Determinants of Prolonged Length of Stay for Patients Treated in a Burn Unit in Addis Ababa, Ethiopia

BACKGROUND: Burn injuries contribute to a significant proportion of unintentional deaths and injuries globally. Prolonged hospitalization is common and leads to a significant economic burden. This study aims to define factors predicting prolonged hospital length of stay (LOS) to inform cost-saving interventions. METHODS: Patients treated for burn injury at Addis Ababa Burn, Emergency and Trauma Center (AaBET) between 2015 and 2017 were included. Patients who were discharged against medical advice, deceased, or transferred to another facility were excluded. Patient and clinical data were prospectively gathered from medical records. Statistical analysis was performed using SPSS version 26 (Chicago, IL). RESULTS: Among the 196 included patients, 55.6% were male, with a mean age of 17.6 years, and a mean LOS of 33.5 days. Few patients had comorbid medical conditions (11.7%) or pre-existing malnutrition as defined by albumin ≤2.00 (n = 14 of 34 tested, 41.2%). Scald burns were the most common etiology (52.0%), followed by flame (26.0%), electrical (20.9%), and chemical (1.0%). Burn depth was variable, with 49.5% deep partial thickness, 36.2% superficial partial thickness, and 14.3% full thickness with a mean TBSA of 12.6%. Patients underwent an average of 0.9 surgeries. ICU admission occurred in 2.6%, infection in 37.2%, and transfusion in 14.8%. Age (p < 0.001), etiology (p < 0.001), TBSA (p = 0.002), depth (p < 0.001), number of surgeries (p < 0.001), infection (p < 0.001), and transfusion requirement (p < 0.001) were significant predictors of LOS. CONCLUSION: We identified several patient and clinical factors predictive of prolonged hospital stay following burn injury. Burn incidence can be mitigated through preventative strategies, whereas surgical burden and short-term complications suggest a role for point-of-care interventions.