Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
J Burn Care Res. 2022 Nov 2;43(6):1227-1232. doi: 10.1093/jbcr/irac105.
A length of stay (LOS) of one day per percent total body surface area (TBSA) burn has been generally accepted but not validated in current pediatric burn studies. The primary objective of this study is to validate previous Pediatric Injury Quality Improvement Collaboration (PIQIC) findings by using a national burn registry to evaluate LOS per TBSA burn relative to burn mechanism, sociodemographic characteristics, and clinical factors which influence this ratio. We evaluated patients 0-18 years old who sustained a burn injury and whose demographics were submitted to the National Burn Registry (NBR) dataset from July 2008 through June 2018. Mixed effects generalized additive regression models were performed to identify characteristics associated with the LOS per TBSA burn ratio. Among 51,561 pediatric burn patients, 45% were Non-Hispanic White, 58% were male, and median age was 3.0 years old (IQR: 1.0, 9.0). The most common burn mechanism was scald (55.9%). The median LOS per TBSA burn ratio across all cases was 0.9 (IQR: 0.4, 1.75). In adjusted models, scald burns had a mean predicted LOS per TBSA burn value of 1.2 while chemical burns had the highest ratio (4.8). Non-Hispanic White patients had lower LOS per TBSA burn ratios than all other races and ethnicities (p < .05). These data substantiate evidence on variance in LOS per TBSA burn relative to burn mechanism and race/ethnicity. Knowing these variations can guide expectations in hospital LOS for patients and families and help burn centers benchmark their clinical performance.
目前的儿科烧伤研究普遍接受每百分之一总体表面积（TBSA）烧伤的住院日（LOS）为 1 天，但尚未得到验证。本研究的主要目的是通过使用国家烧伤登记处评估与烧伤机制、社会人口统计学特征和影响这一比例的临床因素相关的每 TBSA 烧伤 LOS，验证之前的儿科伤害质量改进合作组织（PIQIC）研究结果。我们评估了 2008 年 7 月至 2018 年 6 月期间向国家烧伤登记处（NBR）数据集提交了烧伤人口统计学特征的 0-18 岁烧伤患者。采用混合效应广义加性回归模型确定与 LOS 相关的特征每 TBSA 烧伤比。在 51561 名儿科烧伤患者中，45%是非西班牙裔白人，58%是男性，中位年龄为 3.0 岁（IQR：1.0，9.0）。最常见的烧伤机制是烫伤（55.9%）。所有病例中 LOS 每 TBSA 烧伤比的中位数为 0.9（IQR：0.4，1.75）。在调整后的模型中，烫伤烧伤的 LOS 每 TBSA 烧伤比的平均预测值为 1.2，而化学烧伤的比值最高（4.8）。非西班牙裔白人患者的 LOS 每 TBSA 烧伤比值低于所有其他种族和民族（p <.05）。这些数据证实了 LOS 每 TBSA 烧伤比因烧伤机制和种族/民族而异的证据。了解这些变化可以指导患者和家属对住院 LOS 的期望，并帮助烧伤中心对其临床表现进行基准测试。
