• Users Online: 509
  • Print this page
  • Email this page

Table of Contents
Year : 2022  |  Volume : 19  |  Issue : 4  |  Page : 547-553

Sociodemographic characteristics and fate of hospitalized burned patients in Al-Hilla city

Department of Family and Community Medicine, College of Medicine, University of Babylon, Babylon, Iraq

Date of Submission13-Jul-2022
Date of Acceptance08-Aug-2022
Date of Web Publication09-Jan-2023

Correspondence Address:
Hiba Khaleel Hasan
Department of Family and Community Medicine, College of Medicine, University of Babylon, Babylon
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/MJBL.MJBL_112_22

Rights and Permissions

Background: A burn is defined as a damage to the tissues due to high temperatures or heat, cold, electrical, chemical, friction, or irradiation. In developing countries such as Iraq, burn injuries are widespread, particularly in low-income and rural regions. Burns are considered the fourth most prevalent type of injuries worldwide. Objectives: The aim of this study is to assess the sociodemographic characteristics of hospitalized burned patients, as well as patients’ fate and related risk factors. Materials and Methods: This was a cross-sectional study. The data were collected by interviewing patients who admitted in the burns ward center of Al-Imam Al-Sadiq Teaching Hospital or their companions, for a 3-month period from February 1, 2022 to May 1, 2022. Statistical analysis was done by SPSS version 27. Results: We collected data from 73 burned patients, which showed that most of them were males 53.4%, the mean age ± standard deviation was 18.76 ± 16.81 years, 65.8% living in rural areas, most patients had scald burn 43.9%, with second degree of burns and total body surface area (TBSA) <50%. About the outcome, 38.3% died. We found a significant (P-value >0.05) association between the fate of burned patients and the age, gender, place of burn, degree of burns, TBSA involved, and the presence of inhalational injury. Conclusion: The majority of the burned patients were male children, with scald burns, second-degree burns, and TBSA more than 50%. The mean age was 18.67 ± 16.81 years. The mortality rate was 38.3% and increased with age, female gender, flame burn, TBSA more than 50%, and with inhalation injuries.

Keywords: Burns, fate, scalds

How to cite this article:
Hasan HK, Al-Humairi AK. Sociodemographic characteristics and fate of hospitalized burned patients in Al-Hilla city. Med J Babylon 2022;19:547-53

How to cite this URL:
Hasan HK, Al-Humairi AK. Sociodemographic characteristics and fate of hospitalized burned patients in Al-Hilla city. Med J Babylon [serial online] 2022 [cited 2023 Feb 6];19:547-53. Available from: https://www.medjbabylon.org/text.asp?2022/19/4/547/367321

  Introduction Top

A burn is defined as an injury to the tissues due to high temperatures or heat, cold, electrical, chemical, friction, or irradiation; however the majority of burn injuries are caused by heat from hot water, solids, or flame.[1],[2] One-third of burn casualties are youngsters under the age of five.[3] The high prevalence of burn injuries in preschool children has been related to their developmental lack of motor coordination and high level of physical activity.[3] The burn’s outcome is determined by characteristics such as the degree of burn, time of exposure, surface area involved, location, age, and gender.[4] According to the WHO, 11 million burn injuries of all types occur worldwide each year, and 180,000 of those are fatal.[5] Because of the impairment of host defense mechanisms and the extreme post-injury inflammatory reaction, burns are a leading source of illness and mortality all around the world.[6] Burns are a common type of domestic trauma.[7] Burn injuries are among the most serious health issues that result in prolonged hospital stay and thus risen costs for patients, their families, and community.[8] In developing countries such as Iraq, burn injuries are widespread, particularly in low-income and rural regions.[7] According to the Global Burden of Diseases, in 2017, the number of burn injuries worldwide was extremely high,[9] and accidental burn damage is the third leading cause of death in the USA.[10] Burn injuries have serious physical, psychological, and economic consequences for patients, their families, and community.[11] Following traffic accidents, falls, and physical violence, burns are the fourth most prevalent type of injuries worldwide.[12] Nowadays, burn-related mortality has dropped by much more than half in recent years, and patients with burns affecting up to 90% of their body can live with proper management.[13] Although these advancements bring to light the advantages of burn care innovation, there are still aimed at improving healing and clinical outcomes, as well as reducing patients’ length of stay in hospitals and the additional expenses of burn injuries.[14],[15] Burns are classified according to the depth of the wound into the following: superficial burn (first degree) causes redness, which includes the epidermal layer and is accompanied by redness, minor pain, and swelling[16]; partial thickness, superficial burn (second degree), in which the epidermis and dermis are both damaged[17] and classified as mosaic types, which include (II A) the epidermal and dermal superficial layers are eroded[15] and (IIB) at various depths, the epidermal and dermal layers are eroded[17]; full thickness deep burn (third degree): in this type, the entire layers are eroded,[17] and full thickness including deeper burn (fourth degree): this type of burn invades from the epidermis to the subcutaneous tissue.[16],[17] Even with technological and medical advancements, burns are still severe issues that endanger lives; thus the simplest and most efficient strategy is to prevent burns by taking precautions prior to the event.[18]Objective of the study: This study goal is to assess the sociodemographic characteristics of hospitalized burned patients and also to assess the fate of the patients and related risk factors.

