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Abstract
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INTRODUCTION: In 2018 the World Health Organization (WHO) launched the Global Burn Registry (GBR). Its purpose is to help improve the understanding of burn injury worldwide. The purpose of this study was to identify early findings from this database.
METHODS: The GBR was accessed 05 January 2020. Cases from centers in low income (LIC) and low-middle income countries (LMIC) were combined into a Low Resource (LR) group, and cases in High Income (HIC) and Upper Middle Income (UMIC) countries were combined into a High Resource group (HR). Statistical analysis was performed with SAS 9.4. Data are expressed as mean ± SEM. Logistic Regression was used to identify risk factors for death. Revised Baux Score (RBS) was calculated as described by Osler (2010). Odds ratios are expressed as mean (95% confidence interval). The LA50 was calculated from the regression of death and total burn size (TBSA) for different age groups.
RESULTS: At the time of analysis, there were 4,307 cases in the GBR treated at 28 facilities in 17 countries (5 HIC, 5 UMIC, 4 LMIC, and 3 LIC). There were 2,945 cases (68%) from HR countries and 1,362 (32%) from LR countries. The mean age of patients in both LR and HR was similar (24.5 ± 0.5 years vs 24.2 ± 0.4, p=0.58), but LR had larger TBSA burns (30.5 ± 0.7 % TBSA vs 19.8 ± 0.4, p<0.0001). There were fewer scald burns and more flame injuries in the LR countries (28.4 ± 1.3 % vs 43.3 ± 1.0, and 55.2 ± 1.4 % vs 39.0 ± 0.9, p<0.0001). Case fatality and RBS were greater in LR (31.9 ± 1.3 % vs 9.4 ± 0.5 and 59.4 ± 1.1 % vs 45.3 ± 0.6, p<0.0001). In regression analysis, LR was an independent risk factor for death with an odds ratio of 4.2 (3.2 - 5.4). The LA50 for HR countries was similar to those in the National Burn Repository. For LR countries the LA50 was lower for all ages except those 65 and older, ranging from 30-43% TBSA.
CONCLUSIONS: Only a few facilities have contributed data to the GBR so far, with lower resourced countries less represented than higher resourced ones. The proportion of cases in the pediatric age group is much less represented in LR countries than in HR, possibly because many burned children in LR countries do not get burn care at specialized centers. Survival in HR countries is similar to that in North America. The GBR provides early insights into global burn care. Opportunities for improvement are greatest in LR countries. New Innovations may be necessary to increase participation from burn centers in LR countries.
Language: en |