Mortality Rate and Associated Factors of Electrical Burns at Douala, Cameroon: A 5-Year Retrospective Analytical Study
Mortalité et Facteurs Associés aux Brûlures Électriques à Douala, Cameroun : Une Étude Rétrospective Analytique de 5 Ans
DOI:
https://doi.org/10.67260/hra.v4i8.7920Keywords:
Electrical burns; Mortality; ABSI score; Head injury; Cameroon; Sub‑Saharan AfricaAbstract
RÉSUMÉ
Introduction. Les brûlures électriques sont des lésions graves associées à une morbi‑mortalité élevée, mais les données d'Afrique subsaharienne restent limitées. Cette étude a estimé le taux de mortalité des brûlures électriques et identifié les facteurs associés pour améliorer la prise en charge précoce et la prévention à l'Hôpital Général de Douala. Méthodes. Étude rétrospective descriptive analytique menée sur cinq ans (2008‑2014) dans l'unité des brûlés de l'Hôpital Général de Douala. Nous avons inclus tous les patients hospitalisés pour brûlure électrique avec dossiers complets. Les données sociodémographiques, cliniques et évolutives ont été analysées par régression logistique univariée et multivariée. Résultats. Nous avons inclus 98 patients (âge moyen 31,8±15,2 ans ; 75,5 % d'hommes). Les accidents survenaient principalement sur la voie publique (67,3 %) et impliquaient un courant de haute tension (92,9 %). Le taux de mortalité global était de 16,3 % (16/98), avec la défaillance multiviscérale et les problèmes respiratoires comme principales causes (37,5 % chacun). En analyse multivariée, les facteurs prédictifs indépendants de mortalité étaient un score ABSI élevé (ORa=5,4 ; IC95 % 1,06‑27,47 ; p=0,04) et l'atteinte de la tête (ORa=9,3 ; IC95 % 1,22‑70,7 ; p=0,03). Conclusion. Les brûlures électriques à l'Hôpital Général de Douala touchent principalement les jeunes hommes, surviennent majoritairement sur la voie publique et sont surtout causées par un courant de haute tension. La mortalité élevée (16,3 %) est indépendamment associée à un score ABSI élevé et à l'atteinte de la tête. Ces résultats soulignent la nécessité d'un meilleur triage, d'une prise en charge précoce en réanimation et de stratégies de prévention ciblées.
ABSTRACT
Introduction. Electrical burns are severe injuries associated with high morbidity and mortality, yet data from sub‑Saharan Africa remain limited. This study estimated the mortality rate of electrical burns and identified associated factors to improve early management and prevention at Douala General Hospital, Cameroon. Methods. We conducted a retrospective descriptive analytical study over five years (2008–2014) in the burn unit of Douala General Hospital. We included all patients hospitalised for electrical burns with complete medical records. We analysed sociodemographic, clinical, and outcome data using univariate and multivariate logistic regression. Results. We included 98 patients (mean age 31.8±15.2 years; 75.5% male). Accidents occurred mainly in public places (67.3%) and involved high‑voltage current (92.9%). The overall mortality rate was 16.3% (16/98), with multi‑organ failure and respiratory problems as the leading causes (37.5% each). In multivariate analysis, independent predictors of mortality were an elevated ABSI score (Abbreviated Burn Severity Index) (adjusted OR=5.4; 95% CI 1.06–27.47; p=0.04) and head involvement (adjusted OR=9.3; 95% CI 1.22–70.7; p=0.03). Conclusion. Electrical burns at Douala General Hospital predominantly affect young males, occur mainly in public places, and are mostly caused by high‑voltage current. The high mortality rate (16.3%) is independently associated with elevated ABSI score and head involvement. These findings highlight the need for improved triage, early intensive care, and targeted prevention strategies.
References
1. Zemaitis MR, Guirguis M, Cindass R. Electrical Injuries. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2025 cité 26 déc 2025. Disponible sur: http://www.ncbi.nlm.nih.gov/books/NBK448087/
2. Bailey B, Gaudreault P, Thivierge RL. Cardiac monitoring of high-risk patients after an electrical injury: a prospective multicentre study. Emerg Med J. mai 2007;24(5):348‑52.
