Recording Patient Data in Burn Unit Logbooks in Rwanda: Who and What Are We Missing?

Author:

Miranda Elizabeth12ORCID,Velin Lotta13,Ntirenganya Faustin4,Riviello Robert15,Mukagaju Francoise6,Shyaka Ian6,Nezerwa Yves6,Pompermaier Laura17

Affiliation:

1. Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA

2. Division of Vascular Surgery, University of Southern California, Los Angeles, CA

3. Surgery and Public Health, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden

4. Plastic Surgery Unit, Department of Surgery, University Teaching Hospital Kigali (CHUK), Kigali, Rwanda

5. Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, MA

6. Plastic Surgery Department, Rwanda Military Hospital, Kigali, Rwanda

7. Linköping University Hospital, Linköping, Sweden

Abstract

Abstract Systematic data collection in high-income countries has demonstrated a decreasing burn morbidity and mortality, whereas lack of data from low- and middle-income countries hinders a global overview of burn epidemiology. In low- and middle-income countries, dedicated burn registries are few. Instead, burn data are often recorded in logbooks or as one variable in trauma registries, where incomplete or inconsistently recorded information is a known challenge. The University Teaching Hospital of Kigali hosts the only dedicated burn unit in Rwanda and has collected data on patients admitted for acute burn care in logbooks since 2005. This study aimed to assess the data registered between January 2005 and December 2019, to evaluate the extent of missing data, and to identify possible factors associated with “missingness.” All data were analyzed using descriptive statistics, Fisher’s exact test, and Wilcoxon Rank Sum test. In this study, 1093 acute burn patients were included and 64.2% of them had incomplete data. Data completeness improved significantly over time. The most commonly missing variables were whether the patient was referred from another facility and information regarding whether any surgical intervention was performed. Missing data on burn mechanism, burn degree, and surgical treatment were associated with in-hospital mortality. In conclusion, missing data is frequent for acute burn patients in Rwanda, although improvements have been seen over time. As Rwanda and other low- and middle-income countries strive to improve burn care, ensuring data completeness will be essential for the ability to accurately assess the quality of care, and hence improve it.

Publisher

Oxford University Press (OUP)

Subject

Rehabilitation,Emergency Medicine,Surgery

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