2014 NBR Annual Report

2014
NATIONAL
BURN
REPOSITORY
REPORT OF DATA FROM 2004-2013
American Burn Association, National Burn Repository 2014. Version 10.0. All Rights Reserved Worldwide.
311 S. Wacker Drive Suite 4150 Chicago, IL 60606 312-642-9260 www.ameriburn.org
National Burn
Repository
2014 Report
Dataset Version 10.0
FIRE/FLAME INJURIES REPRESENT 43% OF THE CASES IN

THIS REPORT WITH A KNOWN ETIOLOGY
SCALD INJURIES REPRESENT 34% OF THE CASES IN THIS

REPORT WITH A KNOWN ETIOLOGY
CONTACT WITH HOT OBJECT INJURIES REPRESENT 9%

OF THE CASES IN THIS REPORT WITH A KNOWN ETIOLOGY
ELECTRICAL INJURIES REPRESENT 4% OF THE CASES IN THIS

CHEMICAL INJURIES REPRESENT 3% OF THE CASES IN THIS

National Burn Repository 2014 Report

American Burn Association NBR Advisory Committee
Christopher W. Lentz, MD, FACS, FCCM
NBR Committee Chair
Paul Silverstein Burn Center
INTEGRIS Baptist Medical Center
Oklahoma City, Oklahoma
Bruce M. Potenza, MD, FACS

UC San Diego Regional Burn Center
UC San Diego School of Medicine
San Diego, California
Cynthia L. Reigart, RN, BSN
The Nathan Speare Regional Burn Treatment Center
Crozer Chester Medical Center
Upland, Pennsylvania
Nicole Bernal, MD
University of California Irvine
UCI Regional Burn Center
Orange, California
Palmer Q. Bessey, MD, FACS, MS, Ad Hoc

Weill Cornell Medical College
New York Presbyterian Hospital
William Randolph Hearst Burn Center
New York, New York
Iris Faraklas, RN, BSN

University of Utah Hospital Burn Center
Salt Lake City, Utah
Steven A. Kahn, MD
Vanderbilt University Medical Center
Nashville, Tennessee
Margaret A. Finocchiaro, BA, Ad Hoc

The Nathan Speare Regional Burn Treatment Center
Crozer Chester Medical Center
Upland, Pennsylvania
M. Anwarul Huq Mian, MD, PhD, MPH

Southeast Pain Management
Augusta, Georgia
Matthew B. Klein, MD, MS, FACS, Ex Officio

Santa Clara Valley Medical Center
San Jose, California
Michael J. Mosier, MD, FACS

Loyola University Medical Center
Maywood, Illinois
Sidney F. Miller, MD, FACS, Ad Hoc

The Ohio State University Wexner Medical Center
Columbus, Ohio
John Myers, PhD

University of Louisville
Louisville, Kentucky
American Burn Association Staff

John A. Krichbaum, JD
CEO and Executive Director
Susan M. Browning, MPH
Deputy CEO and Chief Operating Officer
Maureen T. Kiley, BBA
ABA Director
Bart D. Phillips, MS, Senior Consultant
E-B Research, LLC
Minneapolis, MN
ii
Acknowledgements
The American Burn Association wishes to thank the members of the National Burn Repository Advisory Committee:
Christopher Lentz, Cynthia Reigart, Iris Faraklas, Michael Mosier, Bruce Potenza, Nicole Bernal, Margaret Finocchiaro,
Steven Kahn, M. Anwarul Huq Mian and John Myers, for their commitment, dedication and expedited review of
this years report. Their combined efforts compiled insightful analysis of these data allowing publication for the ABA
membership to receive this report for the 46th Annual Meeting in Boston, Massachusetts.
The ABA is also grateful for the work of Bart Phillips, Senior Consultant of E-B Research, and his dedicated staff.
Their compilation, organization and presentation of this data facilitates its utility into understanding the demographics
of thermal injury.
The NBR Advisory Committee would like to express its gratitude to the ABA Central Office which provides
the support and infrastructure to ensure that this resource is completed in a timely and effective fashion. We are also
thankful for the exceptional work of Maureen Kiley, ABA Director, who ensures fluid communication amongst all who
contribute to this report. We extend our gratitude to the previous Chairmen, Sidney Miller and Palmer Bessey, for their
vision and continued mentorship to this Committee.
Finally, the NBR Advisory Committee and the American Burn Association Board of Trustees would like to personally
thank the contributing American and International burn centers and registrars for maintaining an accurate registry and
submitting their data. Without you, this report would not exist.
iii
Table of Contents
American Burn Association National Burn Repository Advisory Committee...................................................ii
Acknowledgements.........................................................................................................................................iii
Table of Contents............................................................................................................................................iv
Introduction....................................................................................................................................................ix
Summary of Findings......................................................................................................................................x
1) Analysis of Contributing Hospitals..................................................................................................................1
Figure 1: States that have Submitted to the NBR, 2004 to 2013.......................................................................2
Table 1: Burn Center Location and Participation by Region............................................................................2
Figure 2: Contributing U.S. Hospitals by Geographic Region..........................................................................3
Figure 3: Arrival/Admission Year, Acute Burn Admissions.................................................................................3
Figure 4:Volume of Record Submission by Geographic Region......................................................................4
Figure 5: Contributing U.S. Hospitals by Hospital Ownership Type..................................................................4

