Assessing burn care in Brazil: An epidemiologic, cross-sectional, nationwide study

Surgery. 2018 May;163(5):1165-1172. doi: 10.1016/j.surg.2017.11.023. Epub 2018 Feb 8.

Abstract

Background: The aim of this study was to describe the national epidemiology of burns in Brazil and evaluate regional access to care by defining the contribution of out-of-hospital mortality to total burn deaths.

Methods: We reviewed admissions data for Brazil's single-payer, free-at-point-of-care, public-sector provider and national death registry data abstracted from DATASUS for 2008-2014. Admissions, in-hospital mortality, hospital reimbursement, and total deaths from the death registry were assessed for records coded under ICD-10 codes corresponding to flame, scald, contact, and electrical burns.

Results: A total of 17,264 burn deaths occurred between 2008-2014 (mean annual 2,466 [SD 202]). Of all burns deaths 79.1% occurred out of hospital, with marked regional differences in the proportion of out-of-hospital deaths (P < 0.001), the greatest being in the North region. The mean annual number of admissions >24 hours was 18,551 (SD 1,504) with the greatest prevalence of flame burns overall (43.98%) and scalds prevailing in < 5 years (57.8%). Regional differences were found in per-capita admissions (P < 0.001) with the greatest number in the Central-West region. A mean of $1,022 (SD $94) US dollars was reimbursed per burn admission.

Conclusion: Given that nearly 80% of burns mortalities occurred out of hospital, prevention of burns alongside interventions improving prehospital and access to care have potential for the greatest impact.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brazil / epidemiology
  • Burns / mortality*
  • Burns / therapy
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility
  • Hospital Mortality
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Poverty
  • Young Adult