Quantitative Analysis of Estimated Burn Size Accuracy for Transfer Patients
- 1 January 2017
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Burn Care & Research
- Vol. 38 (1), e30-e35
- https://doi.org/10.1097/bcr.0000000000000460
Abstract
The objective of this study was to quantify differences between estimated TBSA from referring hospitals vs calculated TBSA in the burn unit in regards to several variables. We conducted a retrospective review of 735 burn patients admitted over a 17-month period. Three hundred twenty-six patients fit the criteria of transfers with recorded %TBSA estimations from referring hospitals. Referring %TBSA was compared with actual %TBSA, and the difference was expressed as a percentage of actual %TBSA. This was then used to group referring estimations as underestimated (less than −25%), satisfactory (−25 to 25%), or overestimated (greater than 25%). A paired t-test was used to assess the paired differences for significance. Secondary variables were then assessed between groups. When assessing associations of these clinical measures, a one-way analysis of variance was used for continuous variables and Pearson’s χ2 test or Fisher’s exact test was used. Of the 326 patients analyzed, 13 were underestimated, 63 were satisfactory, and 250 were overestimated. The ratio of overestimation to underestimation exceeded 19:1 and the ratio of overestimation to satisfactory estimation was nearly 4:1, with a statistically significant difference in referred %TBSA and actual %TBSA (P < .0001). Within the over and underestimated groups, there were significant differences between referred %TBSA and actual %TBSA (P < .0001). Larger burns were more accurately estimated (P < .0001). There are significant inaccuracies between referring hospital estimated %TBSA and actual %TBSA, which consistently and grossly skew toward overestimation. Inaccuracy in burn size estimation is systemic and can affect patient care and burn unit efficiency.Keywords
This publication has 11 references indexed in Scilit:
- Accuracy of burn size estimation in patients transferred to adult Burn Units in Sydney, Australia: An audit of 698 patientsBurns, 2015
- Discrepancy in Initial Pediatric Burn Estimates and Its Impact on Fluid ResuscitationJournal of Burn Care & Research, 2015
- The potential impact of wrong TBSA estimations on fluid resuscitation in patients suffering from burns: Things to keep in mindBurns, 2014
- Burn size estimation in children: Still a problemEmergency Medicine Australasia, 2011
- Fluid management in major burn injuriesIndian Journal of Plastic Surgery, 2010
- Effects of Differences in Percent Total Body Surface Area Estimation on Fluid Resuscitation of Transferred Burn PatientsJournal of Burn Care & Research, 2007
- Transfers from Emergency Room to Burn CenterThe Journal of Trauma and Acute Care Surgery, 1987
- Comparison of Burn Size Estimates Between Prehospital Reports and Burn Center EvaluationsJournal of Burn Care & Rehabilitation, 1986
- Improving the Accuracy of Burn-Surface EstimationPlastic and Reconstructive Surgery, 1985
- Emergent Burn CareSouthern Medical Journal, 1984