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Annals of Burns and Fire Disasters - vol. XXV - n.

4 - December 2012

EPIDEMIOLOGY AND OUTCOME OF BURNS AT THE SAUD AL
BABTAIN BURNS, PLASTIC SURGERY AND RECONSTRUCTIVE
CENTER, KUWAIT: OUR EXPERIENCE OVER FIVE YEARS (FROM
2006 TO 2010)
Khashaba H.A.,1* Al-Fadhli A.N.,1 Al-Tarrah K.S.,1 Wilson Y.T.,2 Moiemen N.2
1
2

Saud al Babtain Burns, Plastic and Reconstructive Centre, Kuwait
Birmingham Children’s Hospital, Birmingham, United Kingdom

SUMMARY. Aim. To determine the epidemiology and clinical presentation, and any contributing factors responsible for burns and
outcome of care in Kuwait over the 5-yr period January 2006 to December 2010. Patients and methods. The study reviewed 1702
burn patients admitted over the study period to the Saud Al Babtain Burns, Plastic and Reconstructive Surgery Center, Kuwait. Patient characteristics, including age, sex, type of burn, nationality, total body surface area (TBSA) burn, hospital stay in days, and
mortality were recorded. Results. Seventy-one per cent of the 1702 burn patients admitted were males; 540 were children. The majority of patients (64%) had less than 15% TBSA burns and only 14% had more than 50% TBSA burns. Flame burns were the
most common cause of burn injuries (60%), followed by scalds (29%). Scalds were most common in children. The mortality rate
was 5.75%. Flame burn was the leading cause of mortality. Lethal dose 50 (% TBSA at which a certain group has a 50% chance
of survival) for adults (16-40 yr) and for the elderly (>65 yr) was 76.5% and 41.8% TBSA respectively. Conclusion. Burn injury
is an important public health concern and is associated with high morbidity and mortality. Flame and scald burns are commonly a
result of domestic and occupational accidents and they are preventable. Effective initial resuscitation, infection control, and adequate surgical treatment improve outcomes.
Keywords: epidemiology of burns, burns in Kuwait, paediatric burns in Kuwait, LD50 for burns in Kuwait

Introduction
Burn injuries are one of the leading causes of morbidity and mortality in the Middle-East1 representing 5-12%
2
of all traumas.
The incidence of burns ranges from 112 to 518 per
100,000 per yr across all ages.3-9 A much higher incidence
of 1,388 per 100,000 per yr is reported amongst children
below 5 yr in a study from Pakistan,9 while in Kuwait a
study published in 2006 reported an incidence of 34 per
10
100,000 per yr in children aged 0-4.
Most burn incidents occur in domestic settings because
of defective household appliances, flammable agents in the
home, clothing burns, and in some cases self-inflicted injuries.11,12 The majority of burn injuries sustained by children occur at home as the result of an accident,12 thus most
of these injuries are preventable. All cases require some
degree of medical attention and many patients suffer mor-

bidity or even die.1 People affected are mostly of poor socioeconomic status and of employable age. Life styles and
social factors contribute to the high occurrence of burns
at home.
The Saud Al Babtain Center, Ibn Sina Hospital, part
of the Ministry of Health, is the only tertiary level of care
unit specialized in burn management in the State of Kuwait,
so our catchment is area covers the whole country’s population (approx. 3.7 million).
The American Burn Association criteria (Table I) for
referral to a burn centre are the guidelines followed in our
policy of admissions and referral at the Saud Al Babtain
13
Center.
This study was undertaken to describe the epidemiology, clinical presentation, and outcome in burn patients in
our setup and also to identify contributing factors influencing the outcome in burn patients.