  Materials and Methods Top

Study design

This study is conducted to assess the sociodemographic characteristics of hospitalized burned patients also to assess the fate of the patients and related risk factors.

Study location: This study was carried at a burn unit in Al-Imam Al-Sadiq Teaching Hospital, Babylon Governorate, Iraq.

Data collection tool and scoring system

After obtaining verbal permission, data were collected by interviewing patients admitted to the burn unit or their companions. The research questionnaire was prepared by reviewing multiple articles regarding the same subject in Iraq and other countries and by multiple opinions of several experts. Pilot study was done for assessment of questionnaire as well as assessment of the time needed to complete it, also multiple changes was done on the forma before starting of collection of the patients. In this study, the inclusion criteria included all hospitalized burned patients in Al-Imam Al-Sadiq Teaching Hospital Burn Center, whereas exclusion criteria included patients who refused to participate in the study and patients who admitted and discharged on his/her family responsibility on the same day. The limitation of the study was that the time of the study was short.

Pilot study

A pilot study was done before starting the data collection for 1 week from 1st of February to 7th of February at Al-Imam Al-Sadiq Teac hing Hospital to identify any modification required to the questionnaire and time need for data collection and for protocol assessment while is realistic and workable. The sample of the pilot study was 10 burned patients and were excluded from the sample of the study and there are no modifications after this study.

Data analysis

SPSS version 27 was used for statistical analysis. Numbers and percentages were used to represent categorical variables. Means±standard deviation was used to represent continuous variables. The analysis of variance test was used to compare the means of three groups. To predict the association between categorical variables, Pearson’s χ2 and Fisher’s exact test were used. A P-value of ≤ 0.05 was deemed significant.

Ethical approval

The study was conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki. It was carried out with patients’ verbal and analytical approval before the sample was taken. The study protocol and the subject information and consent form were reviewed and approved by a local Ethics Committee according to the document number 62 (including the number and the date in 11/5/2022) to get this approval. This study was approved by the Scientific Committee of Family and Community Medicine Department, College of Medicine, Babylon University. Verbal consent was taken from every patient before data collection.

  Results Top

The following result involves the data of 73 admitted burned patients collected in 2022 (from February 1, 2022 to May 1, 2022). [Table 1] shows that the range of age was 1–85 and the mean age was (18.67±16.81) gender 39 ((53.4%) were male and 34 (46.6%) were female), residence (48 (65.8%) were rural while 25 (34.2%) were urban).
Table 1: The distribution of patients according to sociodemographic characteristics (n = 73)

