Setting the Standard: Using the ABA Burn Registry to Benchmark Risk Adjusted Mortality.

Reports of single center experience and studies of larger databases have identified several predictors of burn center mortality, including age, burn size, and inhalation injury. None of these analyses has been broad enough to allow benchmarking across burn centers. The purpose of this study was to derive a reliable, risk-adjusted, statistical model of mortality based on real-life experience at many burn centers in the U.

Using a National Burn Registry to Develop a Model for Risk-Adjusted Length of Stay Benchmarking.

Length of stay (LOS) is a frequently reported outcome after a burn injury. LOS benchmarking will benefit individual burn centers as a way to measure their performance and set expectations for patients. We sought to create a nationwide, risk-adjusted model to allow for LOS benchmarking based on the data from a national burn registry.

Geriatric Burn Injuries Presenting to the Emergency Department of a Major Burn Center: Clinical Characteristics and Outcomes.

Background: Burn injuries in geriatric patients are common and may have significant associated morbidity and mortality. Most research has focused on the care of hospitalized patients after admission to burn units. Little is known about the clinical characteristics of geriatric burn victims who present to the emergency department (ED) and their ED assessment and management.

The Global Burn Registry: A Work in Progress.

In 2018, the World Health Organization (WHO) launched the Global Burn Registry (GBR). Its purpose is to help improve the understanding of burn injury worldwide. The purpose of this study was to identify early findings from this database.

The relationship between annual hospital volume of trauma patients and in-hospital mortality in New York State.

Background: Several studies in the literature have examined the volume-outcome relationship for trauma, but the findings have been mixed, and the associated impact of the trauma center level has not been examined to date. The purposes of this study are to (1) determine whether there is a significant relationship between the annual volume of trauma inpatients treated in a trauma center (with "patients" defined in multiple ways) and short-term mortality of those patients, and (2) examine the impact on the volume-mortality relationship of being a Level I versus Level II trauma center.

Methods: Data from New York's Trauma Registry in 2003 to 2006 were used to examine the impact of total trauma patient volume and volume of patients with Injury Severity Score (ISS) of at least 16 on in-hospital mortality rates after adjusting for numerous risk factors that have been demonstrated to be associated with mortality.

The development of a regional system for care of the burn-injured patients.

Background: In the mid-20th century, it was recognized that patients with major burn injury required a dedicated, multidisciplinary team approach to receive optimal care. In the subsequent years, regionalized systems of care were developed to provide this level of care to the entire populations. There have been no reports on how an individual regional system evolved and the impact it had on the delivery of care for burn-injured patients.

The impact of a legislative intervention to reduce tap water scald burns in an urban community.

To review the efficacy municipal legislation in the reduction of tap water scald burns among an urban population. A retrospective chart and database review of patients hospitalized at this burn center between July 1999 and June 2004 for treatment of tap water scalds were performed. Demographic information and injury details, including extent of injury and age, type and location of the dwelling in which the injury occurred, were reviewed.

Tap water scalds among seniors and the elderly: socio-economics and implications for prevention.

Introduction: Tap water scalds among those >or=60 years old are often attributed to physical impairments with aging. This study assesses socio-economics associated with tap water scalds among seniors and the elderly.

Methods: Charts of patients admitted to an urban Burn Center between 7/00 and 6/04 for treatment of tap water scalds were reviewed.

The vulnerabilities of age: burns in children and older adults.

Background: Both children and older adults are thought to sustain burns serious enough to warrant hospitalization disproportionately more often than other age groups, but the incidence, injury characteristics, and outcome have not been precisely defined.

Methods: Patients hospitalized with a burn diagnosis were identified from hospital discharge data from California, Florida, New Jersey, and New York for the 5-year period 2000-2004.

Results: In those states, 60,024 residents were hospitalized with a diagnosis of burn and/or inhalation injury according to the International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes.

Burn-injured patients in a disaster: September 11th revisited.