* Corresponding author: Mr Haitham Ahmed Khashaba (MBBCh, MSc, MRCS), Riggae, Block 2, Street 1, Building 5, Farwaniya, Kuwait. E-mail: oak_80@hotmail.com

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The incidence of burn injuries requiring admission amongst nationals ranged from 7. including lightning injury • Chemical burns • Inhalation injury • Burn injury in patients with preexisting medical disorders that could complicate management.000. emotional or long-term rehabilitative intervention Table II . from January 2006 to December 2010. The highest incidence was recorded in 2008 and 2009 (10. and outcome. adults above 16). the average incidence was 10. On admission to the ward or the Intensive Care Burn Unit (ICBU) the patient received initial resuscitation including burn wound cleansing. of non-nationals X 1000* 2044 2290 2570 2340 2433 Incidence per 100.9 per 100. Data were collected using a data sheet including file number. The history regarding the aetiology of the burn injury was taken directly and confidentially from patients or from their relatives. prolong recovery. regular wound debridement and dressings were performed.8 per 100. and urine output. feet.8 10.8 10. blood pressure. amputation.000.8 per 100.8 per 100.3 11 11.Incidence of burn injuries requiring admissions by nationality Year 2006 2007 2008 2009 2010 Total no.000 in 2008. XXV . • Burn injury in patients who will require special social. pain relief and Ranitidine were given to all patients. burn type. gender.000 9. perineum. nationality.000) of burns requiring admission.8 10.7 Non-national admissions 193 198 266 257 289 No.9 *mid-year population [18] 179 . age (children were classed as being 16 yr old or below. Wound healing was assessed clinically as well as improvement in overall condition.Total incidence of burn cases requiring admission Year 2006 2007 2008 2009 2010 Total no. airway maintenance (if needed). the incidence of burn injuries requiring admission was an average of 9.4 8.December 2012 Patients and methods This prospective study was carried out at the Saud Al Babtain Center. The incidence of burn injuries in the state of Kuwait among nationals and non-nationals is illustrated in Table III.n. In the five years. or affect mortality rate • Any patients with burns and concomitant trauma (such as fractures) in which the burn injury poses the greatest risk of morbidity or death Results • Burn injury in children at hospitals without qualified personnel or equipment for the care of children Incidence The total incidence of burn injuries requiring hospital admissions in the State of Kuwait is illustrated in Table II.4 per 100.5 *mid-year population [18] Table III .4 9.000 8. of burn admissions 268 293 392 373 376 Population X 1000 3052 3328 3640 3443 3566 requiring admission were included in the study.000 7. Definitive treatment of the burn wound included skin grafts. hands. Consecutive patients with different types of burn injuries Table I . Central venous lines were employed in a few cases. temperature charts.1 11.American Burn Association burn centre referral criteria • Partial-thickness burns greater than 10% of total body surface area in patients who are younger than 10 years old or older than 50 years old • Partial-thickness burns over more than 20% of total body surface area in other age groups • Burns that involve the face.6 10. Incidence per 100. of nationals X 1000* 1008 1039 1070 1102 1133 Incidence per 100. 4 .Annals of Burns and Fire Disasters . genitalia.000) while years 2006 and 2007 recorded the lowest incidence rate (8.3 per 100. Integra® application or.000.2 per 100. in very rare cases. respiratory rate. Regarding non-nationals suffering burn injuries. intravenous fluids (Ringer Lactate) according to Parkland’s formula. percentage of TBSA burned. Patients were monitored for pulse. of admissions 268 293 392 372 375 National admissions 75 95 126 116 87 No. with an average of 9.8 8.000 in 2006 to 11.8 10. or major joints • Third-degree burns in any age group • Electrical burns.vol. After taking emergency measures. Percentage of burn was determined by using the Lund and Browder Chart. moreover. Patients with only minor superficial burns treated as out-patients by the Emergency Department were not included.5 7.