Click here to view

[Figure 1] shows 32 patients with scald burn at 43.9%, followed by flame burn at 34.2%, chemicals burn 20.5%, and electrical burn 1.4%. [Table 2] shows patients with a second degree of burn of 41 with 56.2%, patients with second to third degree of burn of 30 with 41.1%, and patients with third degree of burn with 2.7%. Patients with total body surface area (TBSA) <50% were 19(26%), and patients with total body surface area (TBSA) 11-20% were 18 (24.6%). There were 15 (27.4%) patients with inhalational injury. [Figure 2] shows the distribution of patients according to outcomes: 30 patients (41.1%) were discharged well, 28 patients (38.3%) died, 8 patients (11%) were discharged on responsibility of patient or family, and 7 patients (9.6%) were referred to another department or hospital. [Table 3] shows 20 females died (71.4%). [Table 4] shows that dead patients who had second- and third-degree burns were 20 (71.4%). The burning mechanism for 11 (39.3%) dead patients was the flame, followed by death due to chemical burns [10 (35.7%)]. The majority 16 (57.1%) of the dead patients were with TBSA more than 50%, 6 (21.4%) with TBSA 41–50%, and 5 (17.9%) with 31–40% TBSA. Fifteen patients (53.6%) died due to inhalational injury.
Figure 1: The distribution of patients according to mechanism of burns (n = 73)

Click here to view
Table 2: The distribution of patients according to characteristics of burns (n = 73)

Click here to view
Figure 2: The distribution of patients according to outcome (n = 73)

Click here to view
Table 3: Association between sociodemographic characteristics and fate of patients (n = 73)

Click here to view
Table 4: Association between burn characteristics and fate of patients (n = 73)

Click here to view

  Discussion Top

Regarding the total (73) number of burned patients for a 3-month period (from February 1, 2022 to May 1, 2022), we found that the mean age was 18.7 ± 16.81; this distribution of age matches the research.[19],[20] Regarding the gender, we found that burn injuries are more common in males (53.4%) than in females (46.6%), and this result is in agreement with other studies.[21],[22],[23] Most of the cases in our research were of low economic status (57.5%) and living in rural areas (65.8%), similar to the result in studies,[20],[24] in Jordanian research, the majority of burned patients (79.7%) were living in urban areas.[25] The majority of patients were from rural areas, which might be attributed to the poorly educated, low socio-economic level, and a lack of access to cooking safety precautions. Most of the burned patients were children (34.2%), and this result is also shown in many other researches but at higher percent (46%).[21],[26] This might be explained by the fact that our study included more male children. Children are particularly vulnerable to unintentional accidents because they are typically unaware of basic household risks such as flames, hot liquids, and electrical currents. Most patients (45.2%) had only completed primary school, and this result is in line with a local study’s findings.[27] The most common mechanism of burn in our research were scalds (43.9%), followed by flames (34.2%). These results are similar to the Saudi research,[22] while research[21] found the flame is the most common, followed by scalds. In comparison to adults, children were more frequently afflicted by scalds. They are made largely of hot water and hot tea, and they are typical during meals cooking. This can be explained by a lack of awareness or knowledge of risky situations in children, as well as poor parental consent. The majority of the burn injuries 93.1% in this research happened at home. This result is in accordance with previous researches.[23],[28],[29] Most of the patients in our study (56.2%) had second-degree burn injuries. Several researches conducted in developing countries have also shown similar findings.