2) Analysis of All U.S. Records Included in the Report........................................................................................7
Figure 6: Age Group by Gender.......................................................................................................................8
Table 2: Age Group by Gender........................................................................................................................8
Figure 7: Race/Ethnicity.................................................................................................................................9
Table 3: Race/Ethnicity...................................................................................................................................9
Figure 8: Age Group by White vs. Non-White.................................................................................................9
Figure 9: Burn Size Group (% TBSA)..............................................................................................................10
Table 4: Survived/Died by Burn Group Size (%TBSA)....................................................................................10
Figure 10: Etiology..........................................................................................................................................11
Table 5: Etiology.............................................................................................................................................11
Figure 11: Frequency of Contact with Hot Object, Electrical, Fire, and Fire by Age Group..............................11
Figure 12: Place of Occurrence E849 Code..................................................................................................12
Table 6: Place of Occurrence E849 Code......................................................................................................12
Figure 13: Circumstance of Injury...................................................................................................................12
Table 7: Circumstance of Injury.......................................................................................................................12
Figure 14: Hospital Disposition........................................................................................................................13
Table 8: Hospital Disposition...........................................................................................................................13
Figure 15: Average Hospital Length of Stay by Gender, 2004 to 2013...............................................................14
Figure 16: Mortality Rate by Gender, 2004 to 2013.........................................................................................14
Table 9: Mortality Rate by Age Group and Burn Size......................................................................................15
Figure 17: Complications: Frequency of Top Ten Clinically Relevant Complications........................................16
Figure 18: Complications: Frequency of Top Ten Clinically Relevant Complications by Days on the Ventilator...........16
Figure 19: Complication Rate for Age Categories by Days on Ventilator..........................................................17
Table 10: Complication Count for Age Categories by Days on Ventilator.........................................................17
Figure 20: Mortality Rate for BAUX Score Categories by Gender...................................................................18
Table 11: Number of Cases in BAUX Score Categories by Gender..................................................................18
Figure 21: Mortality Rate for BAUX Score Categories by Inhalation Injury....................................................19
Table 12: Number of Cases in BAUX Score Categories by Inhalation Injury...................................................19
Table 13: Mortality Rates for Matrix of Main Predictors..................................................................................20
Table 14: Primary Insurance Payor...................................................................................................................21
Figure 22: Percent of Patients Utilizing Selected Insurance Types Over Time....................................................22
Table 15: Case Count for Select Insurance Categories Over Time ...................................................................22
Table 16: Hospital Days: Lived/Died by Burn Size Group................................................................................23
Table 17: Hospital Charges: Lived/Died by Burn Size Group...........................................................................23
Table 18: Hospital Charges: Lived/Died by Top 20 MS-DRGs.........................................................................24
Table 19: Days per %TBSA and Charges per Day by Age Groups and Survival.................................................25
3) Analysis by Age Group....................................................................................................................................26
Age Group Birth to .9........................................................................................................... 28

Figure 23: Race/Ethnicity

Table 20: Race/Ethnicity

Figure 24: Etiology

Table 21: Etiology

Table 22: Hospital Days: Lived/Died by Inhalation Injury

Table 23: Top Ten Complications
iv
Table of Contents

Age

Age

Age

Age

Age

Table 24: Top Ten Procedures

Table 25: Lived/Died by Burn Group Size (% TBSA)
Table 26: Hospital Days by Burn Group Size (% TBSA)
Table 27: Mean Charges for Top Five MS-DRGs
Figure 25: Mean Hospital Days for Fire/Flame, Contact with Hot Object, and Scald by Admission Year
Figure 26: Mean Charges for Etiology Categories with Greater than 100 Valid Charge Cases
Group 1-1.9 .................................................................................................................. 32
Figure 28: Etiology
Table 29: Etiology
Group 2-4.9 .................................................................................................................. 36
Figure 32: Etiology
Table 37: Etiology
Group 5-15.9 ................................................................................................................ 40
Figure 36: Etiology
Table 45: Etiology
Group 16-19.9 .............................................................................................................. 44
Figure 40: Etiology
Table 53: Etiology
Group 20-29.9 .............................................................................................................. 48
Table of Contents

Age

Age

Age

Age


Figure 44: Etiology
Table 61: Etiology
Group 30-39.9 .............................................................................................................. 52
Figure 48: Etiology
Table 69: Etiology
Group 40-49.9 .............................................................................................................. 56
Figure 52: Etiology
Table 77: Etiology
Group 50-59.9 .............................................................................................................. 60
Figure 56: Etiology
Table 85: Etiology
Group 60-69.9 .............................................................................................................. 64
Figure 60: Etiology
Table 93: Etiology
vi
Table of Contents

Age

Age


Group 70-79.9 .............................................................................................................. 68
Figure 64: Etiology
Table 101: Etiology
Group 80 and Over ....................................................................................................... 72
Figure 68: Etiology
Table 109: Etiology
4) Analysis by Etiology........................................................................................................................................77
Fire/Flame Injuries............................................................................................................... 78

Figure 71: Circumstance of Injury

Table 116: Circumstance of Injury

Figure 72: Place of Occurrence E849 Code

Table 117: Place of Occurrence E849 Code

Figure 73: Percent of Patient with Clinically Relevant Complications by Age Group

Table 118: Complication Rate by Age Group




Table 122: Hospital Days: Lived/Died by Burn Size Group (%TBSA)

Table 123: Mortality Rate for Matrix of Main Predictors

Figure 74: Mortality Rate for BAUX Score Categories by Gender

Table 124: Number of Cases in BAUX Score Categories by Gender
Scald Injuries....................................................................................................................... 84










