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

Abstract

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