Doud Andrea N, Swanson John M, Ladd Mitchell R, Neff Lucas P, Carter Jeff E, Holmes James H
Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Am Surg. 2014 Sep;80(9):836-40.
Though multiple studies have demonstrated superior outcomes amongst adult burn patients at verified burn centers (VBCs) relative to nondedicated burn centers (NBCs), roughly half of such patients meeting American Burn Association (ABA) referral guidelines are not sent to these centers. We sought examine referral patterns amongst pediatric burn patients. Retrospective review of a statewide patient database identified pediatric burn patients from 2000 to 2007 using International Classification of Disease (ICD-9) discharge codes. These injuries were crossreferenced with ABA referral criteria to determine compliance with the ABA guidelines. 1831 children sustained burns requiring hospitalization during the study period, of which 1274 (70%) met ABA referral criteria. Of 557 treated at NBCs, 306 (55%) met criteria for transfer. Neither age, gender, nor payer status demonstrated significant association with treatment center. VBCs treated more severely injured patients, but there was no difference in survival or rate of discharge home from NBCs versus VBCs. Studies to evaluate differences in functional outcomes between pediatric burn patients treated at VBCs versus NBCs would be beneficial to ensure optimization of outcomes in this population.
尽管多项研究表明，与非专门的烧伤中心（NBCs）相比，经认证的烧伤中心（VBCs）治疗成年烧伤患者的效果更佳，但约有一半符合美国烧伤协会（ABA）转诊指南的此类患者并未被送往这些中心。我们试图研究儿科烧伤患者的转诊模式。通过对全州患者数据库进行回顾性审查，使用国际疾病分类（ICD - 9）出院编码确定了2000年至2007年的儿科烧伤患者。将这些损伤与ABA转诊标准进行交叉对照，以确定是否符合ABA指南。在研究期间，有1831名儿童因烧伤需要住院治疗，其中1274名（70%）符合ABA转诊标准。在NBCs接受治疗的557名患者中，有306名（55%）符合转院标准。年龄、性别和支付者身份与治疗中心均未显示出显著关联。VBCs治疗的患者伤势更严重，但NBCs和VBCs在患者生存率或出院回家率方面没有差异。评估在VBCs和NBCs接受治疗的儿科烧伤患者功能结局差异的研究，将有助于确保该人群的治疗效果达到最佳。
