Mason SA, et al. - A population-based analysis was performed to assess trends in the epidemiology of major burn injury among hospitalized patients. Researchers observed that over time, mortality rates have decreased. They observed significant improvements in mortality rates at burn centers, whereas there appeared wide variation at nonburn centers. They identified a high proportion of patients who continue to receive care outside of burn centers. Findings suggested further opportunities to regionalize burn care and lower burn-related mortality.

Methods

• A retrospective, population-based cohort study was performed of all patients with 20% or higher total body surface area burn injury in Ontario, Canada.
• Researchers included adult (≥16 years) patients injured between 2003 and 2013.
• Exclusion was performed of deaths in the emergency department.
• They used logistic generalized estimating equations to assess risk-adjusted 30-day mortality.
• Comparison of mortality trends at burn and nonburn centers was performed.

Results

• At 84 centers (2 burn, 82 nonburn), researchers identified 772 patients.
• In this study, 74% (n = 570) of the patients were male; median age was 46 (interquartile range [IQR], 35–60) years and median total body surface area was 35% (IQR, 25–45).
• At 30 days, mortality was 19% (n = 149).
• From 2003 to 2013, an increase in the proportion of patients treated at a burn center was observed from 57% to 71% (p=0.07).
• A decrease in average risk-adjusted 30-day mortality rates was evident over time; they observed significantly reduced odds of death in 2010 to 2013 compared with 2003 to 2006 (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.25–0.61).
• From 2003–2006 to 2010–2013, burn centers exhibited significantly reduced mortality (OR, 0.36; 95% CI, 0.34–0.38) compared with nonburn centers (OR, 0.41; 95% CI, 0.13–1.24).