[24],[25] This could be linked to the fact that scald burns were the most prevalent causes of burn injuries in this research, which impacted the epidermisand a portion of the dermisand exposing the body to infections, of which Pseudomonas aeruginosa was the most common bacterium found in burned patients.[30] Regarding TBSA, we found 26% of patients with more than 50% burned surface area, and this percentage is almost close to the researches of Pakistan and India.[31],[32] Our data revealed that the most often impacted anatomical areas in burn patients were multiple areas (90.5%); this was similar to the finding of Alipour et al.[33] in their study. This explains the inclusion of more than one area of the body in the burn, where the TBSA is large. In our study, we found that the death frequency among burned patients was 38.3%. This result is lower than the death rate (84.95%) in the research of Pakistan[31] and more than the rate (9%) of research in Kenya.[28] This is determined by the extent of the body’s reaction to therapy, as well as the degree of burning and problems that occur as a result of the burn, and these variances may be attributed to the character of these communities. In our study, we found significant correlation (P-value 0.029) between mean age and the fate of burned patients, in which the mortality rate increased with age; the mean age of the dead patients was 25.14 ± 19.25. This was similar to the findings in Vagholkar et al.,[34] Obaid et al.,[35] and Tan Chor Lip et al.[36] Ages patients become more likely to suffer from problems and have a greater incidence of elevated body surface area, partly owing to a decline in immunological function and physiological skin thinning. They also have more difficulty in defending themselves during an accident, contributing to worse outcomes.[34] There was a significant association (P-value 0.002) between gender and fate of patients, as the number of females [20 (71.4%)] exceeded the number of males [8 (28.6%)] among the deceased patients. There are multiple studies whose results are consistent with us.[23],[33],[35] About 71.4% of the dead patients had second- and third-degree burns, and there was a significant association (P< 0.001) between the degree of burns and the fate of the patients, and similar results are found in studies.[35],[37] The mortality rate of burned patients with <50% TBSA was high (57.1%). There was a significant association between TBSA that affected and mortality (P <0.001), and our finding was in agreement with the recent research in Ankara[38] and research in Nasiriyah.[39] As for the site of burning, it is also considered significant (P = 0.015), where all dead patients had multiple sites involvement. This means that patients with burns with a large surface area, multiple parts of the body, and with a second- and third-degree burn together are with a high mortality rate. Many (39.3%) patients burnt by flames died, and flame burns were responsible for the bulk of deaths, followed by chemical burns (35.7%) and scald burns (25%). A study in Cameroon showed burns with flame caused the majority of death.[40] This can be explained by the fact that most of the deaths are females, as most of their burns are due to the flame first, because they spend most of the time in the kitchen and approach the flame while cooking without good protection, as well as sometimes they wear quick-burning clothes, as well as females committing suicide using flames and chemicals. In this study, patients with inhalation injury had a mortality rate of about 53.6%, and other studies[22],[36],[41] agreed with us. Inhaling smoke damages the upper airways, and generalized massive edema can cause respiratory tract obstruction. Besides, hypoxia may necessitate endotracheal intubation or mechanical ventilation.

