Utility of an intervention scoring system in documenting effects of changes in burn treatment.
The consequences of the introduction of a program of consistent use of topical antimicrobials and early aggressive excision of deep burn wounds by utilizing a comprehensive, computerized patient registry/therapeutic intervention scoring system, were investigated. Prospectively, the clinical course, mortality, outcome and hospital costs were compared for the year preceding (89 patients) and the 4 years following (226 patients) the introduction of the new treatment program. It was found that mortality decreased from 10.1 to 4.6% after change in therapy (P<0.001), despite an increase in mean burn extent. The length of hospital stay per % burn surface area declined from 1.2 to 1.0 days (P<0.001). The number and complexity of therapeutic interventions and the associated costs, also declined. Patients in the new treatment program had a better level of physical and psychosocial function at follow up. In conclusion, the introduction of a program of consistent use of topical antimicrobials and early, aggressive surgical excision was associated with an improved outcome at lesser cost. The combined registry-intervention scoring system permits ready analysis of results using data entered on a daily, near-real time basis.
Sjöberg
F
F
The Burn Unit, Department of Hand and Plastic Surgery, University Hospital, Linköping, Sweden. folke.sjoberg@lio.se
Danielsson
P
P
Andersson
L
L
Steinwall
I
I
Zdolsek
J
J
Ostrup
L
L
Monafo
W
W
D000328:Adult; D002056:Burns / Q000191:economics / Q000628:therapy*; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D006801:Humans; D011446:Prospective Studies; D016896:Treatment Outcome