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Abstract
Introduction. Severe burns are a major cause of morbidity and mortality, yet their epidemiological and outcome profile is poorly documented in Chad. This study described the epidemiological, clinical, therapeutic, and outcome characteristics of severe burns admitted to the intensive care unit at the Renaissance University Hospital Center in N’Djamena (CHUR). Methods. A retrospective descriptive and analytical study was conducted from 2021 to 2024 in the CHUR ICU, including all patients hospitalized for severe burns. Sociodemographic, clinical (burn surface area, ABSI score), therapeutic, and outcome data were collected. Results. Among 1,576 admissions, 25 patients had severe burns (prevalence 1.6%). Mean age was 32.4 years, with male predominance (68%). Only 8% of patients were admitted within the first 6 hours. Domestic accidents were the main cause (40%). Mean burned body surface area was 55%. Flame burns predominated (76%). Hypoalbuminemia was present in 96% of patients, empirical antibiotic therapy was administered in 92%, and skin grafting was performed in 12%. Septic shock occurred in 61.5% of patients. Overall mortality was 72%. Factors associated with death were burn extent, time to treatment, and smoke inhalation. Conclusion. Severe burns in Chad are dominated by flame burns, often related to butane gas use. Mortality is very high (72%). Enhanced prevention and rigorous antibiotic prophylaxis are needed to reduce secondary infections and improve survival.
RÉSUMÉ
Introduction. Les brûlures graves sont une cause majeure de morbidité et de mortalité, mais leur profil épidémiologique et évolutif est peu documenté au Tchad. Cette étude décrit les caractéristiques épidémiologiques, cliniques, thérapeutiques et évolutives des brûlures graves admises en réanimation au Centre Hospitalier Universitaire Renaissance de N’Djamena (CHUR). Méthodes. Notre étude rétrospective descriptive et analytique a été menée de 2021 à 2024 dans l’unité de réanimation du CHUR, incluant tous les patients hospitalisés pour brûlures graves. Les données sociodémographiques, cliniques (surface brûlée, score ABSI), thérapeutiques et évolutives ont été collectées. Résultats. Sur 1 576 admissions, 25 patients présentaient des brûlures graves (prévalence 1,6 %). L’âge moyen était de 32,4 ans, avec une prédominance masculine (68 %). Seuls 8 % des patients ont été admis dans les 6 premières heures. Les accidents domestiques étaient la cause principale (40 %). La surface corporelle brûlée moyenne était de 55 %. Les brûlures par flamme prédominaient (76 %). Une hypoalbuminémie était présente chez 96 % des patients, une antibiothérapie empirique administrée dans 92 % des cas, et une greffe cutanée réalisée chez 12 %. Un choc septique est survenu chez 61,5 % des patients. La mortalité globale était de 72 %. Les facteurs associés au décès étaient l’étendue des brûlures, le délai de prise en charge et l’inhalation de fumées. Conclusion. Les brûlures graves au Tchad sont dominées par les brûlures par flamme, souvent liées à l’usage de gaz butane. La mortalité est très élevée (72 %). Une prévention accrue et une antibioprophylaxie rigoureuse sont nécessaires pour réduire les infections secondaires et améliorer la survie.
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References
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References
1. Yoboué YD, Koffi KP, Diarrassouba A, Kouamé K, Kouadio L, Konan K, et al. Burns in the home environment in Abidjan. Rev Afr Public Health. 2020; 14(2 ): 103-107.
2. Kumakawa Y, Kondo Y, Hirano Y, Sueyoshi K, Tanaka H, Okamoto K. Characteristics and clinical outcomes of patients with combined Burns and trauma in Japan: Analysis of a national trauma registry database . Burns. 2024 Sep; 50(7 ): 1719-25.
3. Smith J, Thompson R, Lee A. Epidemiology of Burn Injuries in Urban Canada: A 5-Year Retrospective Study . Can J Burn Care. 2025; 12(2 ): 75-82.