3. Seyfrydova M, Rokyta R, Rajdl D, Huml M. Arrhythmias and laboratory abnormalities after an electrical accident: a single-center, retrospective study of 333 cases. Clin Res Cardiol. déc 2023;112(12):1835‑47.
4. Kym D, Seo DK, Hur GY, Lee JW. Epidemiology of electrical injury: Differences between low- and high-voltage electrical injuries during a 7-year study period in South Korea. Scand J Surg. juin 2015;104(2):108‑14.
5. Ding H, Huang M, Li D, Lin Y, Qian W. Epidemiology of electrical burns: a 10-year retrospective analysis of 376 cases at a burn centre in South China. J Int Med Res. mars 2020;48(3):300060519891325.
6. Gandhi G, Parashar A, Sharma RK. Epidemiology of electrical burns and its impact on quality of life - the developing world scenario. World J Crit Care Med. 9 janv 2022;11(1):58‑69.
7. Yakupu A, Zhang J, Dong W, Song F, Dong J, Lu S. The epidemiological characteristic and trends of burns globally. BMC Public Health. 22 août 2022;22(1):1596.
8. Gerstl JVE, Ehsan AN, Lassarén P, Yearley A, Raykar NP, Anderson GA, Smith TR, Sabapathy SR, Ranganathan K. The Global Macroeconomic Burden of Burn Injuries. Plast Reconstr Surg. 1 mars 2024;153(3):743‑52.
9. Shih JG, Shahrokhi S, Jeschke MG. Review of Adult Electrical Burn Injury Outcomes Worldwide: An Analysis of Low-Voltage vs High-Voltage Electrical Injury. J Burn Care Res. 2017;38(1):e293‑8.
10. Solem L, Fischer RP, Strate RG. The natural history of electrical injury. J Trauma. juill 1977;17(7):487‑92.
11. Sokhal AK, Lodha KG, Kumari M, Paliwal R, Gothwal S. Clinical spectrum of electrical burns - A prospective study from the developing world. Burns. févr 2017;43(1):182‑9.
12. Cancio LC, Jimenez-Reyna JF, Barillo DJ, Walker SC, McManus AT, Vaughan GM. One hundred ninety-five cases of high-voltage electric injury. J Burn Care Rehabil. 2005;26(4):331‑40.
13. Arnoldo BD, Purdue GF, Kowalske K, Helm PA, Burris A, Hunt JL. Electrical injuries: a 20-year review. J Burn Care Rehabil. 2004;25(6):479‑84.
14. Hsueh YY, Chen CL, Pan SC. Analysis of factors influencing limb amputation in high-voltage electrically injured patients. Burns. juin 2011;37(4):673‑7.
15. Reinbold C, Serror K, Mimoun M, Chaouat M, Marco O, Boccara D. Electrical Burns and Late Spontaneous Artery Ruptures: About Three Cases. J Burn Care Res. 1 janv 2019;40(1):120‑7.
16. Mt S, Nl A, Dl C. Modified first world mortality scores can be used in a regional South African burn service with resource limitations. Burns : journal of the International Society for Burn Injuries [Internet]. sept 2016 [cité 26 déc 2025];42(6). Disponible sur: https://pubmed.ncbi.nlm.nih.gov/27143339/
17. Ho CWG, Yang SH, Wong CH, Chong SJ. High-voltage electrical injury complicated by compartment syndrome and acute kidney injury with successful limb salvage: A case report and review of the literature. Int J Surg Case Rep. 2018;48:38‑42.
18. Ogura A, Tsurumi A, Que YA, Almpani M, Zheng H, Tompkins RG, Ryan CM, Rahme LG. Associations between clinical characteristics and the development of multiple organ failure after severe burns in adult patients. Burns. déc 2019;45(8):1775‑82.