  Conclusion Top

Our study in the current year (2022), which was applied in the burn center at Imam Al-Sadiq Teaching Hospital in Al-Hilla city, found that the majority of burned patients were male, children, mean age was 18.67 ± 16.81 years, with low level of education and low economic state, living in rural areas, scald was the most common mechanism of burns, most of them were with second-degree burns with multiple body sites involvement and TBSA more than 50%. The mortality rate in our study was 38.3%, and we found that the mortality rate increased with age, high in female gender, high in flame burn, elevated when the place of burn was in the home, when multiple body sites were involved with TBSA more than 50%. The mortality increased in the presence of inhalation injuries.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Chithrani WA, Ruwanpura PR A study on characteristics of burn patients who were admitted to a tertiary care hospital in the Southern Province of Sri Lanka. Medico-Legal J Sri Lanka 2020;8:8-14.  Back to cited text no. 1
American Burn Association. National Burn Repository 2019 Update. Report of data from 2009-2018. Available from: https://ameriburn.siteym.com/store/ViewProduct.aspx?id=14191872. [Last accessed on 2022 Mar 15].  Back to cited text no. 2
Ozlu O, Basaran A Sociodemographic factors and living conditions of pediatric burn patients. Paediatr Indones 2022;62:149-5.  Back to cited text no. 3
Kumar M, Yasmin E, Kumar C, Kashyap V Pattern of burn injury among patients admitted in a Tertiary Care Hospital of Jharkhand. Int J Community Med Public Health 2018;5:3056-60.  Back to cited text no. 4
World Health Organization. Burns. 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/burns. [Last accessed on 2022 Mar 23].  Back to cited text no. 5
Corcione S, Pensa A, Castiglione A, Lupia T, Bortolaso B, Romeo MR, et al. Epidemiology, prevalence and risk factors for infections in burn patients: Results from a regional burn centre’s analysis. J Chemother 2021;33:62-6.  Back to cited text no. 6
Allawi BSA, Baiee HA, Baiee AH Burn injury characteristics and outcomes among hospitalized patients in tertiary burn unit. Medico-legal Update 2020;20:764-9.  Back to cited text no. 7
Mohadeth Ardebili F, Bozorg Nejad M, Manzari ZS Burn injury in Mottahari Burn Center in Tehran, Iran. World J Plast Surg 2016;5:77-9.  Back to cited text no. 8
GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional and national incidence, prevalence and years lived with disability for 354 diseases and injuries for 195countries and territories1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1789-858.  Back to cited text no. 9
Lee CJ, Mahendraraj K, Houng A, Marano M, Petrone S, Lee R, et al. Pediatric burns: A single institution retrospective review of incidence, etiology, and outcomes in 2273 burn patients (1995–2013). J Burn Care Res 2016;37:e579-85.  Back to cited text no. 10
Mohammed AAQ The prevalence of burn related deaths in Basrah. Med J Basrah Univ 2018;36:22-8.  Back to cited text no. 11
Greenhalgh DG Management of burns. N Engl J Med 2019;380: 2349-59.  Back to cited text no. 12
Kruger E, Kowal S, Bilir SP, Han E, Foster K Relationship between patient characteristics and number of procedures as well as length of stay for patients surviving severe burn injuries: Analysis of the American Burn Association National Burn Repository. J Burn Care Res 2020;41:1037-44.  Back to cited text no. 13
Stone Ii R, Natesan S, Kowalczewski CJ, Mangum LH, Clay NE, Clohessy RM, et al. Advancements in regenerative strategies through the continuum of burn care. Front Pharmacol 2018;9:672.  Back to cited text no. 14
Rowan MP, Cancio LC, Elster EA, Burmeister DM, Rose LF, Natesan S, et al. Burn wound healing and treatment: Review and advancements. Critical Care 2015;19:1-12.  Back to cited text no. 15
Johnson C Management of burns. Surgery 2018;36:435-40. http://doi.org/10.1016/j.mpsur.2018.05.004.  Back to cited text no. 16
Markiewicz-Gospodarek A, Kozioł M, Tobiasz M, Baj J, Radzikowska-Büchner E, Przekora A Burn wound healing: Clinical complications, medical care, treatment, and dressing types: The current state of knowledge for clinical practice. Int J Environ Res Public Health Int 2022;19:1-25.  Back to cited text no. 17
Erbiş H, Aliosmanoglu I, Ozturk B, Ülger BV, Timucin H, Turkoglu MA, et al. Factors affecting mortality in patients with burns. J Clin Exp Investig 2015;6:240-3.  Back to cited text no. 18
Obaid EM, Baiee HA Epidemiological and clinical characteristics of burn injuries among hospitalized patients in Babylon Province. Med J Babylon 2022;19:9-14.  Back to cited text no. 19