Figure 78: Mortality Rate for BAUX Score Categories by Gender

Table 131: Number of Cases in BAUX Score Categories by Gender
Contact with Hot Object Injuries........................................................................................... 89


vii
Table of Contents







Electrical Injuries................................................................................................................. 93









Figure 85: Frequency of Records by Age Categories and Gender
Chemical Injuries................................................................................................................. 97


Table 143:Circumstance of Injury



Figure 88 Percent of Patient with Clinically Relevant Complications by Age Group

Table 145:Complication Rate by Age Group

Table 146:TopTen Complications

Table 147:TopTen Procedures

Figure 89: Frequency of Records by Age Categories and Gender
5) Hospital Comparisons.....................................................................................................................................102
2010-2013 Fire/Flame Injuries................................................................................................ 103

Figure 90: 2010-2013 Fire/Flame Injuries Mortality Rate

Figure 91: 2010-2013 Fire/Flame Injuries Mean Charges

Figure 92: 2010-2013 Fire/Flame Injuries Mean Length of Stay

Figure 93: 2010-2013 Fire/Flame Injuries Complication Rate
6) Analysis of International Records....................................................................................................................109

Figure 94: Age Group by Gender

Table 148: Age Group by Gender

Figure 95: Etiology

Table 149: Etiology







Table 153: Mortality Rate for BAUX Score Categories by Gender

Appendix............................................................................................................................................................115
A. Minimum Data Set and Data Quality................................................................................. 116

Table 155: Data Completeness by Variable

Figure 99: Data Quality Expressed as Mean Percent of Missing Variables of the Minimum Data Set per

Record by Admission Year

Figure 100: Data Quality Expressed as Mean Percent of Missing Variables of the Minimum Data Set per

Record by Facility

Figure 101: Percent of Records with Number of MissingVariables Compared Between Data Submitted in 2013 and Before

Figure 102: Count of Records with Number of Missing Variables Compared Between 2013 and Before
B. List of Participating Hospitals............................................................................................ 122
C. Selected List of Peer-Reviewed Publications Utilizing NBR Data.......................................... 125
viii
Introduction
Data! Data! Data! he cried impatiently, I cannot make bricks
without clay.
Sherlock Holmes in The Adventure of the Copper Beeches
Sir Arthur Conan Doyle
This National Burn Repository (NBR) report represents
ten years of cumulative data from 96 United States Burn
Centers, four Canadian Burn Centers, and two Swedish
Burn Centers. The report contains over 190 thousand
entries. This report represents the largest resource on the
epidemiology of thermal injury, of patients admitted to
burn centers, in North America. It also is the single most
useful reference for determining benchmark standards for
outcomes such as mortality rate and hospital length of stay.
As we venture into the uncharted waters of medical quality
improvement, this report will be the foundation for our
specialty.
Although the report does not change much from year to
year, the results over time have changed. One striking finding
in this years report has been changes in overall length of
stay and burn mortality. Since 2004, the average hospital
length of stay has dropped from nine to eight days. Although
it represents only 11% reduction, this can have significant
impact on health care costs. Also during the 10 year period
from 2004 to 2013, the overall mortality has decreased from
3.4% to 2.7% for males and from 4.6% to 3.3% for females.
The clear message is that our burn care facilities are centers
of excellence that have a track record of improving the
efficiency and quality of burn care.
This next year, the NBR will have to evolve. The
implementation of the ICD-10 will bring granularity to the
burn diagnoses. Each ICD-10 burn code will specifically
delineate the exact location, depth and if appropriate, the
laterality of the injury. This will certainly improve queries

