STUDY OF FACTORS AFFECTING MORTALITY IN BURN PATIENTS ABOVE 18 YEARS OF AGE

This is a cross - sectional, prospective, observational study conducted at M. R. BANGUR HOSPITAL, TOLLYGUNGE, KOLKATA- 33 over 157 patients to study factors affecting mortality in burn patients from January 2014 to December 2015. Most of the burns are domestic 88.6% and 56.1%% of these occur in kitchen. Flame catching fire is the chief cause of burn (72%) in this part of country. Females (house-wives 54.1%) are the most common victims of burn, the male: female ratio being 1:2.01. The risk of death was 2.38 times more among females as compared to males. Most of the patients are Hindu 86% and comes from rural areas 81.5%. 47.1% patients come from the age group 19-39 years and female predominates in each group. Mortality increases with the increase in total body surface area burn, increase in age, degree of shock, type of first aid received, presence of infection, previous health of patient and degree of anaemia and hypoproteinaemia. Other factors remaining constant, mortality increased proportionately with the advancement of age and extent of burn. About 66.2% of cases reached this hospital after 10 hours of burn injury but 77.1% of cases reached within 20 hours of burn injury. 50.3% of cases developed oliguria and 7.6% cases anuria in 1st 48 hours due to burn shock. There is marked haemoconcentration in the 1st 48 hours followed by low haemoglobin contents and hypoproteinemia later on. 91 Majority of cases brought here for admission received either no first aid or inadequate first aid and only 10.8% of cases got proper first aid which greatly influenced mortality. About 38.7% of patients got infection of the wound. Staphylococcus aureus is the most common contaminant (26.1%) followed by Pseudomonas pyocyaneus (6.7%). Other organisms isolated are E. coli and Proteus. Involvement of anterior trunk and head & neck has poor prognostic value regarding mortality in burn patients. Surgical interventions like early debridement and split thickness skin grafting has in reduction of hospital stay and mortality. Majority of patients have dyselectrolytemia at the time of admission. Shock and renal failure (67.3%) are the most common causes of death in burn cases in this hospital followed by septicaemia (28.8%). Chest infection, anaemia and hypoproteinemia are the next important causes of death.