D AND BROWDER CHART VERSUS RULE-OF-NINES IN ASSESSMENT OF ADEQUACY OF FLUID RESUSCITATION IN PATIENTS ADMITTED WITH THERMAL BURNS AT THE BURNS UNIT OF KENYATTA NATIONAL HOSPITA

A total of 72 patients (36 per arm), presenting with thermal burns in the KNH Accident and Emergency Department, were recruited during the study period and allocated into the 2 groups: Group A for Lund and Browder Chart and Group B for Wallace Rule of Nines. The two groups were found to be statistically similar with regard to demographic and, injury and burn characteristics. There were no statistical differences between the two groups with regard to assessment of adequacy of fluid resuscitation: Serum lactate at 0 hours (p = .716), 8 hours (p = .876), and 24 hours (p = .164); base deficit at 0 hours (p = .314), 8 hours (p = .869), and 24 hours (p = .731); and urine output at 8 hours (p = 1.000), and at 24 hours (p = .693). The mortality rate within the first week of admission was 47.2% (34 patients). There were no statistical differences between the two groups in respect to mortality ?2 (1) = 0.223, p = .637, measures of adequacy of fluid resuscitation in the patients who died, and factors influencing mortality in burns patients (% TBSA, burn depth and presence of inhalational injury). The Lund and Browder group had a higher mean of %TBSA (52.5 ± 20.2 SD) than the Rule of Nines group (45.9 ± 20.4 SD), a not statistically significant difference of 6.6 (95% CI, -7.62 to 20.84), t (32) = 0.946, p = .351.The majority of the patients who died (44.1%) had mixed 2nd and 3rd degree burns. Of the patients who died, 88.2% had inhalational injury. In terms of the measures of adequacy of resuscitation in the patients who died, there were no significant differences between the two groups.