Division of overall duration of stay into operative stay and postoperative stay improves the overall estimate as a measure of quality of outcome in burn care

PLoS One. 2017 Mar 31;12(3):e0174579. doi: 10.1371/journal.pone.0174579. eCollection 2017.

Abstract

Patients and methods: Surgically managed burn patients admitted between 2010-14 were included. Operative stay was defined as the time from admission until the last operation, postoperative stay as the time from the last operation until discharge. The difference in variation was analysed with F-test. A retrospective review of medical records was done to explore reasons for extended postoperative stay. Multivariable regression was used to assess factors associated with operative stay and postoperative stay.

Results: Operative stay/TBSA% showed less variation than total duration/TBSA% (F test = 2.38, p<0.01). The size of the burn, and the number of operations, were the independent factors that influenced operative stay (R2 0.65). Except for the size of the burn other factors were associated with duration of postoperative stay: wound related, psychological and other medical causes, advanced medical support, and accommodation arrangements before discharge, of which the two last were the most important with an increase of (mean) 12 and 17 days (p<0.001, R2 0.51).

Conclusion: Adjusted operative stay showed less variation than total hospital stay and thus can be considered a more accurate outcome measure for surgically managed burns. The size of burn and number of operations are the factors affecting this outcome measure.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Body Surface Area
  • Burns*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Period
  • Retrospective Studies
  • Sex Distribution
  • Young Adult

Grants and funding

This work was supported by, and done at, the Burn Centre, Department of Plastic Surgery, Hand Surgery, and Burns, and the Linköping University, Linköping, Sweden. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.