4. Eftekhari H, Amini R, Khoshnevisan M, Razzaghi A, Zardosht M, Salehi SH. Epidemiology of chemicals burns : An 11-year retrospective study of 126 patients at a referral burn center in the north of Iran. Int Wound J. 2023; 20(5 ): 1475-1483.
5. Mobayen M, Bagheri Toolaroud P, Attarchi M, Feizkhah A, Esmallzadeh M, Rimaz S, et al. Epidemiology of work-related burn injuries: A ten-year retrospective study of 429 patients at a referral burn center in the north of Iran. Int Wound J. 2023 Sep; 20(9 ): 3599-3605.
6. Ţolescu RŞ, Zorilă MV, Zăvoi RE, Popescu C, Dumitru I, Oprică AC, Mogoantă L. Correlations between the Glasgow Score and the Survival Period in Patients with Severe Traumatic Brain Injury . Curr Health Sci J. 2020 Oct- Dec; 46(4 ): 412–419.
7. Cohler S, Krasner H, Batra K, Saquib S. The Individual-Level and Community- Level Social Determinants of Burn Injuries: A Single-Institution Study From the Southwestern United States. J Burn Care Res . 2025 Mar; 46(2 ) : 245-52.Akinlabi AA, Ojo AA, Akpor OA. Prevalence and Management Outcomes of Burns in a Teaching Hospital in Ekiti State, Nigeria: A Five- Year Review . Ann Burns Fire Disasters . 2022 Dec .
8. Akinlabi AA, Ojo AA, Akpor OA. Prevalence and Management Outcomes of Burns in a Teaching Hospital in Ekiti State, Nigeria: A Five- Year Review . Ann Burns Fire Disasters . 2022 Dec 31; 35(4 ): 298-305.Liu SY, Song JC, Mao HD, et al. Glasgow Coma Scale as an Indicator of Patient Prognosis : A Retrospective Study of 257 Patients with Heatstroke from 3 Medical Centers in Guangdong, China. J Clin Med. 2023 Feb 6; 12(3 ): 789. doi : 10.3390/jcm12030789.
9. Radzikowska -Büchner E, kopuszynska 1, Flieger W, Tobiasz M, Maciejewski R, Flieger J. Burns: classification, pathophysiology , and treatment : has review . Int J Mol Sci . 2023; 24 (4 ): 3749. doi : 10.3390/jms24043749.
10. Bagheri M, Fuchs PC, Lefering R, Grigutsch D, Busche MN, Niederstätter I, The German Burn Registry , Schiefer JL. Effect of comorbidities on clinical outcome of patients with burn injury - An analysis of the German Burn Registry . Burns. 2021 Aug; 47(5 ): 1053-1058.
11. Zhang Y, Su J, Liu Y, Sun R, Sun R. Epidemiological and clinical characteristics of severe burns in adults : A retrospective study at a burn center in Suzhou, China. Int Wound J. 2024 Dec; 21(12 ):e 70097. doi : 10.1111/iwj.70097.
12. Schaefer TJ, Szymanski KD. Burn Evaluation and Management. In: StatPearls . Treasure Island (FL ): StatPearls Publishing ; 2023 Aug 8 [2025 May 30]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430741/
13. Schaefer TJ, Szymanski KD. Burn assessment and management. In: StatPearls . Treasure Island (FL ): StatPearls Publishing ; January 2025. Available at: https://pubmed.ncbi.nlm.nih.gov/28613492/
14. Wardhana A, Wibowo J. Predicting Mortality in Burn Patients: Literature Review of Risk Factors for Burn Mortality and Application in Scoring Systems . Ann Burns Fire Disasters . 2023 Mar 31; 36(1 ): 3-10.
15. Bbaale D, Mohr C, Lindert J, Allorto N, Mabanza T, Katabogama JB, Chamania S, Elrod R, Boettcher M, Elrod J. Barriers and prospects for skin grafting in burn treatment across African countries. Burns. 2024 Jun; 50(5 ): 1150-1159.
16. Haïdara TM, Hissein HA, Anas B, Amal J, Mok. Burns in adults in the General Surgery Department of Gabriel Touré University Hospital. 2021. Available at: https://bibliosante.ml