BACKGROUND:Optimal burn care is provided at specialized burn centers. Given the geographic location of these centers, many burn patients receive initial treatment at local emergency departments prior to transfer. The purpose of this study was to determine whether patients transferred from other facilities have worse outcomes than those admitted directly from the field. STUDY DESIGN:A retrospective cohort study was performed comparing the outcomes of patients admitted to our burn center directly from the field with patients requiring transfer from a preliminary care facility. The outcomes of interest were mortality, length of stay, length of stay/TBSA burned, number of operations and hospital charges. Poisson regression or Cox proportional hazards model was used to evaluate differences in outcomes after adjusting for potential confounders. RESULTS:From 2000 to 2003 a total of 1877 patients were admitted to our burn center and 953 (51%) were transferred from a preliminary care facility. No difference (p<0.05) was found in length of stay, number of operations, hospital charges and mortality between the two cohorts. CONCLUSIONS:This study demonstrates that patients transferred to a regional burn center from local hospitals have equivalent mortality, length of stay and hospital charges as those admitted directly from the field.

译文

背景:在专门的烧伤中心提供最佳的烧伤护理。考虑到这些中心的地理位置,许多烧伤患者在转移之前会先在当地急诊科接受初步治疗。这项研究的目的是确定从其他机构转移来的患者是否比直接从现场接受的患者具有更差的结局。
研究设计:进行了一项回顾性队列研究,比较了直接从现场进入我们烧伤中心的患者与需要从初级保健机构转诊的患者的结局。感兴趣的结果是死亡率,住院时间,住院时间/ TBSA烧伤,手术次数和医院费用。泊松回归或Cox比例风险模型用于评估潜在混杂因素后评估结局的差异。
结果:从2000年到2003年,共有1877名患者被收录到我们的烧伤中心,其中953名(51%)从初级护理机构转入了治疗。两组的住院时间,手术次数,住院费用和死亡率均无差异(p <0.05)。
结论:这项研究表明,从当地医院转移到区域烧伤中心的患者的死亡率,住院时间和住院费用与直接从现场接受的患者相同。

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