Epidemiology of burn patients presenting to a tertiary hospital emergency department in Lebanon

Abstract

Background: The epidemiology of burns is well described in the United States, Europe and Asia. However, few studies address this topic in the Levant region. This study aims to describe characteristics of burn victims treated at the emergency department of a tertiary care center in Beirut, Lebanon and to report on factors that affect ED disposition.

Methods: A retrospective cohort study was conducted in the ED of a tertiary care hospital, in Beirut, Lebanon, between 2009 and 2013. Patients were recruited if their final ED diagnosis was burn. A descriptive analysis of patients' characteristics including burns was done, followed by a bivariate analysis to compare two groups (admitted vs discharged). Statistical analysis included the use of Student t-test and Pearson chi-square where appropriate. A multivariate analysis was then conducted to determine the predictors of hospital admission.

Results: A total of 366 patients had their charts queried. Age category distributions of the patients were 73 (19.9%) <5 years, 39 (10.7%) 5-14 years, 236 (64.5%) 15-65 years and 18 (4.9%) >65 years of age. Around half of the patients (47.3%) were males, with scalding being the most common mechanism of burn (53.9%), followed by contact with hot object (16.8%) and flame (11.9%). In terms of disposition from the ED, 58 (15.8%) patients were admitted to the hospital with 42 (72.4%) going to GPU, 12 (20.6%) to ICU and 4(6.9%) transferred to either another hospital or to an acute burn facility. Admitted patients tended to be at the extremes of ages (<5 years or ≥65 years), male dominant, more likely to be brought in by family, with higher proportions of more severe mechanisms of injury (flame, electric, chemical). Admitted patients also sustained higher degrees of burns with more TBSA injured. Predictors of hospital admission included the aforementioned factors with the strongest predictors of admission being full-thickness degree burn (OR 18.56 (4.67-73.72 CI95% p≤0.001)) and mechanism of injury such as electrical (OR 23.01 (3.23-163.89 CI95% p=0.002)) and chemical (OR 17.43 (2.33-130.14 CI95% p=0.003)).

Conclusion: Characteristics of burn patients treated in an urban ED in Lebanon mirror those of burn victims in other international studies. Future larger epidemiologic studies are needed to better quantify the impact of burns in Lebanon.

Keywords: Burn; ED disposition; Emergency department; Levant.