Causes and pattern of thermal burns sustained during seizures by patients with epilepsy seen at Kenyatta national hospital.

Abstract

Background: Burns is an important health problem in the developing countries and epilepsy is a major predisposing factor to severe burns. The severity of burns in these countries is also high. The total burn surface area and the depth of burns are important prognostic factors. In persons with epilepsy, the burns may involve a small area but may be deep. Most burns tend to occur in domestic setting and are more common in females than males. Inadequate seizure control is noted to increase the risk of burns in persons with epilepsy. Objective: To describe the causes and pattern of thermal burns sustained during seizures by persons with epilepsy treated at Kenyatta National Hospital. Variables that were evaluated are: Causes of burns, depth of burns (superficial, deep or mixed), distribution of the burns (head and neck, upper limbs or trunk), other injuries sustained during seizures (cuts, head injuries, fractures, or dislocations) and complications arising from the burns (contractures, traumatic amputations, wound sepsis, facial disfiguring.) Study design: Observational descriptive prospective study. Setting: Kenyatta National Hospital, in Nairobi, Kenya Study duration: 1st December 2012 to 31st March 2013. Methods and materials: Purposive sampling method was used to select 30 patients who had sustained thermal burns during seizures. The causes of burns, their depth, their distribution, other associated injuries and the complications arising from the burns were documented. Data collection and statistical analysis: Data was collected from the patients/next of kin and from their records at Kenyatta National Hospital. Predesigned data collection sheets were used. It was analyzed using SPSS version 19 and descriptive statistics for sample variables was presented in form of tables and graphs. Data was considered significant at p≤0.05 and presented with 95% confidence interval. Results: These were obtained from 30 PWE who sustained thermal burns during seizures and treated at KNH. The age ranges was from 10 to 38 years. There were more females than males who sustained thermal burns during seizures among these patients; ratio 1.3:1. Open flame caused most thermal burns in this group of patients; (76.7%). Most thermal burns were deep (53.3%) followed by mixed burns (26.7%). These thermal burns involved areas less than 20% based on TBSA; this accounting to 83.3%. These burns mainly involved the upper limbs (70%) and trunk (53.3%). Head injuries and fracture/dislocations were the main injuries associated with the thermal burns. Sepsis and contractures accounted for the highest percentages of complications arising from thermal burns while skin grafting and escharectomy were the main procedures performed in the management of severe burns. Counseling on the risk of burns during seizures was noted to be statistically significant in reduction of TBSA (P=0.04). Conclusion: The thermal burns sustained by PWE during seizures occurred in the domestic setting and affected more females than males. Most thermal burns were deep and required surgical management. Counseling on the risk of burns during seizures was noted to be associated with reduction in severity of burns.