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Published on: February 23, 2024
Pediatric burn-trauma patients have increased length of stay compared to trauma-only patients: A propensity matched
Chloe C Krasnoff1, Areg Grigorian1, Theresa Chin1
1University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
Insights
Pediatric patients with combined burn and trauma injuries experienced twice the length of hospital stay compared to trauma-only patients. However, mortality rates and complications remained similar between the groups.
Area of Science:
- Pediatric trauma care
- Burn injury management
- Health services research
Background:
- Trauma is a leading cause of mortality in children.
- Burn injuries are resource-intensive, particularly in pediatric cases.
- Understanding the impact of combined burn-trauma is crucial for resource allocation.
Purpose of the Study:
- To compare length of stay (LOS) and mortality in pediatric patients with combined burn-trauma (BT) versus trauma-only (T) injuries.
- To identify differences in intensive care unit (ICU) LOS, complications, and mortality between the two groups.
- To inform risk-stratified quality metrics in pediatric trauma care.
Main Methods:
- Utilized data from the Pediatric Trauma Quality Improvement Program (2014-2016).
- Employed 1:2 propensity-score matching to compare BT patients with T patients.
- Matched patients based on age, gender, hypotension, injury type, and severity.
Main Results:
- 93 BT patients were matched with 186 T patients, with no significant differences in baseline characteristics.
- BT patients had a significantly longer median LOS (4 vs 2 days, p<0.001).
- No significant differences were observed in mortality, ICU LOS, or complication rates between BT and T groups.
Conclusions:
- Pediatric patients with combined burn-trauma injuries have a doubled LOS compared to trauma-only patients.
- Mortality and complication rates are comparable between the two groups.
- Concomitant burn injury must be considered in risk-stratified quality metrics for pediatric trauma.
Background:
Trauma is the leading cause of mortality in children. Burn injury involves intensive resources, especially in pediatric patients. We hypothesized that among pediatric trauma patients, combined burn-trauma (BT) patients have increased length of stay (LOS) and mortality compared to trauma-only (T) patients.
Methods:
The Pediatric Trauma Quality Improvement Program (2014-2016) was queried and BT patients were 1:2 propensity-score-matched to T patients based on age, gender, hypotension on admission, injury type and severity.
Results:
93 BT patients were matched to 186 T patients. There were no differences in matched characteristics. BT patients had a longer median LOS (4 vs 2 days, p<0.001) with no difference in mortality (1.1% vs 1.1%, p=1.00), intensive care unit (ICU) LOS (3 vs 3 days, p=0.55), or complications including decubitus ulcer (0% vs 1.1%, p=0.32), deep vein thrombosis (0% vs 0.5%, p=0.48), extremity compartment syndrome (1.1% vs 0%, p=0.16), and urinary tract infection (1.1% vs 1.1%, p=1.00).
Conclusion:
Pediatric BT patients had twice the LOS compared to a matched group of pediatric T patients. There was no difference between the cohorts in ICU LOS, complications or mortality rate. When evaluating risk-stratified quality metrics such as LOS, concomitant burn injury should be incorporated.
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