Bridging Acuity and Anesthesia: A Novel Tiered Framework for Anesthetic Stratification in Operative Burn Management

Area of Science:

• Anesthesiology
• Trauma Surgery
• Burn Care

Background:

• Burn injuries present diverse clinical challenges, lacking standardized anesthesia coordination frameworks.
• Existing scoring systems predict morbidity/mortality but not anesthesia needs.
• A novel tiered system aims to stratify anesthesia requirements by burn severity.

Purpose of the Study:

• Evaluate a new tiered classification system for operative burn cases.
• Stratify anesthesia needs based on clinical severity and physiologic risk.
• Assess the system's utility in resource allocation and education.

Main Methods:

• Retrospective analysis of 132 operative burn cases over one year.
• Categorization into Green (low), Yellow (moderate), and Red (high) risk tiers.
• Analysis of physiologic factors: burn extent (TBSA), hemodynamic instability, vasopressor use.

Main Results:

• Pediatric cohort (<18 years) had larger mean TBSA burns (43.3% vs. 21.8%) and more Red-tier cases.
• Significant differences in intraoperative blood product administration across tiers (p<0.001).
• The tiered system identified distinct clinical groups based on severity and instability.

Conclusions:

• The proposed tiered system effectively categorizes operative burn cases by severity.
• Implementation may enhance patient outcomes and anesthesia resource allocation.
• The framework can guide standardized education for acute burn injury management.