of the database. Also, the outcomes defined by the Burn
Quality Improvement Program (BQIP) Committee will be
incorporated into the NBR. This will elevate this repository to
a standard defined by the experts; the burn care professionals.
Its imperative that the NBR continues to serve as the
single best resource for health care planners within our
institutions and within our governments. With the shrinking
pool of health care dollars, resources still need to be allocated
to our centers registries and registrars. This data is the
foundation on how burn care quality will be measured. As
good as it has become, only 24% of the records are complete;
75% of the reports are missing one or more key variables.
The majority of the records added this year had zero deficits.
This represents approximately 75% of the new submissions.
Compared to the previous nine years, the majority of
the records were missing 2-5 key variables. Although the
accuracy has improved over the past decade, we still have
significant room for improvement.
The NBR Committee and the American Burn
Association still have a vision for making this registry a living
resource that permits continuous data entry in real time. We
also want to evolve with the changes in world technology to
make access to this data much suppler in this digital age of
information.Your data submission is the clay allowing the
NBR to become the bricks on which we will build our
towers as centers of excellence and our bridges to improve
our interoperability.
Christopher W. Lentz, MD, FACS, FCCM
Chair, ABA NBR Advisory Committee
ix
Summary of Findings
The 2014 National Burn Repository Annual Report reviewed the combined data set of acute burn admissions for the
time period between 2004 and 2013. Key findings included the following:
1. Ninety-six hospitals from 35 states, and the District of Columbia, contributed to this report, totaling 191,848
records. Seventy-seven hospitals contributed more than 500 cases. Data are not dominated by any single center and
appeared to represent a reasonable cross section of U.S. hospitals.
2. Nearly 69% of the burn patients were men. The mean age for all cases was 32 years old. Children under the age of 5
accounted for 19% of the cases, while patients age 60 or older represented 13% of the cases.
3. Seventy-four percent of the reported total burn sizes were less than 10%TBSA and these cases had a mortality rate
of .6%.The mortality rate for all cases was 3.3% and 5.9% for fire/flame injuries.
4. The two most common reported etiologies were fire/flame and scalds, and accounted for almost 8 out of 10
reported. Scald injuries were most prevalent in children under 5, while fire/flame injuries dominated the remaining age
categories. Nine percent of cases did not designate an etiology of injury.
5. Seventy-three percent of the burn injuries, with known places of occurrence, were reported to have occurred in the
home. Seventy-one percent of cases with known circumstances of injury were identified as accident, non-work related.
6. During the ten year period from 2004 and 2013, the average length of stay for both females and males declined from
roughly 9 days to 8 days. The mortality rate decreased from 3.4% to 2.7% for males and from 4.6% to 3.3% for females.
7. Deaths from burn injury increased with advancing age and burn size, and presence of inhalation injury. For patients
under age 60 and with a TBSA between .1 and 19.9, the presence of inhalation injury increased the likelihood of death
by 16 times.
8. Pneumonia was the most frequent clinically related complication and occurred in 5.8% of fire/flame injured
patients. The frequency of pneumonia and respiratory failure was much greater in patients with 4 days or more of
mechanical ventilation, than those with less than 4 days. The incidence of clinically related complications for patients
with 0 days of mechanical ventilation increased with age and topped out at 20% for age 80 and over.
9. For survivors, the average length of stay was slightly greater than approximately 1 day per percent TBSA burned.
For those who died, the total hospital days were roughly 3 weeks for burn patients with TBSA values below 70% and
decreased from 3 weeks to 1 week for the larger burn categories.
10. Overall, the charges per case for a death were over 3 times greater than those charges for a survivor ($285,225
vs. $86,146). Additionally, hospital charges per hospital day in patient deaths averaged roughly $14,000 more than
surviving patients.
All cases received from contributing hospitals (ABA burn registry and ABA non burn registry software) that met the data
structure requirements were initially accepted into the NBR. This report includes only cases with an admit year of 2004
2013, inclusive. Records were excluded from the analysis for this report if the Admit Type or Admit Status was:
Readmission
Admission for reconstruction/rehabilitation
Outpatient encounter
Same patient
Scheduled/elective admission
Acute admission, not burn injury related.
In addition, records were excluded from the analysis of this report if they contained missing values for the following
variables:
Gender
LOS < ICU days
Discharge disposition
Both Calculated Age and Manually entered Age
Both TBSA and Etiology
Summary of Findings
As was done last year, an algorithm was used to identify and remove potential duplicate records from the analysis.
Duplicate records can exist in the database if a facility submits the same record during two different calls for data. The
algorithm that was implemented identified records that contained identical information on the variables listed below.
The more recently submitted record was included in the analysis while the older record was eliminated as a duplicate.
Facility
AdmissionYear
Age
Gender
Race
AdmissionType
Discharge Date
ECODE
TBSA %
Lastly, the records received from our Canadian and International contributors are not included in the body of the
analysis, but are presented separately in Section 6.
xi
Analysis
of Contributing Hospitals
Analysis
The first section of the National Burn Repository (NBR) report deals with an evaluation of the contributing
hospitals. Because the report reflects a rolling 10-year average and hospitals submit data, the mix of hospitals may vary
from year to year. This years NBR report contains data from thirty-five states in the U.S., four Canadian burn centers
and two Swedish centers. Sixty-four of the reporting centers are ABA verified. Seven states with Burn Centers have
not contributed data to the NBR report. The U.S. data comes from a representative sample of burn centers that appears
quite comparable to the actual distribution of Burn Centers in the U.S.
Figure
STATES THAT SUBMITTED TO THE NBR, 2004 TO 2013
1
2
3
4
5
6
3
2
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Have burn centers which have contributed to the NBR between 2004 to 2013
ANALYSIS
BY AGE
GROUP
Do not have burn centers

Canadian contributing burn centers are noted above and are located in:
(1) Edmonton, Alberta; (2) Hamilton, Ontario; (3) Toronto, Ontario; and (4) Montreal, Quebec.
International contributors not shown above include Uppsala, Sweden and Linkoping, Sweden.
Table
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
BURN CENTER LOCATION AND PARTICIPATION BY REGION
ANALYSIS
BY AGE
ETIOLOGY
Have burn centers that have not contributed data to the NBR
Region
U.S. Burn Care