we calculated the incidence of burns in children from 0 to 14 yr of age (Table V).3 715 17.6 *mid-year population [18] Table V . XXV . mon age groups presenting with burns.4 5.6 9 7.n.Incidence of burn injuries requiring admissions according to gender Year 2006 2007 2008 2009 2010 Total no.5 No. of females X 1000* 1130 1245 1379 1304 1417 Incidence per 100.Burn admissions according to age.1 748 14. The highest number of adult patients (269 cases) admitted due to burns was recorded in 2008. 2 show that children (from 1 to 5 yr) and young adults (17-45 yr) were the most com180 Fig.6 10.7%).Number and percentage of patients of different age groups. of 0-14 years admissions 268 81 293 84 392 123 373 125 376 109 No.9 12.000. Burn cases in both adults (>16 yr of age) and children (≤16 yr) steadily increased in number from 2006 to 2008. of male cases 184 224 288 255 269 No.Number of admitted cases according to age Year 2006 2007 2008 2009 2010 Adults >16 yr 185 203 269 240 265 Children ≤16y 83 90 123 133 111 * mid-year population [18] In the study period. The highest incidence of female burn cases was reported in 2009 (9 per 100. of males X 1000* 1922 2083 2261 2139 2149 Incidence per 100. while in the children’s group the highest number of burn admissions (133 cases) occurred in 2009 (Fig.7 11.000). Fig. respectively accounting for 19% and 54% of total patient admissions from 2006 to 2010.3%). of admissions 268 293 392 373 376 No.2 729 17. The total number of adults admitted from January 2006 to December 2010 was 1162 (68. 1 . coupled with a reduction in bed capacity due to renovations starting in March 2009. 1 and Table VI). .5 7. with an over 20% increase compared to average that is attributed to the Jahra mass incident (Table IV). while the total number of children was 540 (31. of children Incidence 0-14 years per X 1000* 100000 673 12 682 12. of female cases 84 69 104 118 107 No.December 2012 Table IV . with an average of 7.6 Table VI .Incidence of burns in children 0-14 years Year 2006 2007 2008 2009 2010 Total No. in this group of children was 14. 4 .000 7.000.000 9. Data in Table VII and Fig.vol.4 per 100. Age The percentage of paediatric burns remained between 30% and 36% of the total burn cases admitted in the period. The average incidence of burns. from 2006 to 2010. of children no. Using the annual reports regarding age groups issued by the Ministry of Health in the State of Kuwait (Department of Statistics and Information) from 2006 to 2010. with a slightly negative effect on the number of admissions in 2009 and 2010.6 per 100.8 12. 2 .Annals of Burns and Fire Disasters . the average incidence of burns amongst females was lower than amongst males.

6 Gender The number of male burn patients increased from 184 cases in 2006 to 288 in 2008.3 5 1 16 3. 4 . 2010 N % 107 28 268 72 Table IX .Number and percentage of admissions according to gender Gender F M 2006 N % 84 31 184 69 2007 N % 69 24 224 76 2008 N % 104 27 288 73 2009 N % 118 32 255 68 Fig.3 Age Adults Children N % N % 861 75. Causes.2 Gender Male N 781 293 106 21 19 % 64 24 8.Distribution of patients by gender.4 27. 36% of total female admissions that year.2 14 1. Fig. i. 3 . burn admissions due to flame steadily increased in the five years. while in 2009 and 2010 the number of cases decreased to 255 and 269 respectively (Table VIII). burns due to electric current.vol. Interestingly. Forty-two females.7 1.9 84 7.2 29.7 22 1. Flame and electric burns are most commonly seen in 181 .9 4 0. site.3 52.9 31 6.7 75.2 fire incident (the Jahra fire incident).7 21 4. chemicals. XXV . and depth of burns Flame burn was the leading cause of burns.7 2 11 32 51 74 Table VIII .Annual percentage of flame burns and scalds.7 210 42.3 790 65.7 22 1.4 38 6.7 1.6 6 1.n. or contact with hot objects represented only 11% of cases (Table IX).9 13 2.3 Mean age 32.8 205 42.December 2012 Table VII . 3 shows the percentage of females and males in each year. followed by scalds (29% of all causes).2 20 1. In 2009 we recorded the highest number of female burn cases admitted to our centre (118 cases).4 149 13. gender and age Cause Flame Scald Electric Chemical Contact Nationality Kuwaiti Non-Kuwaiti N % N % 231 46.3 10. representing 60% of all causes.2 91 7.7 160 28. From 2006 to 2010.8 32.1 349 61.6 13.5 16 3.3% of all admissions (482 cases). Table X .3 33.1 288 23. were admitted in one month (August 2009) following a major Female N % 240 49. with females representing 28.Annals of Burns and Fire Disasters . with a concomitant decrease in burns due to scald (Fig.Causes of burn according to nationality.Age groups (total number of cases from 2006 to 2010) Age (yr) 0-0.9 1-5 6-16 17-45 46-65 >65 N 66 330 144 924 196 42 % 4 19 8 54 12 2 Mean age 0.Causes of burn injuries Year 2006 2007 2008 2009 2010 Total Flame Burn 141 174 232 228 246 1021 Scald Burn 96 92 110 111 89 498 Electric Chemical Contact Burn Burn Burn 24 5 2 14 7 6 30 4 16 27 3 4 27 7 7 122 26 35 Total 268 293 392 373 376 1702 Fig.6 2.0 Median age 0.e. 4). 4 .

