622 Seasonal Impact on Burn Admissions in a Desert Burn Unit

Abstract

Abstract Introduction In much of the US and the world, burn injuries are more common in the winter season. However, to our knowledge there has not been any study reviewing the seasonal variation of burn injuries in a desert climate. This study examines the seasonal impact of admissions, acuity, mortality and resource utilization at an accredited burn center located in a desert climate. Methods This is a retrospective analysis of all patients admitted from March 1, 2014 to February 28, 2019 for acute burns at our specialized burn center located in a desert climate. Patients were categorized in four groups according to each season based on their date of admission. The seasonal breakdown was the following: Spring (March/April/May), Summer (June/July/August), Fall (September/October/November), and Winter (December/January/February). Demographics include age, gender, etiology, and TBSA. Outcome measures included are total admissions for each season, average daily inpatient census, mortality, ICU-free and hospital-free days (30 days). Statistical analysis was completed with STATA. Results A total of 1519 patients were included in this study. 1016 were male (66.9%) with an average age 39.6 years (IQR 20–59). Most admissions came during the Summer (35%), followed by Winter (23%), Spring (21%) and Fall (21%). Figure 1 displays the burn admissions per month throughout the year separated by etiology. Most common mechanisms are flame/flash (677, 44.6%), scald (414, 27.3%) and pavement (194, 12.8%). 169 (87.1%) of 194 pavement burn admissions occurred during the Summer. Average TBSA was 12.8%, and was highest for flash/flame (16.8%), electrical (10.6%) and pavement (9.5%). Average hospital free days was 19.9, lowest for pavement (16.2 days), flash/flame (18.0 days) and contact (21.8 days). Average ICU free days were lowest for flash/flame (24.4 days), followed by pavement (26.4 days) and electrical (27.9 days). Overall 1437 patients (94.6%) survived to hospital discharge. Average daily inpatient census was highest in Summer (14.1), followed by Winter (9.8), Spring (8.7) and Fall (7.1). Conclusions In a desert climate, the summer months are the peak season for burn admissions and average daily inpatient census in large part due to pavement burns. As these burns have a longer length of stay, it leads to increase in resource utilization compared to the other mechanisms. Applicability of Research to Practice The results of this study justify the need for continued community education focused on prevention of pavement burns. It highlights the need to increase hospital resources such as nursing staff, residents, fellows and mid-level providers during the Summer season.