Facilities*
U.S. Facilities in the

Annual Report
ABA Verified
Centers**
ABA Verified
Centers in the
Annual Report
East
34
23
14
14
North
39
28
22
22
South
29
23
14
14
West
26
22
14
14
Total
128
96
64
64
EAST DC, Maryland, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island, and Connecticut. NORTH Illinois,
Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, Wisconsin, and South Dakota. SOUTH Alabama,
Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Kentucky, Oklahoma, Virginia, West
Virginia, and Texas. WEST Arizona, California, Colorado, Nevada, New Mexico, Utah, and Washington
*ABA Burn Care Resource Directory, Edition March 2014
** ABA Verified Burn Centers, March 2014
American Burn Association, National Burn Repository 2014.Version 10.0. All Rights Reserved Worldwide.
Analysis
24,591 records used for this report were submitted by 93 burn centers during this years Call for Data. This brings the
total number of records in this report to 191,848. The 2014 report contains roughly 15,000 more records than the 2013
report.
The north region, which has the largest number of burn centers, contributes the highest number of records.
Figure
VOLUME OF RECORD SUBMISSION BY GEOGRAPHIC REGION
Number of Cases
60,000
56,307
50,000
47,348
44,743
40,000
43,450
30,000
20,000
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
10,000
East
North
South
West
Figure
Record Submission
Before 2013
ARRIVAL/ADMISSION YEAR, ACUTE BURN ADMISSIONS
2013
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
25,000
Number of Cases
1
2
3
4
5
6
20,000
15,000
HOSPITAL
COMPARISONS
10,000
5,000
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Year of Admission
24,591 records were submitted in 2013 for this report
191,848 records are included in this report
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
Two groups of Burn Centers continue to contribute the largest number of records. Programs in hospitals with greater
than 500 beds lead the way. However, the next largest group continues to come from hospitals in the 200-299 bed range.
The majority of records submitted came from non-governmental, not-for-profit hospitals.
ANALYSIS OF
CONTRIBUTING
HOSPITALS
Figure
100,000
80,000
Number of Cases
1
2
3
4
5
6
CONTRIBUTING U.S. HOSPITALS BY HOSPITAL BED SIZE CATEGORY
60,000
40,000
20,000
ANALYSIS OF ALL
U.S. RECORDS
25-49
beds
50-99
beds
100-199
beds
200-299
beds
300-399
beds
400-499
beds
500 or
more beds
Hospital Bed Size
ANALYSIS
BY AGE
GROUP
Figure
CONTRIBUTING U.S. HOSPITALS BY HOSPITAL OWNERSHIP TYPE
ANALYSIS
BY AGE
ETIOLOGY
Number of Cases
HOSPITAL
COMPARISONS
100,000
80,000
60,000
40,000
20,000
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Army
Church
Operated
County
Hospital
District
Investor,
Corporation
Other Notfor-Profit
Ownership Type
State
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
THIS PAGE INTENTIONALLY LEFT BLANK
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
of All U.S. Records
21
Analysis
of All U.S. Records
Figure 6 and Table 2 show the number of cases in various age groups. Each column shows the total number of cases
and the gender distribution within a specific age category. Males outnumber females in all categories. Children less than
age 16 make up 29% of all patients. The most prevalent age groups remain ages 20 60, accounting for greater than 50%
of all patients.
Figure
ANALYSIS OF
CONTRIBUTING
HOSPITALS
Female
Male
30,000
Number of Cases
1
2
3
4
5
6
AGE GROUP BY GENDER
20,000
10,000
ANALYSIS OF ALL
U.S. RECORDS
0-.9
1-1.9
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
5-15.9 16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
80+
Age Categories
Total N=191,848 (Excluding 0 Unknown/Missing)
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
2-4.9
AGE GROUP BY GENDER
Age Categories
0-.9
1-1.9
2-4.9
5-15.9
16-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80 and over
Subtotal
Missing
Total
Cases
10,360
14,380
12,609
18,068
10,027
28,516
24,411
27,042
22,056
12,319
7,150
4,910
191,848
0
191,848
Total
Column N %
5.4
7.5
6.6
9.4
5.2
14.9
12.7
14.1
11.5
6.4
3.7
2.6
100.0
0.0
100.0
Table
Gender
Female
Male
Cases
Column N %
Cases
Column N %
6.9
6,188
4.7
4,172
5,706
9.4
8,674
6.6
5,508
9.1
7,101
5.4
6,119
10.1
11,949
9.1
2,505
4.1
7,522
5.7
7,037
11.6
21,479
16.4
6,320
10.4
18,091
13.8
7,480
12.3
19,562
14.9
6,375
10.5
15,681
12.0
4,178
6.9
8,141
6.2
2,880
4.7
4,270
3.3
2,450
4.0
2,460
1.9
60,730
100.0
131,118
100.0
0
0.0
0
0.0
60,730
100.0
131,118
100.0
Analysis
of All U.S. Records
Figure 7 and Table 3 depict the distribution of cases in the NBR by race. The table shows that 4.1% of records did not
specify race. The figure is based on those records in which race was specified.
Figure 8 shows the number of cases of white and non-white patients in various age categories. Non-whites
predominate in children less than 5 admitted to burn centers. In all other age categories, however, there are more whites
than non-whites. This suggests that racial factors may influence the occurrence of burn injuries and/or admission to a
burn center differently as a function of age.
Figure
Table
RACE/ETHNICITY
RACE/ETHNICITY
Race
Cases
% of Valid
White
107,310
58.9%
Black
35,789
19.7%
Hispanic
25,557
14.0%
Other
7,491
4.1%
Asian
4,398
2.4%
Native
American
1,495
0.8%
Unknown
9808
Total
191,848
Race
White
Black
Hispanic
Other
Asian
Native American
Total N=182,040 (Excluding 9,808 Unknown/Missing)
Non-White
White
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
ETIOLOGY
15,000
Number of Cases
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS
BY AGE
GROUP
Figure
AGE GROUP BY WHITE VERSUS NON-WHITE
1
2
3
4
5
6
10,000
HOSPITAL
COMPARISONS
5,000
0-.9
1-1.9
2-4.9
5-15.9 16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
80+
Age Categories
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
of All U.S. Records
Figure 9 shows the distribution of cases in the NBR by burn size. The proportion of records with no value for burn size
was 12.9%. These presumably included both patients who truly had no burn or skin loss, e.g. pure inhalation injury, and
those whose burn size was unknown or simply not recorded. For patient whom had a recorded burn size, 78% were less
than 20% total BSA. Patients with a total burn size of 40% BSA or more accounted for only 3.2% of cases.
Table 4 shows the proportion of patients in each category of total burn size who died, and the case fatality rate.This clearly
increased with burn size.The burn size associated with a 50% case fatality (LD-50) appears to be approximately 70% TBSA.
Figure
1
2
3
4
5
6
120,000
100,000
ANALYSIS OF
CONTRIBUTING
HOSPITALS
80,000
Number of Cases
ANALYSIS OF ALL
U.S. RECORDS
BURN SIZE GROUP (% TBSA)
60,000
40,000
20,000
ANALYSIS
BY AGE
GROUP
.1-9.9
10-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80-89.9
90-100
% TBSA (Full+ Partial Thickness)