Number and percentage of facial and hand burns 2006 Face burn Hand burn Total admissions N 228 225 2007 % 85 84 N 249 261 268 2008 % 85 89 N 353 357 293 392 2006 2007 2008 2009 2010 Number of flame burn cases 141 174 232 228 246 Number of cases with inhalational lung injury 1 4 28 12 42 N 336 332 2010 % 90 89 N 331 323 373 % 88 86 376 improved diagnostic techniques or to overzealous diagnosis.Inhalational burn injury Year 2009 % 90 91 % 0. nationality. As shown in Table XIII. Some patients.3 50. The face and hands were involved in almost 88% of the cases admitted since 2006 (Table XI).Annals of Burns and Fire Disasters . especially those with a high TBSA percentage.9 17 37.9 3 6.8 62.2 34.8 .8 2.4 32. affecting less than 15% TBSA.3 20.7 29. 55% of patients admitted required surgery in the form of excision and split-thickness skin grafts.8%.8 2.3 17 non-nationals.7 27.3 0.1% of cases they were due to flame. and in 91.2 % 16. 13 yr) (Table X). Surgery On average.3 12. XXV .n.8 70.2 Total Body Surface Area Above 30% From above 50% up to 50% up to 75 % N % N % 18 11.8 2 4.Percentage TBSA according to year.5 76.December 2012 Table XI .7% respectively).2 89.2 2 1.1%) were considered minor.9 43 28.6 19.6 12.0 1 2. the majority of the burns treated (64.3 0 0 0 0 1 2.7 118 77.7 25. Scald burns represented almost 62% of all burn cases in children 16 yr and below (mean age. Kuwaiti Non-Kuwaiti Type Chemical Contact Electric Flame Scald Age Group Child Adult 182 Less than 15% 15% up to 30% N 181 207 259 240 204 303 788 353 738 20 30 112 548 381 412 679 N 60 46 75 73 108 108 254 85 277 1 3 9 256 93 108 254 % 16.0 10.7 20. as shown in Table XII (from 0.1 7 15.6%.7 9 20.2 20.9 2.6 1.2 29. adults. and males.7% of total flame burn cases in 2006 to 17% in 2010).5 70.9 37. This is followed by cases of moderate burns with 16% to 30% TBSA (21.7 22. 69.7 10.1 42 93.2 23.7 41 26. 5).5 5 11.4 21 13.4 67.7 2.2 125 81.1 35 22.8 70.4 3 2. Patients with severe burns (30% TBSA and above) represented 14. 6).5 0. Table XII . i.0 0 0 95.6 2.6 110 71.7 67.0 36 23.7 16.4 79.4 34.3 18.8 43 28.3 Above 75% N 5 10 17 8 9 16 33 10 39 1 0 0 47 1 5 44 % 10. gender. Only 1.9 38 84.8 29.0 18.0 0 0 35 22.6% of cases (Fig.or a bit of both.3%). 4 .vol.2 32. males and adults (78. or it may be considered a true increase .8 72.e. and 86. This may be either a false increase due to more detailed documentation and Percentage of total body surface area burned (% TBSA) Severe burns (above 30% TBSA) were most commonly seen amongst non-nationals.6 23 15. type of burn and age Year 2006 2007 2008 2009 2010 Sex Female Male Nat.7 20.7 43 95.8 14 31. Almost 76% of adult admissions were due to flame burns.1 112 73.1 5.5% of children admitted presented more than 50% TBSA (8 cases) (Fig.1 12 26.0 23.2 31 68. The recorded incidence of inhalational lung injury associated with flame burns has increased dramatically since 2006. Table XIII .

