Does Referral Distance Deteriorates the Burn Patients Outcome? Results From an Academic Tertiary Hospital in a Developing Country.

Autor:	Zeinalipour Z; Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran., Goldani F; Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran., Khadem-Rezaiyan M; Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran., Ahmadabadi A; Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran., Tavousi SH; Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Jazyk:	angličtina
Zdroj:	Journal of burn care & research : official publication of the American Burn Association [J Burn Care Res] 2024 Mar 04; Vol. 45 (2), pp. 318-322.
DOI:	10.1093/jbcr/irad120
Abstrakt:	Every year millions of people are burned and many of them are transported to specialized burn centers. One of the most important challenges in the face of burn patients in urban areas is deciding about referring patients to specialized burn centers. In this study, correlation between referral distance and mortality rate is investigated. Our cross-sectional analytic study included admission data of 7248 burn patients from Imam Reza Burn Center (Mashhad, Iran) over 9 years. The outcomes of interest were mortality, length of hospital stay, and the Abbreviated Burn Severity Index (ABSI). Also, we measured the distance between the patient referral location to Mashhad. SPSS version 16 was used for data analysis. Overall, 52.7% of admitted patients were referred from hospitals in other cities. The referred group had more severe burn injury (P < .001), higher mortality rate (P < .001), and longer length of hospital stay (P < .001). The referred distance was associated with an increased risk of death (Odds ratio = 1.68, 95% CI, 1.47-1.92), but after controlling the severity of burns, only ABSI was the statistically significant predictor of mortality (Odds ration = 2.17, 95% CI, 2.05-2.28). Therefore, increasing the distance from urban areas to specialized burn center did not increase the mortality rate. After adjusting for ABSI, the mortality rate in referred patients was not related to referral distance. By observing referral points based on available guidelines, distance from a referral burn center does not affect mortality rate independently. Therefore, equipping the existing burn centers instead of building new ones and focusing on improving referral system can be a good strategy in low- and middle-income countries with limited resources. (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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