Cureus | Mortality from Thermal Burns in Patients Using EMS in India

Mortality from Thermal Burns in Patients Using EMS in India


Abstract

Abstract

Objectives: Characterize the demographics, management, and outcomes of patients using emergency medical services (EMS) for thermal burns in India.

Methods: A prospective observational study of patients using EMS for thermal burns across five Indian states over four months in 2015.

Results: We enrolled 439 patients, 30-day follow-up rate 85.9%. The median age was 31 years; 50.3% (N = 221) lived in poverty; and 65.6% (N = 288) were women. EMS transported most patients within two hours (94.3%; N = 395). Overall 30-day mortality was 64.5%, but was 90.2% in women with self-inflicted burns. In total, 45.6% (N = 200) reported self-inflicted burns. Intentional burns involved a median total body surface area (TBSA) of 80%, versus 35% in accidental burns.  Inhalation injury (OR 6.7; 95% CI 3.1, 14.5), intentionality (OR 6.6; 95% CI 3.6, 12.2), economic status (OR 2.6; 95% CI 1.2, 6.0), and gender (OR 2.3; 95% CI 1.3, 4.0) predicted mortality by multivariate regression.

Conclusions: EMS connects critically burned patients to needed care in India. Mortality from thermal burns remains exceedingly high, with women disproportionality suffering self-inflicted burns and higher mortality. Burn prevention in India must recognize the prevalence and severity of self-inflicted burns and the need for mental health and gender-based violence supportive services.

Poster
non-peer-reviewed

Mortality from Thermal Burns in Patients Using EMS in India


Author Information

Jennifer Newberry Corresponding Author

Emergency Medicine, Stanford University School of Medicine, Palo Alto, USA

Corey B. Bills

Emergency Medicine, University of California, San Francisco , San Francisco, USA

Elizabeth A. Pirrotta

Department of Emergency Medicine, Stanford University School of Medicine, Stanford, USA

Sybil Zachariah

Emergency Medicine, Stanford University School of Medicine

G.V. Ramana Rao

Emergency Medicine Learning Centre & Research, Gunupati Venkata Krishnareddy Emergency Management and Research Institute, Hyderabad, IND

Swaminatha Mahadevan

Emergency Medicine, Stanford University School of Medicine, Palo Alto, USA

Matthew Strehlow

Emergency Medicine, Stanford University School of Medicine, Palo Alto, USA


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