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Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients

Lincoln M. Tracy Orcid Logo, Anne Darton, Belinda Gabbe Orcid Logo, Kathryn Heath, Rochelle Kurmis, Carl Lisec, Cheng Lo, Yvonne Singer, Fiona M. Wood, Heather J. Cleland

ANZ Journal of Surgery, Volume: 92, Issue: 10, Pages: 2641 - 2647

Swansea University Author: Belinda Gabbe Orcid Logo

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DOI (Published version): 10.1111/ans.17985

Abstract

BackgroundBurn injuries are a common subtype of trauma. Variation in models of care impacts clinical measures of interest, but a nation-wide examination of these measures has not been undertaken. Using data from the Burns Registry of Australia and New Zealand (BRANZ), we explored variation between A...

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Published in: ANZ Journal of Surgery
ISSN: 1445-1433 1445-2197
Published: Wiley 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa60992
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Abstract: BackgroundBurn injuries are a common subtype of trauma. Variation in models of care impacts clinical measures of interest, but a nation-wide examination of these measures has not been undertaken. Using data from the Burns Registry of Australia and New Zealand (BRANZ), we explored variation between Australian adult burn services with respect to treatment and clinical measures of interest.MethodsData for admissions July 2016 to June 2020 were extracted. Clinical measures of interest included intensive care admission, skin grafting, in-hospital death, unplanned readmissions, and length of stay (LOS). Estimated probabilities, means, and corresponding 95% confidence intervals (CI) were calculated for each service.ResultsThe BRANZ recorded 8365 admissions during the study period. Variation between specialist burn services in admissions, demographics, management, and clinical measures of interest were observed. This variation remained after accounting for covariates. Specifically, the adjusted proportion (95% CI) of in-hospital mortality ranged from 0.15% (0.10–0.21%) to 1.22% (0.9–1.5%). The adjusted mean LOS ranged from 3.8 (3.3–4.3) to 8.2 (6.7–9.7) days.ConclusionsA decade after its launch, BRANZ data displays variation between Australian specialist burn services. We suspect differences in models of care between services contributes to this variation. Ongoing research has begun to explore reasons underlying how this variation influences clinical measures of interest. Further engagement with services about models of care will enhance understanding of this variation and develop evidence-based guidelines for burn care in Australia.
Keywords: adult, Australia, burn, registry, variation
College: Faculty of Medicine, Health and Life Sciences
Funders: Accident Compensation Corporation; Australasian Foundation for Plastic Surgery; Australian and New Zealand Burn Association; Australian Commission on Safety and Quality in Health Care; Australian Research Council. Grant Number: FT170100048; Clipsal by Schnieder Electric National Community Grants Program; HCF Research Foundation; Helen Macpherson Smith Trust; Julian Burton Burns Trust; Thyne Reid Foundation; Victorian Agency for Health Information
Issue: 10
Start Page: 2641
End Page: 2647