The impact of infection on length of stay in burns: a scoping review

Emma Choong¹, Danika Jurat², Sandeep B³, Briana Rainnie³, Fiona Wood²,
¹St Vincent’s Public Hospital, Melbourne, Victoria, Australia
²Fiona Stanley Hospital, Murdoch , Western Australia, Australia
³Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia

Abstract

Background: Burns are a complex injury whereby the protective skin barrier is lost. The profound metabolic response and the disruption to the immune system that ensues gives rise to a unique susceptibility to infection. Indeed, infection is one of the most frequently encountered complications in burn patients, placing significant burden on individuals and the healthcare system. Advancements in burn care have led to marked improvements in burn-related mortality and morbidity; however, with scarce hospital resources available for burn-related care, patient length of stay (LOS) in hospital remains an important consideration. Thus, the aim of this scoping review was to present the existing literature relating to the impact of infections on LOS in hospitalised, adult burn patients.
Methods: Electronic searches were performed in Medline and Embase. Articles published before 2000 were excluded to ensure that the analysis was focused on literature that reflected the current clinical management of burn patients.
Results: 19 studies were included. All studies were retrospective, with the majority undertaken in North America (14 studies). The types of infection included pneumonia, blood stream infections (BSI), soft tissue infections and sepsis. A positive association between infection and LOS was reported in 89% of identified studies.
Conclusion: The results of this scoping review suggest a trend towards a positive association between infection and LOS. There remains, however, significant gaps in the literature that call for high-quality research. Furthermore, standardised definitions for the collection of infection data and the use of burns specific infection control guidelines are critical to improving patient outcomes.

Biography

Emma Choong is a junior doctor currently undertaking her second year at St Vincent’s Hospital in Melbourne, having completed her Doctor of Medicine at the University of Melbourne in 2021. In addition to her clinical activities, Emma is an active advocate for junior doctors interested in surgical training as a committee member of the St Vincent’s Hospital Pre-SET Surgical Society, which aims to provide improved education, mentorship and collegiately for all surgical aspirants.