24.76%), with a mean age of 32.16 ±10.12 years. This finding aligns with Jaiswal et al. [9], who also reported burns more commonly in middle-aged groups. Similarly, Chakraborty et al. [10] found that 56.6% of cases were in the 20-39 years age group.

Our study observed a female predominance (62.38%), which is consistent with Jaiswal et al. [9], where females accounted for 70.3% of cases, and Chakraborty et al. [10], who reported 61.5% female cases . However, Banotra et al. [11] found a male predominance (58.7%), possibly due to differences in study population and geographical factors.

Most patients in our study were married (78.09%), which is similar to the findings of Jaiswal et al. [9], where most burns were domestic and involved cooking activities. This suggests household-related incidents contribute significantly to burn injuries.

Alcohol consumption was the most common addiction (26.66%), followed by tobacco (20.47%) and smoking (14.76%). This suggests a possible link between substance use and burn risk, a factor that requires further investigation. Diabetes mellitus (8.57%) was the most common comorbidity, followed by hypertension (7.61%), coronary heart disease (3.33%), and kidney/liver diseases (1.42%). This aligns with Mulugeta et al. [12], who emphasized the need for early medical intervention to improve burn prognosis in patients with comorbidities.

Flame burns were the most common (64.76%), followed by scalds (17.61%). Jaiswal et al. [9] also found flame burns to be the predominant cause (80.3%). However, Mulugeta et al. [12] reported scalds (47.6%) as the most common cause, particularly among younger patients.

Most burns (90.0%) occurred at home, which is consistent with Jaiswal et al. [9], who reported that domestic burns were common, particularly during cooking (8).

Accidental burns were the most frequent (84.28%), while suicidal burns accounted for 7.61%. Chakraborty et al. reported a lower percentage of accidental burns (61.4%) and a higher proportion of suicidal (18.1%) and homicidal (20.5%) burns (79). This variation may be due to sociocultural differences and reporting biases. Most patients (51.9%) were admitted within 6-12 hours, with 27.14% arriving within the first 6 hours.

The majority of patients (60.95%) had burns covering 11-20% BSA, while severe burns (>50% BSA) were seen in only 2.85% of cases. Mulugeta et al. [12] found that 95.88% of their patients had burns covering less than 20% of BSA, emphasizing that early intervention and fluid resuscitation improve outcomes (80).

The trunk (45.23%) was the most commonly affected area, followed by hands/wrists (34.76%). Mulugeta et al. noted that extremities were most frequently affected (93.5%) (80), likely due to differences in exposure mechanisms. Superficial burns were the most common (75.71%), followed by deep burns (12.85%). Second-degree burns were most frequent (75.71%), followed by third-degree (12.85%). Jaiswal et al. [9] found that third-degree burns led to higher mortality, emphasizing the importance of depth in prognosis. In our study, 86.66% of patients recovered, while 13.33% died. Jaiswal et al. [9] reported a much higher mortality rate (62.3%) due to severe burns and complications like septicemia and DIC. Chakraborty et al. [10] reported a mortality rate of 23.5%, while Mulugeta et al. [12] found longer hospital stays in patients undergoing surgical interventions. The better survival rate in our study may be attributed to a lower percentage of high BSA burns and timely medical intervention. Many previous studies have observed similar mortality rates. They mentioned that early surgical care in these cases was proved lifesaving. [13-16]

These findings reinforce the need for preventive measures, early medical care, and multidisciplinary management of burn injuries to reduce morbidity and mortality.

The present study concludes that burns were predominately involving productive age group especially females. Most of the burn patients were discharged without complication. The most causative agent of these accidents was scald; upper extremities also were the most affected area.

The mortality among burn patients was 13.33%. Mortality among the patients with co-morbidities, suicidal burns, time from burn to admission to hospital ≥12 hours and TBSA statistically associated with an increased risk of mortality.

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