Burn mortality in Iraq

Qader, Ari Raheem

doi:10.1016/j.burns.2011.12.016

Cited by 14 publications

(5 citation statements)

References 20 publications

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“…According to burn types, burn injuries most frequently occurred due to exposure to flames (68.3%); the second frequent cause was electrical current (18.8%), followed by hot fluids and others (chemical burns and contact) (4.9%). These results are consistent with previous studies from both developed and developing countries (17,18). According to mortality rates in different types of burns, 53.6% of patients with flame burns, 31% of patients with electrical burns, and 8% of patients with hot fluid burns were lost.…”

Section: Discussionsupporting

confidence: 92%

Analysis of factors associated with mortality in major burn patients

Güldoğan¹,

Kendirici²,

Gündoğdu³

et al. 2018

Turk J Surg

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Objective: Major burn injury is a type of trauma with high morbidity and mortality rates at all age groups. There is no consensus on the provided guidelines regarding the prediction of severity of the victims. Not being accessible to sophisticated clinical and blood monitoring in developing countries, it remains a challenge for them. The aim of the present study was to analyze the factors that have an effect on mortality and serve as a guide for burn treatment. Factors affecting mortality in major burn patients treated in a burn treatment center of a third step hospital with over 30% of burns of the total body surface area were evaluated, and parameters indicating severity were specifically determined. Material and Methods: Medical records and follow-up notes of patients hospitalized in Ankara Numune Education and Research Hospital Burn Center between 2008 and 2014 were evaluated retrospectively. Data on age, gender, comorbidities, burn percentage, locality, type of burn, process of the burn (suicide or accident), presence of inhalation injury, results of blood hemogram and biochemical tests, length of hospitalization, type of surgical procedures performed, presence of multitrauma, and ventilatory support requirement were analyzed to determine the factors affecting mortality. White blood cell count, hemoglobin count, platelet count, and lactate dehydrogenase level were examined at admission, at the middle of the clinical course, and at the end of treatment (at both exitus date or discharge date). Results: A total of 224 patients were hospitalized with burns ≥ 30% total body surface area. Of the 224 patients, 81.7% were males, and 18.4% were females. In the mortality group, 41.3% were males, and 58.5% were females. Gender (female, p< 0.041), age (p< 0.001), age group (0-14/15-59/> 60 years, p< 0.001), total body surface area (p< 0.001), type of burn (flame, p< 0.002), presence of inhalation injury (p< 0.001), process of the burn (p< 0.002), time spent between the event and admission to the hospital (p< 0.001), length of hospitalization (p< 0.001), presence of comorbidity (p< 0.038), diabetes mellitus (p< 0.05), ventilation support (p< 0.001), lactate dehydrogenase values (lactate dehydrogenaseadmission, p< 0.001; lactate dehydrogenasemiddle, p< 0.015; lactate dehydrogenaselast, p< 0.001), white blood cell count (p< 0.001), and platelet count (p< 0.043) were found to be significant for univariate analyses. These parameters were further evaluated using multivariate analyses. Lactate dehydrogenaselast level (p< 0.001), age (p< 0.001), length of hospitalization (negative odds ratio), p< 0.001), presence of inhalation injury (p< 0.029), total body surface area burned (p< 0.029), and leukocytosis (p< 0.006) were found to be significantly associated with mortality; however, leukocytosis and length of hospitalization did not pose risk for mortality with regard to odds ratios. Conclusion: Early recognition of the factors affecting morbidity and mortality in patients and taking preventive measures, in addition to earlier de...

