Is the target of 1 day length of stay per 1 total body surface area burned actually being achieved? A review of paediatric thermal injuries in South East Scotland

摘要

Objectives: Length of stay is a standard variable used to evaluate outcomes in burn care. Is the target of 1 day length of stay per 1% total body surface area burned actually being achieved? Methods: A retrospective analysis of 328 paediatric thermal injuries admitted to the South East Scotland Regional Burn Unit between January 2003 and March 2007 to assess whether the target is met and if not, which factors are contributing to a prolonged hospitalisation. Results: 57% achieved the target and 43% failed the target. Factors associated with a lengthened hospital stay were burn depth, burn location, presence of infection/sepsis and the need for theatre visits for either dressing change or surgical intervention. Conclusions: Many factors can contribute to patients’ length of hospital stay. It is valuable to identify areas of practice which can be altered to minimise the impact of these factors. For example, consider the use of laser Doppler imaging to help assess burn depth more accurately; this leading to potentially more accurate requirements for surgery or not, early excision of deep burns, improved infection control and use of dressings may all contribute to reduce the length of inpatient stay with a view to improving patient outcome.