Analysis of functional outcomes in patients discharged from an acute burn center

Burn patients require careful consideration of their post-discharge needs to maximize their recovery. Patient-specific variables or a combination of variables that might allow clinicians to develop pathways and objective endpoints for appropriate discharge would assist in expediting the patient's post-discharge care. While there have been numerous studies examining a single variable and its ability to predict outcomes, these studies may not be directly applicable to burn patients. A burn clinician must incorporate a number of variables into their prediction of discharge disposition and outcomes. Our study included 202 burn patients aged 16 and older discharged from the acute burn unit from February 2004 to June 2005. Descriptive data collection included age, total body surface area, location of burn, presence/absence of inhalation injury, gender, length of stay, discharge disposition, insurance status, and presence/absence of social support. The analysis that also incorporated data containing functional status consisted of FIM scores for locomotion, transfers, dressing, and feeding. The classification tree analysis was utilized to demonstrate what variables could predict discharge disposition. The only variable that could strongly predict those patients that went home versus another setting was the FIM locomotion score. Of the patients who went home, 87.2% were at or above a supervision level for locomotion, whereas 85.2% of the patients not discharged to home were at or below a maximal assist level. The level of functional independence at the time of a patient's discharge as assessed by the patient's ability to walk was the most powerful identifier of their ongoing needs.