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Hospital-Based Emergency Department Visits With Pediatric Burns

Characteristics and Outcomes

Abramowicz, Shelly DMD, MPH*†; Allareddy, Veerasathpurush BDS, PhD; Lee, Min Kyeong DMD, DMSc§; Nalliah, Romesh P. MHCM, BDS; Rampa, Sankeerth MBA, MPH; Allareddy, Veerajalandhar MD, MBA#

doi: 10.1097/PEC.0000000000001699
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Objective The objective of this study was to examine the characteristics and outcomes in children presenting to emergency departments (EDs) with burn injuries.

Methods The Nationwide Emergency Department Sample (NEDS) for the years 2008 to 2013 was used. All patients younger than 18 years who visited a hospital-based ED with a burn injury were selected. The study focused on (1) demographics (age, sex, insurance status), (2) characteristics of burns (types, causes), (3) disposition status after ED/hospitalization, (4) charges (ED and hospital), and (5) patient outcomes. Inclusion criteria were a visit to ED in the United States with a burn. Descriptive statistics were used to summarize the findings.

Results During the study period, there were 746,593 ED visits due to burn injuries. Majority were insured by Medicaid (52.8%). Most frequent injuries were burns of wrists/hands (39.5%), lower limbs (24.1%), and upper limb—except wrist/hand (20.1%). The most common causes of burns were heat from electric appliances (37.1%) or hot liquids and vapors (24.8%). Following the ED visit, 89.1% were discharged routinely, and 4.3% were admitted. Mean charge per patient per ED visit was $1117. Total ED charges across the United States was $708.7 million. When admitted, mean length of stay was 5.7 days. Total hospitalization charge across the United States was $1.7 billion.

Conclusions Pediatric burn injuries require significant resources for stabilization and treatment by EDs. The present study highlights the burden and impact of pediatric burn injuries in the United States.

From the *Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine; and

Section of Dentistry/Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA;

Department of Orthodontics, College of Dentistry, University of Illinois, Chicago, IL;

§Department of Dentistry, Children's Hospital of Los Angeles, Los Angeles, CA;

College of Dentistry, University of Michigan at Ann Arbor, Ann Arbor, MI;

Health Services Research & Administration Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE; and

#Division of Critical Care, Stead Family Children's Hospital, University of Iowa, Iowa City, IA.

Presented at the Society of Critical Care Medicine Annual Meeting; Honolulu, Hawaii; January 21 to 25, 2017.

Disclosure: The authors declare no conflict of interest.

Reprints: Shelly Abramowicz, DMD, MPH, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University, 1365 Clifton Rd, NE, Bldg B, Suite 2300, Atlanta, GA 30306 (e-mail: sabram5@emory.edu).

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