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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
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URI: https://cronfa.swan.ac.uk/Record/cronfa60992
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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&#x2013;0.21%) to 1.22% (0.9&#x2013;1.5%). The adjusted mean LOS ranged from 3.8 (3.3&#x2013;4.3) to 8.2 (6.7&#x2013;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.</abstract><type>Journal Article</type><journal>ANZ Journal of Surgery</journal><volume>92</volume><journalNumber>10</journalNumber><paginationStart>2641</paginationStart><paginationEnd>2647</paginationEnd><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1445-1433</issnPrint><issnElectronic>1445-2197</issnElectronic><keywords>adult, Australia, burn, registry, variation</keywords><publishedDay>22</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-08-22</publishedDate><doi>10.1111/ans.17985</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><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. 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spelling 2023-01-04T15:29:13.3369561 v2 60992 2022-08-31 Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients 4bdcc94332b2bd10530c5e71ceb04f14 0000-0001-7096-7688 Belinda Gabbe Belinda Gabbe true false 2022-08-31 FGMHL 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. Journal Article ANZ Journal of Surgery 92 10 2641 2647 Wiley 1445-1433 1445-2197 adult, Australia, burn, registry, variation 22 8 2022 2022-08-22 10.1111/ans.17985 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University Another institution paid the OA fee 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 2023-01-04T15:29:13.3369561 2022-08-31T15:49:35.6878767 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Lincoln M. Tracy 0000-0002-9783-6415 1 Anne Darton 2 Belinda Gabbe 0000-0001-7096-7688 3 Kathryn Heath 4 Rochelle Kurmis 5 Carl Lisec 6 Cheng Lo 7 Yvonne Singer 8 Fiona M. Wood 9 Heather J. Cleland 10 60992__25059__03dc0963a6814d3a9050c6dd022f9f9e.pdf 60992_VoR.pdf 2022-08-31T16:02:00.8712462 Output 442416 application/pdf Version of Record true © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License true eng http://creativecommons.org/licenses/by/4.0/
title Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients
spellingShingle Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients
Belinda Gabbe
title_short Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients
title_full Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients
title_fullStr Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients
title_full_unstemmed Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients
title_sort Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients
author_id_str_mv 4bdcc94332b2bd10530c5e71ceb04f14
author_id_fullname_str_mv 4bdcc94332b2bd10530c5e71ceb04f14_***_Belinda Gabbe
author Belinda Gabbe
author2 Lincoln M. Tracy
Anne Darton
Belinda Gabbe
Kathryn Heath
Rochelle Kurmis
Carl Lisec
Cheng Lo
Yvonne Singer
Fiona M. Wood
Heather J. Cleland
format Journal article
container_title ANZ Journal of Surgery
container_volume 92
container_issue 10
container_start_page 2641
publishDate 2022
institution Swansea University
issn 1445-1433
1445-2197
doi_str_mv 10.1111/ans.17985
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description 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.
published_date 2022-08-22T04:19:33Z
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