Burns in the Emergency Department: A National Perspective
Burns in the Emergency Department: A National Perspective
Background: Burns are a common cause of injury presenting to the Emergency Department (ED). Several reports state that admission for and mortality from burn injury are declining. Total visits to the ED, however, have increased. Objectives: The objective of this study was to determine the number and trends over time of patients presenting to the ED for burn injury. Methods: The study was a retrospective analysis of National Hospital Ambulatory Medical Care Survey databases for 1996–2005 available from the Centers for Disease Control and Prevention. Subjects were patients with a first diagnosis of a burn. Patient weights in the database were used to obtain estimated national values. Measures used were estimated total numbers and percentages of patients by year. Trends from 1996 through 2005 were examined overall and by demographic factors and injury characteristics. Linear regression was used to evaluate trends. Results: There was a significantly decreasing trend in ED burn visits from 1996 to 2000 (614,745 to 433,681 visits), but no apparent trend for the years 2000 to 2005. Annually, about 60% of ED burn patients were male, and about half were between the ages of 19 and 44 years. Less than 5% of burns were third degree or full thickness injuries. Admissions per year were stable at 5%. The most common causes of burn injury were contact with a hot liquid and contact with a hot object, and the most common body region affected was the upper extremities (40% each year), followed by burns to the head/face/neck. Use of medications showed no trends over time. Conclusions: ED visits for burn injuries have been decreasing; however, patterns of cause, admission, and treatment show no consistent temporal change.
Burns are a common cause of injury resulting in visits to the Emergency Department (ED). Over the past several decades, hospital admissions for and mortality from burn injury have been reported to be declining. Brigham and McLoughlin in 1996 published a review of the national trends in burn incidence and admissions and found substantial declines in the national incidence of burn injury. Previous studies suggest the decline in admissions can be attributed to several factors, including prevention programs, improved pre-hospital and ED care, and more aggressive outpatient management of burn injury. Current widely employed prevention measures include scald prevention programs, smoke detector campaigns, and sleepwear flammability standards. The Brigham study in the 1990s, however, was the last large-scale attempt at quantification of national trends in burn injury.
Over the same time period, the number of total ED visits has increased. Thus, any decline in the number of burn admissions could be attributed to a decrease in the incidence of new burns presenting to the ED or to changing patterns in admission rates from the ED. Few studies have addressed epidemiologic trends of patients presenting to the ED for burn injury in the United States. The objective of this study is to determine the number and trends over time of patients presenting for burn injury to the ED using a large nationally representative database.
Abstract and Introduction
Abstract
Background: Burns are a common cause of injury presenting to the Emergency Department (ED). Several reports state that admission for and mortality from burn injury are declining. Total visits to the ED, however, have increased. Objectives: The objective of this study was to determine the number and trends over time of patients presenting to the ED for burn injury. Methods: The study was a retrospective analysis of National Hospital Ambulatory Medical Care Survey databases for 1996–2005 available from the Centers for Disease Control and Prevention. Subjects were patients with a first diagnosis of a burn. Patient weights in the database were used to obtain estimated national values. Measures used were estimated total numbers and percentages of patients by year. Trends from 1996 through 2005 were examined overall and by demographic factors and injury characteristics. Linear regression was used to evaluate trends. Results: There was a significantly decreasing trend in ED burn visits from 1996 to 2000 (614,745 to 433,681 visits), but no apparent trend for the years 2000 to 2005. Annually, about 60% of ED burn patients were male, and about half were between the ages of 19 and 44 years. Less than 5% of burns were third degree or full thickness injuries. Admissions per year were stable at 5%. The most common causes of burn injury were contact with a hot liquid and contact with a hot object, and the most common body region affected was the upper extremities (40% each year), followed by burns to the head/face/neck. Use of medications showed no trends over time. Conclusions: ED visits for burn injuries have been decreasing; however, patterns of cause, admission, and treatment show no consistent temporal change.
Introduction
Burns are a common cause of injury resulting in visits to the Emergency Department (ED). Over the past several decades, hospital admissions for and mortality from burn injury have been reported to be declining. Brigham and McLoughlin in 1996 published a review of the national trends in burn incidence and admissions and found substantial declines in the national incidence of burn injury. Previous studies suggest the decline in admissions can be attributed to several factors, including prevention programs, improved pre-hospital and ED care, and more aggressive outpatient management of burn injury. Current widely employed prevention measures include scald prevention programs, smoke detector campaigns, and sleepwear flammability standards. The Brigham study in the 1990s, however, was the last large-scale attempt at quantification of national trends in burn injury.
Over the same time period, the number of total ED visits has increased. Thus, any decline in the number of burn admissions could be attributed to a decrease in the incidence of new burns presenting to the ED or to changing patterns in admission rates from the ED. Few studies have addressed epidemiologic trends of patients presenting to the ED for burn injury in the United States. The objective of this study is to determine the number and trends over time of patients presenting for burn injury to the ED using a large nationally representative database.