Mr Dane Holden1,2, Ms Yvonne Singer1, Dr Belinda Gabbe4,5, A/prof Heather Cleland1,2,4, Marc Schnekenburger3, Dr Lincoln Tracy4
1Victorian Adult Burns Service, The Alfred Hospital, Melbourne, Australia, 2Monash University, Department of surgery, Melbourne, Australia, 3Emergency and Trauma Centre, The Alfred , Melbourne, Australia, 4Monash University, Department of Epidemiology and Preventive medicine, Melbourne, Australia, 5Health Data Research UK, Swansea University, Swansea, Wales
Severe Burns (Total body surface area [TBSA] >20%) necessitate time critical treatment. The majority of Severe Burn injuries occur outside of normal ‘business hours’, when minimal expert staffing is present, such as overnight and weekends. The aim of this study was to compare the profile and outcomes of adult patients with severe burns admitted during business hours compared to those admitted at other times.
Data was extracted from the Burns Registry of Australia and New Zealand for adults admitted between July 2016 and June 2020. Differences in patient profiles, clinical management and in-hospital outcomes were investigated.
623 patients were eligible for inclusion. Most were admitted out of hours (69.2%). Median age was 42 years, 78% were male and the median TBSA was 30%. Inhalation injury was identified in 32% of patients. Both groups had similar in-hospital mortality (OR, 95%CI 1.49 [0.64, 3.48]), rate of acute kidney injury < 72 hours (OR, 95%CI 0.58 [0.32, 1.07]) and sepsis (OR, 95%CI 1.04 [0.46, 2.35]). No correlation was found between time of admission and Length of stay (total or intensive care).
This is the first Australasian study exploring the association between time of admission outcomes in severe Burns Patients. Interestingly, out of hours admission was not associated with the difference in patient outcomes expected.
Full Time Burns Surgeron at Victorian Adult Burns Service, The Alfred Hospital
Adjunct senior lecturer in Surgery, Monash University