XXV .9 6.2 67.0 41.9 60. The capacity of beds assigned for burn case admissions was 46 beds from 2006 to 2008.3% of the total mortality recorded. the average length of hospital stay (the average number of hospitalization days by a patient in a certain period) decreased from 19 days in 2006 to 8 days in 2010.4% (Table XV). 0. Using logistic regression.5 60 16 6.4 57.December 2012 were operated on two or more times. mortality.n. 5 .Number and percentage of patients requiring surgery (deep burns) Year 2006 2007 2008 2009 2010 Number of surgical operations performed 125 133 162 173 106 % 61.5 71. These high bed occupancy rates increase the risk of hospital-acquired infec- Table XV .3 55. i.2 21 8.1 16 7.5 26.6 7.Mortality among age groups Year Admissions 2006 2007 2008 2009 2010 268 293 392 373 376 >50% TBSA 7 19 22 25 21 Total deaths 11 22 23 25 17 Mortality rate in >16 yr of age N % Mean Mean % age TBSA 11 5.000 per yr.76% of all admissions.5 80. In the same context.1 62 37.6 Mortality rate in ≤16 yr of age N % Mean Mean % age TBSA 0 0 N/A N/A 6 5. Other causes are shown Table XVI. Table XIV .2 29. with an almost 55% decrease.Annals of Burns and Fire Disasters .8 43. LD50 is defined as the % TBSA at which a certain group has a 50% chance of survival.9 38.8 42.vol. The average mortality rate in this group from 2006 to 2010 was 2. 7).3 2 1. Mortality Throughout the study period.7 4. 4 .6 7.8%).6 Hospital stay Total hospital days (total number of hospitalization days by all patients in a certain period) more than halved in the five years under investigation. falling from 6860 days in 2006 to 3128 days in 2010. age. and % TBSA were plotted against each other in a graph to extract the Lethal Dose 50 (LD50) for each age group (Fig. reaching up to 100% and 90% in some months of 2009 and 2010 respectively. Fig.5 1 0. Flame burn was the leading cause of mortality (88.5 183 . 6 .1 7. This may indicate better surgical practices and a decrease in the number of days of unnecessary hospital stay.Percentage TBSA burned.e.Percentage adults and children burned. The average bed occupancy rate remained around 60% in the 5-yr period. effective from March 2009. Fig.5 25 Overall mortality rate 4. Mortality in the group of patients under 16 yr of age represented 14.9 0. In 2009 and 2010 bed capacity was reduced to 32 beds. due to renovation works.58 per 100. the average mortality rate in our centre was 5. The mortality rate was found to correlate closely to the number of burn cases admitted with over 50% TBSA burns. The LD50 for each age group is shown in Table XVII.5 4 3 12.5 5.9 40 67 21 7. Table XIV shows the number of burn patients with deep burns requiring excision and split-thickness skin grafts every year.

