Epidemiology, Management, and Alarmingly High Mortality of Burn Patients: A Retrospective Analysis From a...

Burn injuries pose a significant challenge in resource-limited settings, particularly during humanitarian crises. This study examines the epidemiology, management, and outcomes of burn patients at a tertiary hospital in Damascus, Syria, from 2021 to 2024. A single-centre retrospective cohort study was conducted on 500 admitted burn patients. Data on demographics, injury characteristics, management, complications and mortality were analysed using descriptive statistics, chi-square tests, Mann-Whitney U tests and binary logistic regression. The lethal area 50% (LA50) was estimated using the logistic regression equation: $\mathrm{LA}50=-\frac{\text{constant}+\sum \left(b_i{x}_i\right)}{b_{\text{TBSA}}}$ . The mean patient age was 20.5 ± 17.9 years, with a male predominance (55%). Flame burns (72.4%) at home (87.6%) were most common. The mean total body surface area burned was 30.99% ± 21.31%, with 68.6% being full-thickness injuries. The complication rate was 91%, with infection being most prevalent. The overall mortality rate was 39%, with sepsis (56.4%) as the leading cause. Logistic regression identified larger burn area (OR = 1.152, p < 0.001), full-thickness depth (ref. partial thickness, OR = 0.281, p < 0.001), older age and female gender as independent predictors of increased mortality. Deceased patients had significantly shorter hospital stays. LA50 was 42.63% for a 40-year-old male with a partial-thickness flame burn and a 10-day hospital stay; for a female with a full-thickness flame burn under the same conditions, it was 27.43%. This study reveals an alarmingly high burden of burn injuries in a crisis-affected setting, with extreme complication and mortality rates. The findings highlight the critical impact of extensive burns and sepsis, underscoring severe systemic constraints on care. Urgent context-specific interventions to strengthen acute burn management, infection control, and prevention strategies are imperative.