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Does "off-hours" admission affect burn patient outcome?
Breena R Taira1, Hongdao Meng, Melody S Goodman
1Department of Emergency Medicine, Stony Brook University Medical Center, HSC L4, 080, Stony Brook, NY 11794-8350, United States. btaira@notes.cc.sunysb.edu
Summary
Off-hours admission does not impact outcomes for severe burn patients. This study found no significant difference in mortality or length of stay for patients admitted during off-hours versus weekdays.
Area of Science:
- Trauma Surgery
- Critical Care Medicine
- Burn Injury Research
Background:
- Critically ill patients admitted during off-hours (nights/weekends) often experience worse outcomes.
- Severe burn injuries are emergent, prompting investigation into potential off-hours disparities.
Purpose of the Study:
- To determine if off-hours hospital admission affects outcomes for severe burn patients.
- To test the hypothesis that burn patients admitted during off-hours have worse outcomes.
Main Methods:
- Secondary analysis of the National Trauma Data Bank (NTDB) from 2002-2006.
- Included 25,572 burn patients, comparing outcomes for off-hours admissions (6 PM-6 AM, weekends) versus weekday admissions.
- Utilized descriptive statistics, chi-squared tests, t-tests, and multivariable logistic/linear regressions.
Main Results:
- 68.9% of burn patients were admitted during off-hours.
- No significant differences were observed in ICU length of stay (p=0.233), hospital length of stay (p=0.82), or mortality (p=0.546) between off-hours and weekday admissions.
- Multivariate analysis confirmed off-hours admission was not predictive of mortality (OR=1.06, 95% CI 0.91-1.23) after controlling for key patient and hospital factors.
Conclusions:
- Off-hours admission is not associated with adverse outcomes in severe burn patients.
- Findings contrast with existing literature on other critically ill populations.
- This suggests specialized burn care may mitigate off-hours admission risks.
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