Temporal trends in burn size estimation and the impact of the NSW Trauma App on estimation accuracy.
Assessment
Burn estimation
Smartphone app
Trends
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:
09 2023
09 2023
Historique:
received:
21
08
2022
revised:
30
12
2022
accepted:
05
02
2023
medline:
4
9
2023
pubmed:
7
3
2023
entrez:
6
3
2023
Statut:
ppublish
Résumé
Several studies demonstrated that burn size calculations by referring clinicians are poor. The purpose of this study was to determine if inaccuracies in burn size estimation have improved with time within the same population, and whether widespread roll-out of a smartphone-based TBSA calculator (in the form of the NSW Trauma App) had an impact on accuracy. A review of all burn-injured adult patients transferred to Burn Units from August 2015, following the roll out of the NSW Trauma App, to January 2021 was performed. The TBSA determined by the referring centre was compared with the TBSA calculated by the Burn Unit. This was compared to historical data from the same population between January 2009 and August 2013. There were 767 adult burn-injured patients transferred to a Burn Unit between 2015 and 2021. The median overall TBSA was 7%. There were 290 patients (37.9%) who had equivalent TBSA calculations by the referring hospital and the Burn Unit. This was a significant improvement compared to the preceding time period (P < 0.005). Overestimation by the referring hospital occurred in 364 cases (47.5%), which was significantly reduced compared to 2009 - 2013 (P < 0.001). Unlike the earlier time period where changes in estimation accuracy were seen in relation to increasing time after the burn injury, burn size estimation accuracy remained relatively consistent in the contemporary time period with no significant change observed (P = 0.86). This cumulative, longitudinal study of nearly 1500 adult burn-injured patients over 13 years demonstrates improvements in burn size estimation by referring clinicians over time. It is the largest cohort of patients analysed with respect to burn size estimation and is the first to demonstrate improvements in accuracy of TBSA in association with a smartphone-based app. Adopting this simple strategy into burn retrieval systems will augment early assessment of these injuries and improve outcomes.
Sections du résumé
BACKGROUND
Several studies demonstrated that burn size calculations by referring clinicians are poor. The purpose of this study was to determine if inaccuracies in burn size estimation have improved with time within the same population, and whether widespread roll-out of a smartphone-based TBSA calculator (in the form of the NSW Trauma App) had an impact on accuracy.
METHODS
A review of all burn-injured adult patients transferred to Burn Units from August 2015, following the roll out of the NSW Trauma App, to January 2021 was performed. The TBSA determined by the referring centre was compared with the TBSA calculated by the Burn Unit. This was compared to historical data from the same population between January 2009 and August 2013.
RESULTS
There were 767 adult burn-injured patients transferred to a Burn Unit between 2015 and 2021. The median overall TBSA was 7%. There were 290 patients (37.9%) who had equivalent TBSA calculations by the referring hospital and the Burn Unit. This was a significant improvement compared to the preceding time period (P < 0.005). Overestimation by the referring hospital occurred in 364 cases (47.5%), which was significantly reduced compared to 2009 - 2013 (P < 0.001). Unlike the earlier time period where changes in estimation accuracy were seen in relation to increasing time after the burn injury, burn size estimation accuracy remained relatively consistent in the contemporary time period with no significant change observed (P = 0.86).
CONCLUSIONS
This cumulative, longitudinal study of nearly 1500 adult burn-injured patients over 13 years demonstrates improvements in burn size estimation by referring clinicians over time. It is the largest cohort of patients analysed with respect to burn size estimation and is the first to demonstrate improvements in accuracy of TBSA in association with a smartphone-based app. Adopting this simple strategy into burn retrieval systems will augment early assessment of these injuries and improve outcomes.
Identifiants
pubmed: 36878736
pii: S0305-4179(23)00015-3
doi: 10.1016/j.burns.2023.02.002
pii:
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1403-1411Informations de copyright
Copyright © 2023 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest statement The authors declare that there is no source of financial or other support, or any financial or professional relationships which may pose a competing interest.