Maan Zeshaan N, Frew Quentin, Din Asmat H, Unluer Zeynep, Smailes Sarah, Philp Bruce, El-Muttardi Naguib, Dziewulski Peter
St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom; Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom.
Burns. 2014 Dec;40(8):1458-62. doi: 10.1016/j.burns.2014.07.026. Epub 2014 Aug 22.
Prediction of total length of stay (LOS) for burns patients based on the total burn surface area (TBSA) is well accepted. Total LOS is a poor measure of resource consumption. Our aim was to determine the LOS in specific levels of care to better inform resource allocation. We performed a retrospective review of LOS in intensive treatment unit (ITU), burns high dependency unit (HDU) and burns low dependency unit (LDU) for all patients requiring ITU admission in a regional burns service from 2003 to 2011. During this period, our unit has admitted 1312 paediatric and 1445 adult patients to our Burns ITU. In both groups, ITU comprised 20% of the total LOS (mean 0.23±0.02 [adult] and 0.22±0.02 [paediatric] days per %burn). In adults, 33% of LOS was in HDU (0.52±0.06 days per %burn) and 48% (0.68±0.06 days per %burn) in LDU, while in children, 15% of LOS was in HDU (0.19±0.03 days per %burn) and 65% in LDU (0.70±0.06 days per %burn). When considering Burns ITU admissions, resource allocation ought to be planned according to expected LOS in specific levels of care rather than total LOS. The largest proportion of stay is in low dependency, likely due to social issues.
基于烧伤总面积(TBSA)预测烧伤患者的总住院时间(LOS)已被广泛接受。总住院时间并不能很好地衡量资源消耗情况。我们的目的是确定特定护理水平下的住院时间,以便更好地为资源分配提供依据。我们对2003年至2011年期间在某地区烧伤服务中心入住重症监护病房(ITU)的所有患者在重症治疗病房(ITU)、烧伤高依赖病房(HDU)和烧伤低依赖病房(LDU)的住院时间进行了回顾性研究。在此期间,我们的科室共收治了1312名儿科患者和1445名成人患者至烧伤重症监护病房。在两组患者中,重症监护病房的住院时间占总住院时间的20%(成人平均为0.23±0.02天/%烧伤,儿童平均为0.22±0.02天/%烧伤)。在成人患者中,33%的住院时间在高依赖病房(0.52±0.06天/%烧伤),48%在低依赖病房(0.68±0.06天/%烧伤);而在儿童患者中,15%的住院时间在高依赖病房(0.19±0.03天/%烧伤),65%在低依赖病房(0.70±0.06天/%烧伤)。在考虑烧伤重症监护病房的收治情况时,资源分配应根据特定护理水平下的预期住院时间而非总住院时间来规划。住院时间占比最大的是在低依赖病房,这可能是由于社会问题导致的。