TY - JOUR
T1 - Hospital-based, acute care within 30 days following discharge for acute burn injury
AU - Anderson, Spencer R.
AU - Sensing, Thomas A.
AU - Thede, Katrina A.
AU - Johnson, R. Michael
AU - Fox, Justin P.
N1 - Publisher Copyright:
© 2021 Elsevier Ltd and ISBI
PY - 2021/9
Y1 - 2021/9
N2 - Background: While the acute management of burn injury has received substantial attention, patients may undergo additional hospital based, acute care following initial management. We conducted this study to quantify and describe patients’ full hospital based, acute care needs within 30 days following an acute burn injury. Methods: Using Florida, Nebraska, and New York state inpatient and emergency department databases, we identified adult patients discharged for an acute burn injury from January 1, 2010-November 30, 2014. The primary outcome was the frequency of hospital based, acute care (ED visit or hospital admission) within 30 days of initial discharge. Multivariable logistic regression modeling was used to identify patient factors associated with more frequent hospital based, acute care in the overall population. Results: The final sample included 126,685 patients who sustained an acute burn injury and were initially managed through the ED (88.3%) or by hospital admission (11.7%). Overall, 16.5% of patients experienced at least one hospital based, acute care encounter within 30 days of discharge of their initial encounter. Most commonly, these were ED visits not undergoing hospital admission for wound care, ongoing burn care, or infectious complications. Patient-level factors associated with more frequent encounters included a history of opioid misuse or abuse (Adjusted Odds Ratio = 2.23, [95% Confidence Interval 2.01−2.47]), chronic obstructive pulmonary disease (AOR = 1.25, [1.12–1.38]), diabetes mellitus (AOR = 1.13, [1.04–1.23]), and mental health diagnoses (AOR = 1.22, [1.11–1.34]). Conclusions: Hospital based, acute care encounters are common after initial burn management. Further efforts are needed to improve the transition to outpatient care.
AB - Background: While the acute management of burn injury has received substantial attention, patients may undergo additional hospital based, acute care following initial management. We conducted this study to quantify and describe patients’ full hospital based, acute care needs within 30 days following an acute burn injury. Methods: Using Florida, Nebraska, and New York state inpatient and emergency department databases, we identified adult patients discharged for an acute burn injury from January 1, 2010-November 30, 2014. The primary outcome was the frequency of hospital based, acute care (ED visit or hospital admission) within 30 days of initial discharge. Multivariable logistic regression modeling was used to identify patient factors associated with more frequent hospital based, acute care in the overall population. Results: The final sample included 126,685 patients who sustained an acute burn injury and were initially managed through the ED (88.3%) or by hospital admission (11.7%). Overall, 16.5% of patients experienced at least one hospital based, acute care encounter within 30 days of discharge of their initial encounter. Most commonly, these were ED visits not undergoing hospital admission for wound care, ongoing burn care, or infectious complications. Patient-level factors associated with more frequent encounters included a history of opioid misuse or abuse (Adjusted Odds Ratio = 2.23, [95% Confidence Interval 2.01−2.47]), chronic obstructive pulmonary disease (AOR = 1.25, [1.12–1.38]), diabetes mellitus (AOR = 1.13, [1.04–1.23]), and mental health diagnoses (AOR = 1.22, [1.11–1.34]). Conclusions: Hospital based, acute care encounters are common after initial burn management. Further efforts are needed to improve the transition to outpatient care.
KW - Acute care
KW - Burn injury
KW - Emergency department visits
KW - Hospital readmission
KW - Hospital-based
UR - http://www.scopus.com/inward/record.url?scp=85110168026&partnerID=8YFLogxK
U2 - 10.1016/j.burns.2021.05.016
DO - 10.1016/j.burns.2021.05.016
M3 - Article
C2 - 34172328
AN - SCOPUS:85110168026
SN - 0305-4179
VL - 47
SP - 1265
EP - 1273
JO - Burns
JF - Burns
IS - 6
ER -