Burns patients with epilepsy or a learning disability have a greater length of stay in hospital than those patients with a history of drug or alcohol abuse

Othman, Diaa; Jones, O.C.

doi:10.1016/j.burns.2010.10.011

Cited by 6 publications

(3 citation statements)

References 4 publications

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“…Conditions such as depression, attention deficit disorder, anxiety, aggression, and autism afflict 19-80% [23] of persons with seizure disorders, compared to 4.3-26.4% of the general population [24]. Both epilepsy and learning disabilities have been observed to lengthen hospital stay in burn patients [25]. Anecdotal evidence from our own unit suggests the same association, although further research would be needed to support these observations.…”

Section: Discussionmentioning

confidence: 73%

The Role of Seizure Disorders in Burn Injury and Outcome in Sub-Saharan Africa

Boschini

Tyson

Samuel

et al. 2014

Journal of Burn Care & Research

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OBJECTIVE Patients with epilepsy have higher incidence and severity of burn injury. Few studies describe the association between epilepsy and burns in low-income settings, where epilepsy burden is highest. We compared patients with and without seizure disorder in a burn unit in Lilongwe, Malawi. METHODS We conducted a retrospective study of patients admitted to the Kamuzu Central Hospital burn ward from July 2011 to December 2012. Descriptive analysis of patient characteristics and unadjusted and adjusted analyses of risk factors for mortality were conducted for patients with and without seizure disorder. RESULTS Prevalence of seizure disorder was 10.7% in our population. Adults with burns were more likely to have seizure disorder than children. Flame injury was most common in patients with seizure disorder, whereas scalds predominated among patients without seizure disorder. While mortality did not differ between the groups, mean length of stay was longer for patients with seizure disorder, 42.1 days versus 21.6 days. CONCLUSION Seizure disorder continues to be a significant risk factor for burn injury in adults in Malawi. Efforts to mitigate epilepsy will likely lead to significant decreases in burns among adults in sub Saharan Africa and must be included in an overall burn prevention strategy in our environment.

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Section: Discussionmentioning

confidence: 73%

The Role of Seizure Disorders in Burn Injury and Outcome in Sub-Saharan Africa

Boschini

Tyson

Samuel

et al. 2014

Journal of Burn Care & Research

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“…[10][11][12][13]16 However, in studies restricting the analysis to either survivors or nonsurvivors, the results differ. 14,15,17,18 In nonsurvivors, age was not a significant predictor of LOS; however, age was significant for survivors. Our results show that the majority of deaths after a burn injury occur in the first few days after the burn injury, and that patients die owing to injury severity.…”

Section: Discussionmentioning

confidence: 90%

“…For example, in LOS studies on patients with burns, results differ if one analyzes survivors alone, nonsurvivors alone, or the combination of survivors and nonsurvivors. [10][11][12][13][14][15][16][17][18] While age is a predictor of LOS in survivors, age is not predictive in nonsurvivors. 10 Nonsurvivors have a shorter LOS and lower overall costs than survivors.…”

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confidence: 99%

A Competing Risk Analysis for Hospital Length of Stay in Patients With Burns

et al. 2015

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IMPORTANCE Current outcome predictors for illness and injury are measured at a single time point—admission. However, patient prognosis often changes during hospitalization, limiting the usefulness of those predictions. Accurate depiction of the dynamic interaction between competing events during hospitalization may enable real-time outcome assessment. OBJECTIVE To determine how the effects of burn outcome predictors (ie, age, total body surface area burn, and inhalation injury) and the outcomes of interest (ie, mortality and length of stay) vary as a function of time throughout hospitalization. DESIGN, SETTING, AND PARTICIPANTS In this retrospective study, we used the American Burn Association’s National Burn Repository, containing outcomes and patient and injury characteristics, to identify 95 579 patients admitted with an acute burn injury to 80 tertiary American Burn Association burn centers from 2000 through 2009. We applied competing risk statistical methods to analyze patient outcomes. MAIN OUTCOMES AND MEASURES We estimated the cause-specific hazard rates for death and discharge to assess how the instantaneous risk of these events changed across time. We further evaluated the varying effects of patient age, total body surface area burn, and inhalation injury on the probability of discharge and death across time. RESULTS Maximum length of stay among patients who died was 270 days and 731 days among those discharged. Total body surface area, age, and inhalation injury had significant effects on the subdistribution hazard for discharge (P < .001); these effects varied across time (P < .002). Burn size (coefficient –0.046) determined early outcomes, while age (coefficient –0.034) determined outcomes later in the hospitalization. Inhalation injury (coefficient –0.622) played a variable role in survival and hospital length of stay. CONCLUSIONS AND RELEVANCE Real-time measurement of dynamic interrelationships among burn outcome predictors using competing risk analysis demonstrated that the key factors influencing outcomes differed throughout hospitalization. Further application of this analytic technique to other injury or illness types may improve assessment of outcomes.

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