Burn Center Volume Makes a Difference for Burned Children

Tina L Palmieri; Sandra Taylor; Marybeth Lawless; Terese Curri; Soman Sen; David G Greenhalgh

doi:10.1097/PCC.0000000000000366

Burn Center Volume Makes a Difference for Burned Children

Tina L Palmieri, Sandra Taylor, Marybeth Lawless, Terese Curri, Soman Sen, David G Greenhalgh

Burn Surgery and Reconstruction

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

Abstract

OBJECTIVES:: Determine the relationship between the volume of burn admissions and outcomes for children with burns.

DESIGN:: Retrospective review of the National Burn Repository from 2000-2009 using mixed effect logistic regression modeling.

SETTING:: Tertiary burn centers in the United States.

PATIENTS:: All children <18 years of age admitted with burn injury to a burn center submitting data to the National Burn Repository.

INTERVENTIONS:: None.

MEASUREMENTS AND MAIN RESULTS:: Of the 210,683 records in the NBR from 2000-2009, 33,115 records for children ≤18 years of age met criteria for analysis; 26,280 had burn sizes smaller than 10%; only 32 of these children died. Volume of children treated varied greatly among facilities. Age, total body surface area burn, inhalation injury, and burn center volume influenced mortality (p < 0.05) An increase in the median yearly admissions of 100 decreased the odds of mortality by approximately 40%. High volume centers (admitting >200 pediatric patients/year) had the lowest mortality when adjusting for age and injury characteristics (p < 0.05).

CONCLUSIONS:: Higher volume pediatric burn centers had lower mortality, particularly at larger burn sizes. The lower mortality of children a high volume centers could reflect greater experience, resource, and specialized expertise in treating pediatric patients.

Original language	English (US)
Journal	Pediatric Critical Care Medicine
DOIs	https://doi.org/10.1097/PCC.0000000000000366
State	Accepted/In press - Feb 2 2015

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Critical Care and Intensive Care Medicine

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abstract = "OBJECTIVES:: Determine the relationship between the volume of burn admissions and outcomes for children with burns.DESIGN:: Retrospective review of the National Burn Repository from 2000-2009 using mixed effect logistic regression modeling.SETTING:: Tertiary burn centers in the United States.PATIENTS:: All children <18 years of age admitted with burn injury to a burn center submitting data to the National Burn Repository.INTERVENTIONS:: None.MEASUREMENTS AND MAIN RESULTS:: Of the 210,683 records in the NBR from 2000-2009, 33,115 records for children ≤18 years of age met criteria for analysis; 26,280 had burn sizes smaller than 10%; only 32 of these children died. Volume of children treated varied greatly among facilities. Age, total body surface area burn, inhalation injury, and burn center volume influenced mortality (p < 0.05) An increase in the median yearly admissions of 100 decreased the odds of mortality by approximately 40%. High volume centers (admitting >200 pediatric patients/year) had the lowest mortality when adjusting for age and injury characteristics (p < 0.05).CONCLUSIONS:: Higher volume pediatric burn centers had lower mortality, particularly at larger burn sizes. The lower mortality of children a high volume centers could reflect greater experience, resource, and specialized expertise in treating pediatric patients.",

author = "Palmieri, {Tina L} and Sandra Taylor and Marybeth Lawless and Terese Curri and Soman Sen and Greenhalgh, {David G}",

year = "2015",

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doi = "10.1097/PCC.0000000000000366",

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T1 - Burn Center Volume Makes a Difference for Burned Children

AU - Palmieri, Tina L

AU - Taylor, Sandra

AU - Lawless, Marybeth

AU - Curri, Terese

AU - Sen, Soman

AU - Greenhalgh, David G

PY - 2015/2/2

Y1 - 2015/2/2

N2 - OBJECTIVES:: Determine the relationship between the volume of burn admissions and outcomes for children with burns.DESIGN:: Retrospective review of the National Burn Repository from 2000-2009 using mixed effect logistic regression modeling.SETTING:: Tertiary burn centers in the United States.PATIENTS:: All children <18 years of age admitted with burn injury to a burn center submitting data to the National Burn Repository.INTERVENTIONS:: None.MEASUREMENTS AND MAIN RESULTS:: Of the 210,683 records in the NBR from 2000-2009, 33,115 records for children ≤18 years of age met criteria for analysis; 26,280 had burn sizes smaller than 10%; only 32 of these children died. Volume of children treated varied greatly among facilities. Age, total body surface area burn, inhalation injury, and burn center volume influenced mortality (p < 0.05) An increase in the median yearly admissions of 100 decreased the odds of mortality by approximately 40%. High volume centers (admitting >200 pediatric patients/year) had the lowest mortality when adjusting for age and injury characteristics (p < 0.05).CONCLUSIONS:: Higher volume pediatric burn centers had lower mortality, particularly at larger burn sizes. The lower mortality of children a high volume centers could reflect greater experience, resource, and specialized expertise in treating pediatric patients.

AB - OBJECTIVES:: Determine the relationship between the volume of burn admissions and outcomes for children with burns.DESIGN:: Retrospective review of the National Burn Repository from 2000-2009 using mixed effect logistic regression modeling.SETTING:: Tertiary burn centers in the United States.PATIENTS:: All children <18 years of age admitted with burn injury to a burn center submitting data to the National Burn Repository.INTERVENTIONS:: None.MEASUREMENTS AND MAIN RESULTS:: Of the 210,683 records in the NBR from 2000-2009, 33,115 records for children ≤18 years of age met criteria for analysis; 26,280 had burn sizes smaller than 10%; only 32 of these children died. Volume of children treated varied greatly among facilities. Age, total body surface area burn, inhalation injury, and burn center volume influenced mortality (p < 0.05) An increase in the median yearly admissions of 100 decreased the odds of mortality by approximately 40%. High volume centers (admitting >200 pediatric patients/year) had the lowest mortality when adjusting for age and injury characteristics (p < 0.05).CONCLUSIONS:: Higher volume pediatric burn centers had lower mortality, particularly at larger burn sizes. The lower mortality of children a high volume centers could reflect greater experience, resource, and specialized expertise in treating pediatric patients.

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Burn Center Volume Makes a Difference for Burned Children

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