Poster Presentation NZAPS and ANZSOPS Joint Scientific Meeting

Transfer times and outcomes in major New Zealand burns (600)

Sam Hale 1 , Alex Kazemi 2
  1. Plastic and Reconstructive Surgery, Middlemore Hospital, Auckland, New Zealand
  2. Critical Care Unit, Middlemore Hospital, Auckland, New Zealand

It has been suggested that delayed transfer to definitive care worsens outcomes in major burns, however evidence is conflicting. Recent analysis of Australasia-wide data found no association between transfer times and patient outcomes, except where inhalational injury was present. The present study was performed to establish if this holds true in a New Zealand-only context given the significant geographic and systematic differences between Australia and New Zealand, and to act as a quality assessment of the New Zealand system of burn care.

119 patients aged over 16 years with burns greater than 20% TBSA, who were admitted to the National Burn Centre (NBC) between 2010 and 2016, were included. Demographic and transfer data (time from injury to admission to the NBC, and whether admission was direct or via another centre) were analysed for associations with mortality, length of hospital stay, and illness severity in the intensive care unit.

Increasing burn size and age of the patient, and documented inhalational injury were associated with increased mortality and worsened physiologic derangement in intensive care. Burn size predicted length of hospital stay. No statistical association was found between these outcome measures and transfer time or route of admission to the NBC.

These findings are in keeping with recent Australasian data. It is reassuring that no association between patient outcomes and transfer time was found, as this would behove New Zealand to make difficult and costly changes to its burn care system to facilitate more rapid patient transfers. The current system serves its patients at least adequately in this regard.

  1. Cassidy T.J., Edgar D.W., Phillips M., Cameron P., Cleland H., Wood F.M. (2015) Transfer time to a specialist burn service and influence on burn mortality in Australia and New Zealand: A multi-centre, hospital based retrospective cohort study. Burns 41(4):735–741