Understanding the Drivers of Cost and Length of Stay in a Cohort of 21,875 Patients with Severe Burn

Authors

Sacha C. Hauc, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.
Viola Antonia Stögner, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.Follow
Jacqueline M. Ihnat, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.
Helia Hosseini, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.
Lioba Huelsboemer, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.
Martin Kauke-Navarro, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.Follow
Jean C. Rivera, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.
Mica Williams, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.
Joshua Z. Glahn, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.
Alisa Savetamal, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.Follow
Bohdan Pomahac, Department of Surgery, Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, 06511, CT, USA.Follow

Document Type

Article

Publication Title

Journal of burn care & research : official publication of the American Burn Association

Abstract

Burn management has significantly advanced in the past 75 years, resulting in improved mortality rates. However, there are still over one million burn victims in the United States each year, with over 3,000 burn-related deaths annually. The impacts of individual patient, hospital, and regional demographics on length of stay (LOS) and total cost have yet to be fully explored in a large nationally representative cohort. Thus, this study aimed to examine various hospital and patient characteristics using a sample of over 20,000 patients. Inpatient data from the National Inpatient Sample from 2008 to 2015 were analyzed, and only patients with an ICD-9 code for second- or third-degree burns were included. In addition, a major operating room procedure must have been indicated on the discharge summary for patients to be included in the final dataset, ensuring that only severe burns requiring complex care were analyzed. Analysis of covariance models was used to evaluate the impact of various patient, hospital, and regional variables on both LOS and cost. The study found that skin grafts and fasciotomy significantly increased the cost of hospitalization. Having burns on the face, neck, and trunk significantly increased costs for patients with second-degree burns, while burns on the trunk resulted in the longest LOS for patients with third-degree burns. Infections in the hospital and additional procedures, such as flaps and skin grafts, also led to longer stays. The study also found that the prevalence of postoperative complications, such as electrolyte imbalance, was high among patients with burn surgery.

First Page

425

Last Page

431

DOI

10.1093/jbcr/irad168

Publication Date

3-4-2024

Recommended Citation

Hauc, Sacha C.; Stögner, Viola Antonia; Ihnat, Jacqueline M.; Hosseini, Helia; Huelsboemer, Lioba; Kauke-Navarro, Martin; Rivera, Jean C.; Williams, Mica; Glahn, Joshua Z.; Savetamal, Alisa; and Pomahac, Bohdan, "Understanding the Drivers of Cost and Length of Stay in a Cohort of 21,875 Patients with Severe Burn" (2024). Surgery. 6.
https://scholar.bridgeporthospital.org/surgery/6