Contributors to the Length-of-stay Trajectory in Burn-injured Patients

Overview

Journal Burns

Publisher Elsevier

Date 2018 Aug 15

PMID 30104050

Citations 15

Authors

Reinhard Dolp

Sarah Rehou

Matthew R McCann

Marc G Jeschke

Affiliations

Soon will be listed here.

Abstract

Objectives: Burn patients have a highly variable length-of-stay (LOS) due to the complexity of the injury itself. The LOS for burn patients is estimated as one day per percent total body surface area (TBSA) burn. To focus care expectation and prognosis we aimed to identify key factors that contribute to prolonged LOS.

Methods: This was a retrospective cohort-study (2006-2016) in an adult burn-centre that included patients with ≥10% TBSA burn. Patients were stratified into expected-LOS (<2 days LOS/%TBSA) and longer-than-expected-LOS (≥2 days LOS/%TBSA). We assessed demographics, comorbidities, and in-hospital complications. Logistic regression and propensity matching was utilized.

Results: Of the 583 total patients, 477 had an expected-LOS whereas 106 a longer-than-expected-LOS. Non-modifiable factors such as age, 3rd degree TBSA%, inhalation injuries and comorbidities were greater in the exceeded LOS patients. Subsequent matched analysis revealed factors like number of procedures performed, days ventilated and in-hospital complications (bacteremia, pneumonia, sepsis, graft loss, and respiratory failure) were significantly increased in the longer-than-expected-LOS group.

Conclusions: Progress has been made to update the conventional one day/%TBSA to better aid health care providers in giving appropriate outcomes for patients and their families and to supply intensive care units with valuable data to assess quality of care and to improve patient prognosis.

Citing Articles

Evaluating Determinants of Length of Stay in Burn Care: Is One Day per 1% Total Burn Surface Area Still Accurate?.

Rahimpour A, Fox N, Thompson E, Munie S, Harrison C, Denning D Cureus. 2025; 17(1):e77473.

PMID: 39958010 PMC: 11828471. DOI: 10.7759/cureus.77473.

Epidemiological Characteristics of Hospitalized Burn Patients-A 10-Year Retrospective Study in a Major Burn Center in Serbia.

Stojanovic M, Marinkovic M, Jurisic M, Milicic B, Stojicic M, Jovanovic M Life (Basel). 2025; 15(1).

PMID: 39860058 PMC: 11766564. DOI: 10.3390/life15010118.

Impact of Total Body Surface Area Burn Injuries on Clinical Outcomes and Comorbidities in Elderly Patients Aged Over 65.

Rahimpour A, Fox N, Anderson J, Arcand C, Balakrishnan P, Denning D Cureus. 2025; 16(12):e76253.

PMID: 39845211 PMC: 11753819. DOI: 10.7759/cureus.76253.

Factors affecting intensive care length of stay in critically ill pediatric patients with burn injuries.

Lerner R, Gibori A, Hubara E, Sadeh T, Rubinstein M, Paret G Pediatr Surg Int. 2024; 41(1):51.

PMID: 39731634 DOI: 10.1007/s00383-024-05945-0.

The Impact of Surgical Wait Time and Hospital Stay on the Incidence of Burn Wound Infection and Related Complications at a Single Tertiary Hospital Centre: A 10-Year Experience.

Milkovich J, Churchill I, Gallo L, Kim P, Gallo M, Thoma A Plast Surg (Oakv). 2024; :22925503241249756.

PMID: 39553508 PMC: 11561922. DOI: 10.1177/22925503241249756.

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