Does the dispatch distance deteriorate the burn patients’ outcome

Background and Aim : Despite the high prevalence of burn injuries in the low and middle-income countries, accurate data about the epidemiological and etiologic pattern of burns in these countries is limited. The aim of this study was to evaluate the effect of dispatch distance on the final outcome of burn patients. Methods : In this cross-sectional study, we included all patients admitted because of acute burn injuries to Imam Reza Burn Center from March 21, 2010, to March 20, 2014. Demographic and burn-related variables were gathered from hospital information system and patient medical records. Binary logistic regression in SPSS version 26 was used to estimate the effect of each predictor on the final outcome. Results : There were 3352 admissions and only one-third were referred from Mashhad (1153, 34.4%). The referred patients out of Mashhad were younger (26.0±19.4 vs. 27.3±19.1 years, p=0.05), but with higher burnt total body surface area (40.7±25.7 vs. 33.5±23.9 percent, p<0.001), higher Abbreviated Burn Severity Index (ABSI) (7.5±3.1 vs. 6.7±2.8, p<0.001), longer hospital stay (18.0±14.6 vs. 15.8±14.6 days, p<0.001), and higher mortality (24.6% vs. 15.3%, p<0.001). However, logistic regression (Nagelkerke R2= 0.64) showed that while adjusting for ABSI (OR=2.2, CI95%=2.1-2.3, p<0.001), the dispatch location was not a predictor of death (OR=0.77, CI95%=0.58-1.01, p=0.07). Conclusion : It seems that the location of referring does not affect the patient outcome and there is no need to focus on building burn facilities in every minor city. A well-equipped center can cover a large catchment area without deteriorating the patient outcome.

Keywords:

Burns , Catchment Area , Mortality