Albo Jumaa MKJ, Kadhim AA, Tinah HO Epidemiology and outcome of burn patients in the burns specialty center at Al-Diwaniyah Province, Iraq, 2019. Medico-legal Update 2020;20:1443-7.  Back to cited text no. 20
Al-Shamsi M, Othman N The epidemiology of burns in Basra, Iraq. Ann Burns Fire Disasters 2017;30:167-71.  Back to cited text no. 21
Alajmi MM, Aldosari KH, Al-Ghamdi S Clinical, epidemiological, and management aspects of burn injuries in Saudi Arabia—A cross-sectional study. Saudi J Biol Sci 2021;28:4342-7.  Back to cited text no. 22
Tripathee S, Basnet SJ Epidemiology and outcome of hospitalized burns patients in tertiary care center in Nepal: Two-year retrospective study. Burns Open 2017;1:16-9.  Back to cited text no. 23
Mulugeta T, Alemayehu H, Gerema U Clinical profiles and the outcomes of burn patients admitted to the burn unit of Jimma Medical Center. Clin Cosmet Investig Dermatol 2021;14:859-66.  Back to cited text no. 24
Hamdan FR Epidemiology and management outcome of burn injury in Jordanian hospitals. Int J Nurs 2018;5:133-41.  Back to cited text no. 25
Ramli RN, Prawoto A, Riasa NP, Saputro ID, Mas’ud AF Epidemiology and knowledge of first aid treatment related to burn injury in the rural region of Kulon Progo, Indonesia. Open Access Macedonian J Med Sci 2021;9:101-8.  Back to cited text no. 26
Lami FH, Al Naser RK Epidemiological characteristics of burn injuries in Iraq: A burn hospital-based study. Burns 2019;45:479-83.  Back to cited text no. 27
Odondi RN, Shitsinzi R, Emarah A Clinical patterns and early outcomes of burn injuries in patients admitted at the Moi Teaching and Referral Hospital in Eldoret, Western Kenya. Heliyon 2020;6:e03629.  Back to cited text no. 28
Forbinake NA, Dongmo G, Ohandza CS, Chichom-Mefire A, Fokam P, Beyiha G Epidemiologic and clinical profile of burns in a tertiary hospital in Sub-Saharan Africa. Burns Open 2020;4:22-7.  Back to cited text no. 29
Hameed RM, Alafloogee JF, Ma’an GK Bacteriological profile and antibiotics used for septic patients in Karbala, Iraq. Med J Babylon 2021;18:195-9.  Back to cited text no. 30
Saaiq M, Ashraf B Epidemiology and outcome of self-inflicted burns at Pakistan Institute of Medical Sciences, Islamabad. World J Plast Surg 2014;3:107-14.  Back to cited text no. 31
Velayuthan Nair CK, Gopinath V, Ashok VG Demographic and socio-cultural aspects of burns patients admitted in a tertiary care centre. Int Surg J 2017;4:2170-2.  Back to cited text no. 32
Alipour J, Mehdipour Y, Karimi A Epidemiology and outcome analysis of 3030 burn patients with an ICD-10 approach. Ann Burns Fire Disasters 2020;33:3-13.  Back to cited text no. 33
Vagholkar K, Hariharan N, Vagholkar S Factors affecting mortality in burns: A single center study. Int Surg J 2021;8:78-85.  Back to cited text no. 34
Obaid EM, Baiee HA, Ismail IS Aspects of fatal burn injury cases admitted to Al-Sadiq Teaching Hospital, Babylon Province/Iraq during 2020. Medico Legal Update 2020;20:661-7.  Back to cited text no. 35
Tan Chor Lip H, Tan JH, Thomas M, Imran FH, Azmah Tuan Mat TN Survival analysis and mortality predictors of hospitalized severe burn victims in a Malaysian burns intensive care unit. Burns Trauma 2019;7:3.  Back to cited text no. 36
Wardhana A, Winarno GA Epidemiology and mortality of burn injury in Ciptomangunkusumo Hospital, Jakarta: A 5 year retrospective study. J Plastik Rekonstruksim 2019;6:234-42.  Back to cited text no. 37
Güldoğan CE, Kendirci M, Gündoğdu E, Yastı AÇ Analysis of factors associated with mortality in major burn patients. Turk J Surg 2019;35:155-64.  Back to cited text no. 38
Alhaider AKH, Hassan AJ, Hameed LM Case fatality rate, determination and causes of death in Al Nassiriay burn center at 2015 and 2016. Thi-Qar Med J 2018;15:30-42.  Back to cited text no. 39
Forbinake NA, Ohandza CS, Fai KN, Agbor VN, Asonglefac BK, Aroke D, et al. Mortality analysis of burns in a developing country: A Cameroonian experience. BMC Public Health 2020;20:1269.  Back to cited text no. 40
Tian H, Wang L, Xie W, Shen C, Guo G, Liu J, et al. Epidemiologic and clinical characteristics of severe burn patients: Results of a retrospective multicenter study in China, 2011–2015. Burns Trauma 2018;6:1-11.  Back to cited text no. 41


  [Figure 1], [Figure 2]

  [Table 1], [Table 2], [Table 3], [Table 4]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
Materials and Me...
Article Figures
Article Tables

 Article Access Statistics
    PDF Downloaded18    
    Comments [Add]    

Recommend this journal