Identifying risk and protective factors for burn wound infection: A retrospective study.

Abstract

Severe burn injuries remain associated with high morbidity and mortality due to secondary complications such as burn wound infections (BWIs). However, understanding of risk and protective factors for BWIs remains limited. This retrospective cohort study included burn patients admitted to Ghent University Hospital between 2013 and 2023. Comorbidities, demographics, severity-of-illness scores, burn characteristics, and patient flow parameters were analysed. Penalised logistic regression and Cox survival analysis were performed. Patients without BWI served as controls. Among 492 burn patients, 68 (13.8 %) developed BWI, with a median onset of 4.7 days (IQR: 3.0-7.7). Penalised logistic regression identified vascular disease (aOR: 4.82, 95 % CI: [1.68-13.88], p = 0.005), age (p = 0.001), full-thickness burns (aOR: 3.26, 95 % CI: [1.55-6.89], p = 0.002) and TBSA (p < 0.001) as independent risk factors. In Cox models, debridement performed early after admission (days 2-4) was associated with a lower hazard of BWI, with no significant difference from day 5 onwards. This study underscores the association between vascular disease, age, TBSA, and full-thickness burns with BWI. Early debridement (within days 2-4 of admission) was significantly associated with reduced BWI hazard. These findings may provide valuable insights for refining early burn care and treatment protocols.