Total N=167,077 (Excluding 24,771 Missing or 0%)
{4
Table
ANALYSIS
BY AGE
ETIOLOGY
%TBSA
0.1 - 9.9
10 - 19.9
20 - 29.9
30 - 39.9
40 - 49.9
50 - 59.9
60 - 69.9
70 - 79.9
80 - 89.9
> 90
Subtotal
Missing or 0%
TOTAL
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
LIVED/DIED BY BURN GROUP SIZE (%TBSA)

Lived
Cases
123,097
24,940
7,116
3,059
1,501
782
527
273
197
105
161,597
23,877
185,474
Died
Cases
787
703
651
608
553
461
411
333
425
548
5,480
894
6,374
Mortality Rate
0.6
2.7
8.4
16.6
26.9
37.1
43.8
55.0
68.3
83.9
3.3
3.6
3.3
Total N=191,848
10
Analysis
of All U.S. Records
Figure 10 and Table 5 depict the distribution of different burn etiologies amongst the cases in which one was
specified. The table documents that 8.5% of the records did not include an etiology. The figure is based only on those
cases with a specified etiology.
Figure 11 depicts the numbers of cases admitted to the participating hospitals that were caused by one of the four
most common burn etiologies or mechanisms in various age groups. Burns due to Fire/Flame predominated in all cases
5 years and older. Scalds and contact burns were more frequent than Fire/Flame in children less than age 5.
ETIOLOGY
10
Table
ETIOLOGY
Figure
Etiology
Cases
% of Valid
Fire/Flame
75,445
43.0%
Scald
Contact with Hot
Object
Electrical
59,099
33.7%
15,623
8.9%
6,546
3.7%
Chemical
5,839
3.3%
Burn, Unspecified
4,765
2.7%
Other, Non Burn
4,493
2.6%
Inhalation Only
2,814
1.6%
Radiation
470
0.3%
Skin Disease
390
0.2%
Unknown
16,364
Total
191,848
Categories of
Etiology
Fire/Flam e
Scald
Contact with Hot
Object
Electrical
Chemical
Burn,
Unspecified
Other, Non Burn
Inhalation Only
Radiation
Skin Disease
Figure
11
FREQUENCY OF CONTACT WITH HOT OBJECT,