affecting both discharged and hospitalized patients.000).2 Table XVII . Although it might not provide an accurate representation of the real total incidence rate of burn injuries (i. government hospitals. According to the National Burn Repository. as almost all burn injuries requiring any level of hospital care are referred to us.1 76. This indicates a higher flow of patients.000 reported by other studies1 in the same region. Discussion Incidence and demography Considering the fact that the Saud Al Babtain Plastic and Burn Surgery Center is the only specialized centre dealing with burn injuries in the State of Kuwait.9 per 100.000 while our study showed a 2. BTR = bed turnover rate. Contrary to many studies in our region of the world.000.15 The bed turnover rate (BTR).000 (16. XXV . in the general hospital setting.000 hospital admissions for burns from 1995 to 2005.5 per 100.LD50 by age Age group (yr) <1 1-5 6-15 16-40 40-65 >65 Total Lethal dose 50 25 25 54.13 The average overall incidence of burns requiring hospital admissions in Kuwait from 2006 to 2010 was 9.8 63. Table XVIII .6 per 100.000 per yr. compared to 13. BOR = bed occupancy rate. In the Middle East. the incidence of burn injuries among males was higher than among females. the number of times a single bed is used in a given period of time.n. burn cases treated at home. in the US there were 126. In our study the incidence of female burn admissions was 10.December 2012 Table XVI . primary care centres.6%) decrease in the overall incidence of burns in the age group 0-14 between 2006 and 2010 (14.Mortality age and % TBSA plotted to show Lethal Dose 50. it most likely represents the rate of burns requiring admissions. the overall incidence rate for paediatric patients in the 017 14 age group was 17.1 41.5 times18 as much as the population . with an average overall incidence of 7 per 100.14 and also have a significant and quantifiable negative influence throughout on the emergency department throughout.e.8 7.vol. corresponding to a 35% increase in BTR over the five years. private sector). tion among patients and staff. it is fair to correlate the admissions of burn 184 cases with the incidence of burn injuries requiring hospital care in the State of Kuwait. as evidenced by the higher turnover of beds (Table XVIII).000. or burns treated on an out-patient basis).g.Annals of Burns and Fire Disasters .000 per yr. and that it accepts referrals of burn injuries from all Kuwait health services (e.5 57. 7 .3-9 The fact that in the state of Kuwait the number of nonnationals is almost 1.Burn causes and mortality Cause Chemical Electric Contact Flame Scald Mortality (N) 2 2 0 87 7 Mortality (%) 2 2 0 88. i.e.4 per 100. 4 . In a study conducted in Kuwait from 1993 to 2001.4 per 100.Hospital bed utilization indices Year 2006 2007 2008 2009 2010 Bed capacity 46 46 46 33 32 Total hospital days 6860 5222 5421 4110 3128 ALOS (days) 19 14 15 12 8 BOR (%) 60 57 53 63 60 BTR 13 14 13 17 20 ALOS = average length of stay. in the primary care setting.9 Fig. increased from 13 in 2006 to 20 in 2010. the annual incidence of burns requiring hospital admissions for all age groups ranges from 1 112 to 518 per 100.9 per 100.

