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Analysis of Admissions and Outcomes in Verified and Nonverified Burn Centers

Palmieri, Tina L. MD*; London, Jason A. MD, MPH†; O’Mara, Michael S. MD*; Greenhalgh, David G. MD, FACS*

doi: 10.1097/BCR.0b013e31815f31b4
Original Articles: 2006 ABA Papers

The American Burn Association instituted a burn center verification process to ensure optimal care for patients with burn injury. Limited data exist regarding differences in admissions and outcomes between verified (VC) and nonverified burn centers (NVC). The study purpose was to compare demographics, treatment, and outcomes of VC and NVC. The five VC were compared with the 12 NVC using data from California’s discharge database for the year 2003. A total of 2867 patients were admitted to a burn center, 1645 to NVC (132/center), and 1222 (244/center) to VC. NVC admitted 1496 (91%) of their patients from local area and 118 (7%) from other acute care hospitals; in contrast, 948 (78%) of VC patients were local and 253 (21%) were transfers from other acute care hospitals. VCs admitted twice as many burns ≥80% total body surface area as NVC. VCs admitted more patients with face burns (18% VC vs 14% NVC, P < .001), had more patients on mechanical ventilation (12.4% VC vs 9.9% NVC P < .04), and performed fewer operations (61% VC vs 66% NVC, P < .006). Mortality rate was 3% in NVC and 4% in VC. During the study period verified centers in California admitted more patients per center and treated more severely injured patients than nonverified centers. Despite these differences, VC had mortality rates comparable to their nonverified counterparts. These findings support the need for additional studies evaluating the impact of verification on burn care.

From the *Burn Division, University of California Davis and Shriners Hospital for Children Northern California; and †Department of Surgery, Division of Trauma and Emergency Surgery, University of California Davis, Sacramento, California.

Presented at the 38th Annual American Burn Association Meeting, Las Vegas, Nevada.

Address correspondence to Tina L. Palmieri, MD, Shriners Hospital for Children Northern California and University of California Davis, 2425 Stockton Blvd., Suite 718, Sacramento, California 95616.

© 2008 The American Burn Association