ELECTRICAL, FIRE, AND SCALD BY AGE GROUP
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Fire/Flame
Scald
Contact with hot object
Electrical
12,000
ANALYSIS
BY AGE
ETIOLOGY
10,000
Number of Cases
1
2
3
4
5
6
8,000
HOSPITAL
COMPARISONS
6,000
4,000
2,000
0-.9
1-1.9
2-4.9
5-15.9 16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
80+
Age Categories
Total N=156,713 (Excluding 35,135 Cases)
11
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
of All U.S. Records
Figure 12 and Table 6 depict the distribution of cases in the NBR by the place of occurrence.The table shows that 12.1 % of
records did not specify a place of occurrence.The figure is based on those records in which a place of occurrence was specified.
The home remains the most common place of occurrence, accounting for 72.8 % of burn injuries cared for in burn centers.
Figure 13 and Table 7 depict the distribution of cases in the NBR by the circumstances of the injury.The table shows that
9 % of records did not specify the circumstances in which the burn injury occurred.The figure is based on those records in
which these circumstances were specified.The vast majority of burns seen at burn centers were considered accidental, with only
14.1 % of these related to work, and only 3.6 % specified as non-accidental.
1
2
3
4
5
6
12
PLACE OF OCCURRENCE E849 CODE
Categories of
Place of
Occurrence
Home
Industrial
Other Specified
Place
Recreation and
Sport
Street/Highway
Public Building
Residential
Institution
Farm
Mine/Quarry
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Circumstance
of Injury
Accident, NonWork Related
Accident, Work
Related
Accident,
Recreation
Accident,
Unspecified
Other
Suspected
Assault/Abuse
Suspected Child
Abuse
Suspected Self
Inflicted
Suspected
Arson
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Home
122,731
72.8%
Industrial
14,005
8.3%
Other Specified Place
9,218
5.5%
Recreation and Sport
7,834
4.6%
Street/Highway
7,708
4.6%
Public Building
4,381
2.6%
Residential Institution
1,367
0.8%
Farm
1,185
0.7%
Mine/Quarry
175
0.1%
Unspecified
23,244
Total
191,848
Table
CIRCUMSTANCE OF INJURY
12
% of
Circumstance of Injury Cases
Valid
Accident, Non-Work
123,773 71.0%
Related
Accident, Work Related 24,666 14.1%
Accident, Recreation
7,464
4.3%
Accident, Unspecified
7,444
4.3%
Other
4,785
2.7%
Suspected Assault/Abuse 2,314
1.3%
Suspected Child Abuse
1,861
1.1%
Suspected Self Inflicted
1,816
1.0%
Suspected Arson
283
0.2%
Unknown
17,442
Total
191,848
% of Valid
13
Place of Occurrence Cases
Table
Figure
Figure
Analysis
of All U.S. Records
Figure 14 depicts the proportion of patients in the NBR that died. Since outcome is a criterion for inclusion in the
NBR, there were no records in which the outcome was missing. The overall mortality rate from 2004 to 2013 is 3.3%.
Table 8 shows the numbers and proportions of various types of discharge disposition for all cases included in the
NBR. Seventy one percent of patients were discharged from the burn center to home.
Outcome
Lived
Died
HOSPITAL DISPOSITION
Figure
14
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Total N=191,848
Table
HOSPITAL DISPOSITION
Discharge Disposition
Cases
Percent
Discharged Home, No Home Health
135,941
70.9
Discharged Home
19,599
10.2
Discharged Home, With Home Health
10,111
5.3
Death
6,374
3.3
Rehabilitation Facility
5,286
2.8
Nursing Home/Skilled Nursing Facility (SNF)
3,975
2.1
Transfer to Another Hospital
2,872
1.5
Other
1,187
0.6
Discharged to Extended Care Facility (ECF)
1,017
0.5
Transfer to Another Service
965
0.5
Discharged to Foster Care
941
0.5
Unable to Complete Treatment
858
0.4
Jail or Prison
773
0.4
Psychiatry, Inpatient
728
0.4
Discharged to Alternate Caregiver
646
0.3
Transfer to an Acute Burn Facility
381
0.2
Against Medical Advice
98
0.1
Transfer, Unspecified
96
0.1
Total
191,848
100.0
13
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
of All U.S. Records
Figure 15 depicts the average total duration of hospitalization (Total Hospital Days, Length of Stay or LOS) for both
men and women by year. LOS decreased for both genders over the decade (13.6 % and 8.8 %). Although LOS was
substantially greater for women than men at the beginning of the decade depicted, in the last four years there has been a
trend for greater LOS in men.
Figure 16 depicts the proportion of patients in the NBR who died in the hospital (case fatality) by gender and year.
Case fatality decreased by 28 % for women and 20 % for men between 2004 and 2013. Case fatality is greater in women
than men through the decade, but that difference has narrowed over last four years.
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
15
Male
10.0
8.0
6.0
4.0
2.0
04
20
ANALYSIS
BY AGE
GROUP
05
20
06
20
07
20
08
20
09
20
10
20
Year of Admission
11
20
12
20
Admission
Year
2004
Female
Mean +/SEM
9.49+/-0.3
Male
Mean +/SEM
9.12+/-0.2
2005
9.61+/-0.1
9.19+/-0.1
2006
9.46+/-0.1
9.59+/-0.1
2007
9.8+/-0.1
9.4+/-0.1
2008
9.9+/-0.1
9.9+/-0.1
2009
9.5+/-0.1
9.0+/-0.1
2010
8.5+/-0.1
8.6+/-0.1
2011
8.5+/-0.1
8.8+/-0.1
2012
8.2+/-0.1
8.6+/-0.1
2013
8.2+/-0.1
8.4+/-0.1
13
20
Total N=191,848
Figure
16
MORTALITY RATE BY GENDER, 2004-2013
ANALYSIS
BY AGE
ETIOLOGY
Female
Male
6%
Mortality Rate
HOSPITAL
COMPARISONS
Figure
Female
Average Length of Stay
1
2
3
4
5
6
AVERAGE HOSPITAL LENGTH OF STAY

BY GENDER, 2004-2013
4%
2%
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
04
20
05
20
06
20
07
20
08
20
09
20
10
20
11
20
Year of Admission
12
20
13
20
Mortality Rate
Admission Year
Female
Male
2004
4.6
3.4
2005
4.5
3.2
2006
4.3
3.5
2007
4.3
3.5
2008
4.1
3.4
2009
3.9
3.0
2010
3.0
2.7
2011
3.3
2.9
2012
3.2
2.9
2013
3.3
2.7
Total N=191,848
14
Analysis
of All U.S. Records
Table 9 depicts the case fatality for each decile of total burn size in each of several age categories. As age and/or burn
size increased, so did the case fatality. The numbers of cases used to determine these values (proportion of cases in each
group that died) are listed in the row beneath the case fatality values for each age group. The size of some of the groups
is small, so that the calculated case fatality value would have a high variance and standard error.
Table
MORTALITY RATE BY AGE GROUP AND BURN SIZE

