Journal article
The effect of burn center and burn center volume on the mortality of burned adults--an analysis of the data in the National Burn Repository
Journal of burn care & research, Vol.30(5), pp.776-782
09/2009
DOI: 10.1097/BCR.0b013e3181b47ed2
PMID: 19692917
Abstract
Regional variations of care, and improved outcomes with larger volumes, have been well described in the medical and surgical literature for a variety of conditions including heart surgery, vascular surgery, and orthopedic surgery. Burn care has not been recently subjected to such an analysis. The National Burn Repository (NBR) contains de-identified patient and burn center data to allow this analysis. The NBR was queried for adult burn patients admitted for an acute thermal burn injury. A multivariable regression analysis to identify risk of death was performed incorporating patient characteristics, de-identified burn center, and burn center volume. Patient characteristics such as age, size of burn, mechanism of burn, inhalation injury, race, and sex determine mortality. There is also a statistically significant difference in death rates when individual, de-identified centers are compared. This difference in care persists even when accounting for burn center volume. Analysis of registries like the NBR, insurance claims databases, and statewide hospital discharge databases may help identify opportunities to improve burn care. According to this analysis of data available in the NBR, burn mortality depends not only on patient characteristics but also where the patient is treated. Mortality does not linearly improve with burn center volume and plateaus with increasing burn center size. The optimal burn center size is a complicated and contentious question. Future discussions about burn center size and density should incorporate not only mortality but also the region's ability to absorb surges in volume, and the optimal "staffing" ratios for the multidisciplinary aspects of burn care.
Details
- Title: Subtitle
- The effect of burn center and burn center volume on the mortality of burned adults--an analysis of the data in the National Burn Repository
- Creators
- Timothy D Light - Division of Burns Trauma, Surgical Critical Care, University of Iowa Carver College of Medicine, IA, USABarbara A LatenserG Patrick KealeyLucy A WibbenmeyerGary E RosenthalMary Vaughan Sarrazin
- Resource Type
- Journal article
- Publication Details
- Journal of burn care & research, Vol.30(5), pp.776-782
- DOI
- 10.1097/BCR.0b013e3181b47ed2
- PMID
- 19692917
- NLM abbreviation
- J Burn Care Res
- ISSN
- 1559-047X
- eISSN
- 1559-0488
- Publisher
- England
- Language
- English
- Date published
- 09/2009
- Academic Unit
- Health Management and Policy; Surgery; Injury Prevention Research Center; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984063122302771
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