Comparison of burn surface area estimated by ambulance crews or referring hospitals and an Advanced Critical Care and Emergency Center

Burn surface area is an essential factor in determining the need for specialized burn center treatments. Herein, the accuracy of burn surface areas estimated by ambulance crews and referral hospitals was evaluated, providing insight into the effectiveness of patient selection for specialized care. The study was conducted from April 1, 2018 to March 31, 2024. The participants were patients with burns admitted to the Advanced Critical Care and Emergency Center of Yokohama City University Medical Center, Kanagawa Prefecture, Japan. The study population was divided into two groups: direct transport group (patients transported from the scene to our center by ambulance crews) and inter-hospital transfer group (patients transferred from other hospitals). Pre- and post-transfer burn surface area estimates were evaluated in qualitative and quantitative frameworks. During the study period, 176 inpatients were evaluated with respect to the burn surface area at our center, including 134 (76.1%) and 42 (23.9%) in the direct transport and inter-hospital transfer groups, respectively. A comparison of the burn surface area estimates by ambulance crews or referring hospital physicians and those at our center showed that pre-transfer estimates exceeded post-transfer specialist assessments; however, this overestimation was not clinically important. In Japan, the decision to treat patients with burns at an advanced critical care and emergency center depends on evaluations performed by ambulance crews and physicians at the referring hospitals. The results of this study suggest that the burn surface area was properly estimated before transfer, supporting this approach. However, our findings should be generalized with caution.