Pediatric burn-trauma patients have increased length of stay compared to trauma-only patients: A propensity matched analysis.
Adolescent
Burns
/ complications
California
/ epidemiology
Child
Child, Preschool
Female
Humans
Length of Stay
/ statistics & numerical data
Male
Pediatrics
/ methods
Propensity Score
Retrospective Studies
Statistics, Nonparametric
Trauma Centers
/ organization & administration
Wounds and Injuries
/ complications
Burn
Length of stay
Pediatric
Trauma
Journal
Burns : journal of the International Society for Burn Injuries
ISSN: 1879-1409
Titre abrégé: Burns
Pays: Netherlands
ID NLM: 8913178
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
30
01
2020
revised:
17
04
2020
accepted:
24
04
2020
pubmed:
10
12
2020
medline:
9
11
2021
entrez:
9
12
2020
Statut:
ppublish
Résumé
Trauma is the leading cause of mortality in children. Burn injury involves intensive resources, especially in pediatric patients. We hypothesized that among pediatric trauma patients, combined burn-trauma (BT) patients have increased length of stay (LOS) and mortality compared to trauma-only (T) patients. The Pediatric Trauma Quality Improvement Program (2014-2016) was queried and BT patients were 1:2 propensity-score-matched to T patients based on age, gender, hypotension on admission, injury type and severity. 93 BT patients were matched to 186 T patients. There were no differences in matched characteristics. BT patients had a longer median LOS (4 vs 2 days, p<0.001) with no difference in mortality (1.1% vs 1.1%, p=1.00), intensive care unit (ICU) LOS (3 vs 3 days, p=0.55), or complications including decubitus ulcer (0% vs 1.1%, p=0.32), deep vein thrombosis (0% vs 0.5%, p=0.48), extremity compartment syndrome (1.1% vs 0%, p=0.16), and urinary tract infection (1.1% vs 1.1%, p=1.00). Pediatric BT patients had twice the LOS compared to a matched group of pediatric T patients. There was no difference between the cohorts in ICU LOS, complications or mortality rate. When evaluating risk-stratified quality metrics such as LOS, concomitant burn injury should be incorporated.
Sections du résumé
BACKGROUND
Trauma is the leading cause of mortality in children. Burn injury involves intensive resources, especially in pediatric patients. We hypothesized that among pediatric trauma patients, combined burn-trauma (BT) patients have increased length of stay (LOS) and mortality compared to trauma-only (T) patients.
METHODS
The Pediatric Trauma Quality Improvement Program (2014-2016) was queried and BT patients were 1:2 propensity-score-matched to T patients based on age, gender, hypotension on admission, injury type and severity.
RESULTS
93 BT patients were matched to 186 T patients. There were no differences in matched characteristics. BT patients had a longer median LOS (4 vs 2 days, p<0.001) with no difference in mortality (1.1% vs 1.1%, p=1.00), intensive care unit (ICU) LOS (3 vs 3 days, p=0.55), or complications including decubitus ulcer (0% vs 1.1%, p=0.32), deep vein thrombosis (0% vs 0.5%, p=0.48), extremity compartment syndrome (1.1% vs 0%, p=0.16), and urinary tract infection (1.1% vs 1.1%, p=1.00).
CONCLUSION
Pediatric BT patients had twice the LOS compared to a matched group of pediatric T patients. There was no difference between the cohorts in ICU LOS, complications or mortality rate. When evaluating risk-stratified quality metrics such as LOS, concomitant burn injury should be incorporated.
Identifiants
pubmed: 33293153
pii: S0305-4179(20)30340-5
doi: 10.1016/j.burns.2020.04.029
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
78-83Informations de copyright
Copyright © 2020 Elsevier Ltd and ISBI. All rights reserved.