Successive National Burn Repository (NBR) Annual Reports consistently show a mean of approximately 1 hospital day per %TBSA burn across all patient records. For example, analyzing data from Table 16 of the 2017 NBR report [https://ameriburn.site-ym.com/resource/collection/4C72F10C-24FD-401C-8608-417BFAB10138/2017_ABA_NBR_Annual_Report.pdf] (P34/134), which presents data on ‘Hospital Days: Lived/Died by Burn Size Group’ for 124,196 survivors, gives a mean of 1.03 days/%TBSA, consistent with the Summary of Findings (P11/134), which states: “9. For survivors, the average length of stay was slightly greater than approximately 1 day per percent TBSA burned”.
Table 19 of the same report ‘Days Per %TBSA and Charges Per Day by Age Groups and Survival’ (P36/134) shows days/%TBSA for a subset of 47,291 survivors (38%) with valid data hospital days, %TBSA, and hospital charges; however, the mean days/%TBSA is 2.07, double that of all survivors. This means that people with valid hospital charges data are hospitalized for longer than the overall population per extent of burn. What might explain this discrepancy? Furthermore, mean days/%TBSA in this subgroup has increased over the years, while overall length of hospital stay across all patients has steadily declined. Why might that be?
The age profile of the subsample of patients with valid hospital charges data matches that of the overall population. However, it may be that this group is biased toward patients from specialist burn units, who might survive extensive burns but require prolonged treatment lasting 6 month to 2 years upwards. Decreasing mortality in such patients due to treatment advances would explain rising hospital days/%TBSA over time.
For more detailed data and analyses, see Abstract here:
Article Hospital stay per percent TBSA: Factchecks on false trails
Or Letter to the Editor here: Article Hospital stay per percent TBSA: Factchecks on false trails
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