19. Jeschke MG, Gauglitz GG, Kulp GA, Finnerty CC, Williams FN, Kraft R, Suman OE, Mlcak RP, Herndon DN. Long-term persistance of the pathophysiologic response to severe burn injury. PLoS One. 2011;6(7):e21245.
20. Tobiasen J, Hiebert JM, Edlich RF. The abbreviated burn severity index. Ann Emerg Med. mai 1982;11(5):260‑2.
21. Lip HTC, Idris MAM, Imran FH, Azmah TN, Huei TJ, Thomas M. Predictors of mortality and validation of burn mortality prognostic scores in a Malaysian burns intensive care unit. BMC Emerg Med. 7 nov 2019;19(1):66.
22. Salehi SH, As’adi K, Abbaszadeh-Kasbi A, Isfeedvajani MS, Khodaei N. Comparison of six outcome prediction models in an adult burn population in a developing country. Ann Burns Fire Disasters Internet. 31 mars 2017 cité 26 déc 2025;30(1):13‑7. Disponible sur: https://pmc.ncbi.nlm.nih.gov/articles/PMC5446902/
23. Halgas B, Bay C, Foster K. A comparison of injury scoring systems in predicting burn mortality. Ann Burns Fire Disasters. 30 juin 2018;31(2):89‑93.
24. Gomez M, Wong DT, Stewart TE, Redelmeier DA, Fish JS. The FLAMES score accurately predicts mortality risk in burn patients. J Trauma. sept 2008;65(3):636‑45.
25. Huerta-Alardín AL, Varon J, Marik PE. Bench-to-bedside review: Rhabdomyolysis -- an overview for clinicians. Crit Care. avr 2005;9(2):158‑69.
26. Folkestad T, Brurberg KG, Nordhuus KM, Tveiten CK, Guttormsen AB, Os I, Beitland S. Acute kidney injury in burn patients admitted to the intensive care unit: a systematic review and meta-analysis. Crit Care. 2 janv 2020;24(1):2.
27. Lip HTC, Idris MAM, Imran FH, Azmah TN, Huei TJ, Thomas M. Predictors of mortality and validation of burn mortality prognostic scores in a Malaysian burns intensive care unit. BMC Emerg Med. 7 nov 2019;19(1):66.
28. Tahir S, Memon AR, Kumar M, Ali SA. Prediction of mortality after major burn: physiological versus biochemical measures. Wounds. juill 2009;21(7):177‑82.
29. Brusselaers N, Agbenorku P, Hoyte-Williams PE. Assessment of mortality prediction models in a Ghanaian burn population. Burns. août 2013;39(5):997‑1003.
30. Karaca B, Çelik B, Emem MK. Evaluation of clinical outcomes and comparison of prediction models in the burn population hospitalized from the emergency department: Can burn mortality scores be used in a post-conflict area such as northwest Syria? Ulus Travma Acil Cerrahi Derg. mars 2023;29(3):409‑18.
31. Mosier MJ, Pham TN, Klein MB, Gibran NS, Arnoldo BD, Gamelli RL, Tompkins RG, Herndon DN. Early Acute Kidney Injury Predicts Progressive Renal Dysfunction and Higher Mortality in Severely Burned Adults. J Burn Care Res Internet. 2010 [cité 26 déc 2025];31(1):83‑92. Disponible sur: https://pmc.ncbi.nlm.nih.gov/articles/PMC3045668/
32. Lam NN, Minh NTN. Risk Factors For Death And Prognosis Value Of Revised Baux Score For Burn Patients With Inhalation Injury. Ann Burns Fire Disasters Internet. 31 mars 2022 [cité 26 déc 2025];35(1):41‑5. Disponible sur: https://pmc.ncbi.nlm.nih.gov/articles/PMC9020854/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Njall Pouth Clotilde, Charles Emmanuel Toussaint Binam Bikoi, Hassanatou Iyawa, Beyiha Gerard, Metogo Bengono Junette, Penda Calixte Ida
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License CC BY-NC-ND 4.0 that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
