title: Burn center volume makes a difference for burned children.
abstract: OBJECTIVE
  Determine the relationship between the volume of burn admissions and outcomes for children with burns.
  
  
  METHODS
  Retrospective review of the National Burn Repository from 2000-2009 using mixed effect logistic regression modeling.
  
  
  METHODS
  Tertiary burn centers in the United States.
  
  
  METHODS
  All children <18 years of age admitted with burn injury to a burn center submitting data to the National Burn Repository.
  
  
  METHODS
  None.
  
  
  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.
authors: 1Burn Division, Department of Surgery, Shriners Hospital for Children Northern California, Sacramento, CA. 2Department of Surgery, University of California Davis, Sacramento, CA. 3Department of Public Health Sciences, University of California Davis Medical Center, Sacramento, CA.
authors: Tina L
authors: TL
authors: Palmieri
authors: Sandra
authors: S
authors: Taylor
authors: MaryBeth
authors: M
authors: Lawless
authors: Terese
authors: T
authors: Curri
authors: Soman
authors: S
authors: Sen
authors: David G
authors: DG
authors: Greenhalgh
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001830:Body Surface Area; D002053:Burn Units / Q000706:statistics & numerical data*; D002056:Burns / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006739:Hospital Administration / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015208:Smoke Inhalation Injury / Q000453:epidemiology / Q000401:mortality; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
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