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Section: Discussionsupporting

confidence: 92%

Analysis of factors associated with mortality in major burn patients

Güldoğan¹,

Kendirici²,

Gündoğdu³

et al. 2018

Turk J Surg

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“…Reports have shown burns are a common mechanism of domestic violence in Iraq [37,38]. In addition, prospective surveillance from a Burn and Plastic Surgery Hospital in Kurdistan showed that 83% of burn deaths in women were suicides [39]. Given existing research on the use of burning as a common mechanism for domestic violence and self-harm in the region, it is possible that fatal burns classified in our data as unintentional may have been attributable to either interpersonal violence or self-harm, resulting in an underestimation of deaths from these categories.…”

Section: Discussionmentioning

confidence: 99%

“…Fifth, both self-harm and domestic violence deaths may be under-reported, as evidenced by a higher than expected proportion of fatal burns in women attributed to unintentional injuries and no domestic violence reported in some years. Other studies have demonstrated high numbers of domestic violence deaths in other areas of Iraq and increasing rates of suicide in both sexes [39,41]. Domestic violence in Iraq is also considered honorable in some situations, and both mental health and self-harm carry stigma, factors that may impact both reporting and classification [42][43][44][45].…”

Section: Discussionmentioning

confidence: 99%

Injury-related deaths before and during the Islamic State insurgency – Baghdad, Iraq, 2010–2015

et al. 2020

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Background: Following a period of low intensity conflict during 2009-2012, the emergence of the Islamic State of Iraq and Levant (or Islamic State) in 2013 was associated with a resurgence of violence in Baghdad, Iraq's capital and largest city. We evaluated trends in injury-related deaths in Baghdad before and during the Islamic State insurgency. Methods: Iraqi National Injury Mortality Surveillance System prospectively collects information on fatal injuries from governorate coroner offices using standardized reporting forms. Trained coroner clerks collect information on victim demographics, intention of injury and mechanism of injury during medical examinations using reports from police and families. We analyzed data on all deaths reported by the Baghdad Forensic Institute from January 1, 2010 to December 31, 2015.Results: There were 17,555 injury-related deaths with documented intent and mechanism (range 2385-3347 per year): 6241 from gunfire (36%), 1381 explosions (8%), 1348 non-gunfire assaults (8%), 3435 traffic accidents (20%), and 5150 other unintentional injuries (29%). Rates of gunfire (23.45 per 100,000) and explosion (5.90 per 100,000) deaths were significantly higher in 2014 than in all other years during the review period (p < 0.001 and p = 0.03, respectively). During the same period from 2010 to 2015, traffic accident deaths declined significantly from 13.29 to 6.35 (p = 0.002), with declines observed primarily among pedestrians. Trends in the rate of non-gunfire-assault and unintentional deaths, comparing 2010 and 2015, were not significant (p = 0.12 and p = 0.63, respectively). Unintentional deaths were mostly attributed to burns (46%) and electricity-related injuries (31%). The proportion of both females and children was highest in unintentional injury deaths. Conclusions: During the study period, deaths from both gunfire and explosions in Baghdad peaked in 2014, corresponding with emergence of the Islamic State. Trends suggest a potential impact of insurgency-related activity on other injuries as evidenced by a decrease in the death rate from traffic accidents. The decreased traffic-related death rate could be from decreased vehicle and pedestrian activity during times of violence. Monitoring trends in injury mortality during conflict allows Iraq to identify priority injury causes to inform public health interventions.

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“…According to these limitations, early excision and grafting is not considered the standard of care" [8]. Mortality rate is higher in centers with lesser resources, evident through reports from Cameroon and Iraq that showed a mortality rate of 23.4% and 29% respectively [9] [10]. A multicenter study concluded that in modern highly specialized burn centers, adults with more than 40% TBSA burns and children with more than 60% TBSA burns were at high risk of mortality [11].…”

Section: Discussionmentioning

confidence: 99%

Delayed Grafting as a Valid Technique in Burn Management: Experience from a Burn Unit in Oman

Alsafy,

Jacob,

Elias

et al. 2024

MPS

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Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15% -20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.

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Burn mortality in Iraq

Cited by 14 publications

References 20 publications

Analysis of factors associated with mortality in major burn patients

Analysis of factors associated with mortality in major burn patients

Injury-related deaths before and during the Islamic State insurgency – Baghdad, Iraq, 2010–2015

Delayed Grafting as a Valid Technique in Burn Management: Experience from a Burn Unit in Oman

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