title: Burns ITU admissions: length of stay in specific levels of care for adult and paediatric patients.
abstract: Prediction of total length of stay (LOS) for burns patients based on the total burn surface area (TBSA) is well accepted. Total LOS is a poor measure of resource consumption. Our aim was to determine the LOS in specific levels of care to better inform resource allocation. We performed a retrospective review of LOS in intensive treatment unit (ITU), burns high dependency unit (HDU) and burns low dependency unit (LDU) for all patients requiring ITU admission in a regional burns service from 2003 to 2011. During this period, our unit has admitted 1312 paediatric and 1445 adult patients to our Burns ITU. In both groups, ITU comprised 20% of the total LOS (mean 0.23±0.02 [adult] and 0.22±0.02 [paediatric] days per %burn). In adults, 33% of LOS was in HDU (0.52±0.06 days per %burn) and 48% (0.68±0.06 days per %burn) in LDU, while in children, 15% of LOS was in HDU (0.19±0.03 days per %burn) and 65% in LDU (0.70±0.06 days per %burn). When considering Burns ITU admissions, resource allocation ought to be planned according to expected LOS in specific levels of care rather than total LOS. The largest proportion of stay is in low dependency, likely due to social issues.
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom; Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Zeshaan N
authors.initials: ZN
authors.lastname: Maan
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom.
authors.forename: Quentin
authors.initials: Q
authors.lastname: Frew
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom.
authors.forename: Asmat H
authors.initials: AH
authors.lastname: Din
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Unluer
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Smailes
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom.
authors.forename: Bruce
authors.initials: B
authors.lastname: Philp
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom.
authors.forename: Naguib
authors.initials: N
authors.lastname: El-Muttardi
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, CM1 7ET Chelmsford, Essex, United Kingdom. Electronic address: peter.dziewulski@meht.nhs.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Dziewulski
mesh_terms: D000328:Adult; D001830:Body Surface Area; D002053:Burn Units / Q000706:statistics & numerical data*; D002056:Burns; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D015276:Health Care Rationing; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D006113:United Kingdom
keywords: Burns; ITU; Length of stay; Paediatric