the LD50 of the elderly (>70 yr) was 30% TBSA39-41 while in our study the LD50 for the elderly (>65 yr) was 41. and in our centre the LD50 of children needs attention and improvement. 18.58 per 100. Objectif. and that burns can be prevented and controlled by multi-disciplinary approaches within the whole society. Conclusion Burn injuries are an important public health issue in the East Mediterranean region. Oman. Saudi Arabia.000 children. explains the higher incidence rate of burn cases requiring admissions amongst non-nationals. ALOS had decreased to 8 days . Déterminer l’épidémiologie et décrire la présentation clinique et les éventuels facteurs responsables des brûlures et des résultats des soins au Koweït au cours des dernières cinq années. RÉSUMÉ. the LD50 for adults (16-40 yr) was somewhat closer to western world standards.5%) in children than scalds. XXV . was only 28. Our study shows that the epidemiology.3% of all children admitted. Un nombre total de 1702 pa- 185 . the median percentage of males of all ages with burn injuries was 51%.5-8.000 per yr. and with hospitals. being one of the leading causes of morbidity and mortality. and Iran from 1997 to 2005. moreover. Moreover. The exceptionally higher than average incidence of female burn admissions in 2009 is explained by the Jahra mass fire incident (when an arsonist set ablaze a wedding tent trapping almost a hundred women inside).December 2012 of nationals. Compared to the figures from the US for 2002. The mortality rate due to fire-related burns per 100. The female median percentage. pattern.7 and Pakistan.20-24. not at home.1. With regard to all age groups.20 Kuwait. the mortality rate was 4. the building of hospitals.4%. while in our study.e. and outcome of care are closely related to the standard of living of the society.8%.000 per yr. which rewards the State of Kuwait as being a HIC by the WHO.13 the face and hands are most commonly affected in burns (88%). In our study the mortality rate in children less than 14 yr of age from 2006 to 2010 was 0. In the USA in 2005.25 the percentage mortality was higher: 33%. respectively. in the high income countries (HIC) in the Eastern Mediterranean region. as 64% of burns admitted to our centre involved 15% or less TBSA.Annals of Burns and Fire Disasters .7% in our study.1 while in the US and Canada13 62% of all patients had less than 10% TBSA affected.17 Other studies.36 As reported in many studies.35 Most studies report that scalds are more common than flame injuries amongst children. at the workplace. Mortality and hospital stay The World Health Organization37 classifies burn injury as the third most important cause of mortality among children. Percent TBSA In the Middle East region the mean TBSA burned in all ages was found to range from 10 to 48%. plus the fact that most non-skilled occupations are performed by non-nationals (which makes them more vulnerable to burn injuries). 5. is 0. This study can be used as a guideline for devising future national health strategic plans for burns management.4 per 100. in our study the average mortality rate was 0. which was 49% in former studies.74% of admissions. showed that thermal burns were more common (59. In 23 studies conducted in Egypt.19-34 Causes The majority of cases admitted to our centre in the five years under investigation were due to flame burns (60%) and scalds (29%). according to the National Burn Repository. In several studies conducted in Egypt. most of these numbers are consistent with high income countries in the world. 4 . burn management. except for minor changes. and the allocation of intensive care unit beds to burn patients. most burn injuries happen at work. Our results were consistent with the results obtained from the US and Canada. the average percentage of males was 71. Patients et méthodes.3%. i. These significant results may be explained by the high standard of living of most females in Kuwait. by raising awareness at home. such as that conducted in the US between 1990 and 2006.22.this also indicating better surgical practices.3 per 100.n. Other causes of burns represented about 11% of total burn admissions. Similar results were found in many studies conducted in the same region of the world between 1997 and 2006. including public awareness programmes. Pakistan. In 1997.000 per yr. Effectiveness of burn management is best measured by the LD50. Afghanistan. surprisingly the same percentage as was found in our study. the average length of hospital stay (ALOS) in Kuwait32 was 16 days.32 Iran. while in our study of the burn admissions total. and 30%. This may be a good indicator that burns.38 The LD50 in young children (0-5 yr) was 25% TBSA: this is still low and further work is needed to improve our outcome. The results in the study showed that the outcome measured by the LD50 in the 6-15 yr age group was well behind that reported by renowned burn centres. with fire-fighters.vol. This indicates higher standards of care.7%.67% and the ALOS was 8. On the other hand. and causes of burns have been almost similar throughout the past decade in Kuwait. 6. In a similar study conducted in Kuwait in 200610 the child mortality rate was 1.

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