Dr Lincoln Tracy¹, Anne Darton², Professor Belinda Gabbe^1,3, Kathryn Heath⁴, Rochelle Kurmis⁴, Dr Carl Lisec^5,6, Mr Cheng Lo^7,8, Yvonne Singer⁷, Professor Fiona Wood^9,10, Associate Professor Heather Cleland⁷

¹School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia, ²Statewide Burn Injury Service, New South Wales Agency for Clinical Innovation, St Leonards, Australia, ³Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, Swansea, Wales, ⁴Adult Burns Service, Royal Adelaide Hospital, Adelaide, Australia, ⁵Faculty of Medicine, The University of Queensland, St Lucia, Australia, ⁶Professor Stuart Pegg Adult Burns Centre, The Royal Brisbane And Women’s Hospital, Herston, Australia, ⁷Victorian Adult Burns Service, The Alfred, Melbourne, Australia, ⁸Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia, ⁹State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Australia, ¹⁰Burn Injury Research Unit, University of Western Australia, Perth, Australia

Abstract:

Objective: To explore four years of data from the Burns Registry of Australia and New Zealand (BRANZ) to determine the extent of variation between participating Australian adult burn services with respect to treatment and specific in-hospital outcomes.
Methods: This registry-based cohort study used data from the BRANZ for patients admitted between July 1 2016 and June 30 2020. Rates of intensive care unit admission, burn wound management, in-hospital death, readmission to a specialist burn service within 28 days of discharge, and hospital length of stay were examined. Estimated probabilities, means, and corresponding 95% confidence intervals were calculated for each contributing service.
Results: During the four-year study period, 8365 admissions for adult patients were captured by the BRANZ. Variation between specialist Australian burn services in admission numbers (range: 242 to 1599) patient demographics, clinical management (skin grafting rates varied from 14% to 92% of patients), and in-hospital outcomes (intensive care admission rate range: 4% to 18%; median length of stay range: 2.3 to 7.6 days; and in-hospital mortality rate range: 0.3% to 1.4%) were observed. This variation remained after accounting for casemix factors.
Conclusions: A decade after its launch, BRANZ data displays variation between specialist burn services in Australia. Ongoing research has begun to explore the reasons underlying this variation and how the variation is associated with in-hospital outcomes. Further engagement with sites about models of care is required to enhance understanding of this variation and develop evidence-based guidelines for burn care in Australia and New Zealand.

Biography:

Dr Lincoln Tracy is a Research Fellow within the Prehospital, Emergency and Trauma Group at the School of Public Health and Preventive Medicine, Monash University. Working primarily with data from the Burns Registry of Australia and New Zealand, he undertakes research identifying objective and verifiable data on treatment, outcomes, and quality of care to encourage higher standards of burn injury prevention and care.