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Journal of Burn Care & Research ; 42:S56-S56, 2021.
Article in English | CINAHL | ID: covidwho-1174923

ABSTRACT

Introduction The current and long-term impact of the coronavirus disease 2019 (COVID-19) global pandemic on our healthcare system is still unknown. When healthcare resources were being diverted to only the most critical of needs, emergent surgical and burn care remained essential. Currently, no data exist on the impact of a global pandemic on a burn center. Our aim for this study was to understand how the COVID-19 pandemic affected admissions, hospital course, and discharges at a major metropolitan burn center. Methods This was a retrospective cohort study of admissions to our burn center. Our institution's medical record was reviewed from 1/1–8/31 for years 2020, 2019, & 2018. We included all thermal, chemical, and electrical burn inpatient admissions over these time periods. Non-burn wound admissions and vulnerable patient populations were excluded. Our population included 1,358 patients. These patients were grouped by year 2020 (n=425), 2019 (n=470), and 2018 (n=463). The medical record was queried for admission, hospital course, and discharge variables. SAS 9.4 statistical software was used to compare the pre-pandemic 2018/2019 groups against the 2020 group. Group means were compared using two-sample two-tailed t-tests, and categorical variables were compared using Chi-Square analysis. Results In 2020 the burn center had 425 admissions compared to 470 and 463 in 2019 and 2018 respectively. On admission, there were no differences in age, gender, pediatric admissions, burn etiology, total body surface area (TBSA), TBSA >20%, work-related injuries, or suspected abuse related injuries. Of note, the mean days from injury to admission for the groups were (2020 2.5±4.9 vs 2019 1.4±4.3, p=0.001, vs 2018 1.5±4.3, p=0.0017). Groups were similar in respect to burns requiring surgery and mean OR visits. 2019 and 2018 had increased ICU admissions compared to the 2020 cohort (ICU: 2020 60-(14%) vs 2019 91-(19.4%), p=0.041, vs 2018 108-(23.3%), p=0.033). Inpatient mortality was lower in the 2020 cohort compared to the pre-pandemic cohorts (2020 2 (0.6%) vs 2019 9 (2.5%), p=0.04, vs 2018 14 (4.2%) p=0.0017). Conclusions Volume at our burn center remains high during the pandemic. There is an increased lag time from burn injury to hospital admission in the 2020 cohort. We hypothesize this is due to patients' avoiding the hospital due to fear of contracting COVID-19. TBSA is similar across groups, but ICU admissions are down in the 2020 cohort. Further work is needed to understand whether the increased lag time has affected outcomes and whether the decreased ICU admissions are due to yearly variation or the pandemic.

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