We sought to review the steps taken by the New York Presbyterian Healthcare System to address disaster preparedness in the wake of the terrorist attacks of September 11, 2001. We reviewed the institutional records of emergency preparedness efforts, including improvements in infrastructure, employee education and training, and participation in intramural and extramural disaster response initiatives. We used a state discharge database to review burn injury triage within New York State (1995-2004).

National Burn Repository 2005: a ten-year review.

In the early 1990s, the American Burn Association (ABA) started its first burn registry development initiatives. The impetus for the registry development software originated from several directions, including the following: (1) the recognition that national registries were widespread and of proven benefit; (2) growing demands from accrediting institutions, payers, and patient advocacy groups for objective and verifiable data regarding patient costs, treatments, and outcomes; and (3) the shift toward "evidence-based" medicine and the ongoing analysis of treatment effectiveness. The ABA has issued three calls for burn registry data for its National Burn Repository (NBR): 1994, 2002, and 2005.

A regional burn center's response to a disaster: September 11, 2001, and the days beyond.

This report reviews the response of a regional burn center to the disaster that occurred in New York City at the World Trade Center on September 11, 2001. In addition, it assesses that response in the context of other medical institutions in the region. There were facilities in the region that had 120 burn care beds; only two-thirds of the burn-injured patients who required hospital admission were admitted to designated burn centers, and only 28% of burn-injured victims initially were triaged to regional burn centers.

Firefighter burn injuries: a 10-year longitudinal study.

Our metropolitan area employs approximately 11,000 firefighters who respond to more than 435,000 fire-related incidents per year. It is inevitable that some of these firefighters will suffer burn injuries. This 10-year retrospective review describes the epidemiology of firefighters with burn injuries who were treated at our burn center.

Effect of trauma system maturation on mortality rates in patients with blunt injuries in the Finger Lakes Region of New York State.

Background: New York State instituted a statewide trauma system beginning in 1990. By 1993, that system included uniform emergency medical system triage guidelines, designated trauma centers, transfer agreements between trauma centers and noncenters, and a trauma registry containing data on seriously injured patients in each region and the state as a whole. We reviewed the first 4 years of registry data for the Finger Lakes Region to determine what effects the institution of a trauma system has had on the outcome of trauma care in this region.

Accounting for intubation status in predicting mortality for victims of motor vehicle crashes.

Background: Two of the important predictors of mortality for trauma patients are the Glasgow Coma Scale and the respiratory rate. However, for intubated patients, the verbal response component of the Glasgow Coma Scale and the respiratory rate cannot be accurately obtained. This study extends previous work that attempts to predict mortality accurately for intubated patients without using verbal response and respiratory rate.

An examination of the volume-mortality relationship for New York State trauma centers.

Objectives: New York State Trauma Registry data were analyzed to determine whether there is a significant relationship between the volume of trauma patients treated by a trauma center and its risk-adjusted inpatient mortality rate.

Methods: Stepwise logistic regression was used to identify significant independent predictors of mortality, their weights, and the probability of in-hospital mortality for each patient. These data were then used to calculate risk-adjusted mortality rates for various ranges of hospital volume.

Predictors of mortality in adult patients with blunt injuries in New York State: a comparison of the Trauma and Injury Severity Score (TRISS) and the International Classification of Disease, Ninth Revision-based Injury Severity Score (ICISS).

Background: The purpose of this study was to determine the statistical model that best predicted mortality from blunt trauma using a contemporary population-based database.

Methods: 1994-1995 New York State Trauma Registry data for patients with blunt injuries were used to predict mortality using three statistical models: (1) the original Trauma and Injury Severity Score (TRISS) model based on Major Trauma Outcome Study data, (2) a new TRISS model whose coefficients were derived using New York data, and (3) the International Classification of Disease, Ninth Revision-based Injury Severity Score (ICISS) with predicted survival values obtained from the Agency for Health Care Policy and Research's Health Care Utilization Project. The models were compared with respect to discrimination (using the C statistic) and calibration (using the Hosmer-Lemeshow [H-L] statistic).