(EXPRESSED AS THE NUMBER OF DEATHS OVER THE TOTAL NUMBER OF PATIENTS IN THAT GROUP)
Burn Size (% TBSA)
Age Group
0.1 - 9.9
10 - 19.9
> 90
Total
Birth - .9
0.1
1.0
3.8
7.7
21.0
20.5
56.3
41.4
52.2
85.0
1.3
Died/Total
7/7322
14/1471
13/346
13/169
13/62
8/39
18/32
12/29
12/23
17/20
127/9513
1 - 1.9
0.0
0.3
0.6
1.9
7.7
23.8
20.8
18.2
16.7
66.7
0.2
Died/Total
1/10833
6/1881
2/314
2/107
4/52
5/21
5/24
2/11
1/6
2/3
30/13252
2 - 4.9
0.1
0.2
0.8
4.3
7.5
16.4
16.0
18.2
51.5
61.9
0.8
Died/Total
10/8875
3/1599
3/386
8/187
8/106
12/73
8/50
4/22
17/33
13/21
86/11352
5 - 15.9
0.1
0.3
0.9
1.6
4.6
5.2
12.4
14.0
44.7
63.6
0.6
Died/Total
9/12331
6/2167
6/648
5/308
9/195
6/116
11/89
8/57
21/47
21/33
102/15991
16 - 19.9
0.1
0.3
1.3
3.3
4.3
6.0
18.4
20.7
53.1
72.2
1.0
Died/Total
7/6486
4/1299
5/400
6/183
5/116
4/67
9/49
6/29
17/32
26/36
89/8697
20 - 29.9
0.2
0.6
1.6
5.8
12.6
18.6
25.9
42.2
56.0
76.5
1.5
Died/Total
29/18369
22/3725
19/1182
30/520
35/277
31/167
35/135
35/83
51/91
75/98
362/24647
30 - 39.9
0.2
1.0
2.7
7.1
11.0
21.4
36.7
52.9
65.5
91.8
2.1
Died/Total
37/15037
32/3308
28/1040
37/519
31/281
34/159
51/139
46/87
57/87
90/98
443/20755
40 - 49.9
0.5
1.3
4.7
10.7
24.3
43.8
38.0
59.0
74.0
84.9
3.0
Died/Total
77/16672
48/3728
58/1229
63/588
79/325
89/203
54/142
46/78
77/104
101/119
692/23188
50 - 59.9
0.9
3.3
10.4
21.0
39.8
51.9
65.6
73.1
82.3
86.4
4.9
Died/Total
128/13596
97/2980
104/996
95/453
109/274
81/156
80/122
68/93
79/96
89/103
930/18869
60 - 69.9
2.0
6.4
18.6
40.0
57.4
67.5
88.4
87.0
94.3
92.7
7.9
Died/Total
151/7554
110/1731
107/576
110/275
89/155
77/114
61/69
47/54
33/35
51/55
836/10618
70 - 79.9
4.0
15.4
35.1
58.2
74.6
83.1
89.1
89.3
80.0
88.2
13.8
Died/Total
168/4160
154/1001
126/359
121/208
91/122
54/65
41/46
25/28
24/30
30/34
834/6053
80 or Greater
6.2
27.5
61.9
78.7
89.9
95.2
92.7
97.1
94.7
100.0
22.9
Died/Total
163/2649
207/753
180/291
118/150
80/89
60/63
38/41
34/35
36/38
33/33
949/4142
Total
0.6
2.7
8.4
16.6
26.9
37.1
43.8
55.0
68.3
83.9
3.3
Died/Total
20 - 29.9 30 - 39.9
40 - 49.9
50 - 59.9 60 - 69.9 70 - 79.9 80 - 89.9
787/123884 703/25643 651/7767 608/3667 553/2054 461/1243 411/938 333/606
425/622 548/653 5480/167077
15
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
of All U.S. Records
Figure 17 depicts the number of several complications in all NBR case records. Pneumonia, cellulitis, and urinary tract
infections are the most prevalent complications recorded in burn center patients.
Figure 18 demonstrates the association of several complications with duration of mechanical ventilation. Except for cellulitis
and wound infections, the prevalence of complications increased with the number of days on mechanical ventilation.The
duration of mechanical ventilation might be considered a cause of some complications, e.g. the development of pneumonia.
In other cases, the duration of ventilation could be a marker of illness severity and correlate with other complications of the
critically ill, such as renal failure.
3,000
2,000
1,000
ANALYSIS OF ALL
U.S. RECORDS
mi
mi
th
rry
re
cte
Ba
ia
d/
re
re
on
ilu
ilu
loo ion
a
a
m
B
F
F
t
l
r
eu
ry
na
he fec
Pn
ato
Re
Ot ic In
r
i
sp
em
Re
yst
tis
uli
ll
Ce
mi
ce
pti
Se
ct
on
Tra ion
cti
e
y
f
r
t
n
ina fec nd I
Ur In
ou
W
Total N=176,796 (Excluding 15,052 cases from non ABA burn registry software centers)
ANALYSIS
BY AGE
GROUP
COMPLICATIONS: FREQUENCY OF TOP TEN CLINICALLY

RELEVANT COMPLICATIONS BY DAYS ON THE VENTILATOR
0 Ventilator Days
Figure
18
1-3 Ventilator Days

4+ Ventilator Days
4,000
Number of Cases
ANALYSIS
BY AGE
ETIOLOGY
17
4,000
ANALYSIS OF
CONTRIBUTING
HOSPITALS
Figure
5,000
Number of Cases
1
2
3
4
5
6
COMPLICATIONS: FREQUENCY OF TOP TEN CLINICALLY RELEVANT COMPLICATIONS
3,000
2,000
HOSPITAL
COMPARISONS
1,000
ia
hm
t
rry
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Ba
ia
em
r
cte
/
ia
re
re
od
on
ilu
ailu
Blo tion eum
F
Fa
l
r
y
na
he fec
Pn
tor
Re
Ot ic In
ira
p
s
m
Re
ste
tis
uli
ll
Ce
Sy
Se
ia
em
c
pti
n
ct
tio
Tra ion
ec
y
f
r
t
n
ina fec nd I
Ur In
ou
W
16
Analysis
of All U.S. Records
Figure 19 and Table 10 depict the association of occurrence of at least one complication with duration of mechanical
ventilation by categories of age. For patients who did not require mechanical ventilation, age had a strong, direct
association with the risk of developing a complication. For patients who required four or more days of mechanical
ventilation, however, the association between age and the risk of complications was much less pronounced. The total
complication rate increases with age category.
Figure
19
COMPLICATION RATE FOR AGE CATEGORIES BY DAYS ON VENTILATOR
0 Ventilator Days
1-3 Ventilator Days
4+ Ventilator Days
% of Patients with a Clinically

Related Complication
60%
40%
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
20%
0-.9
1-1.9
2-4.9
5-15.9
16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
80+
Age Categories
Total N=161,721 (Excluding 30,127 cases from non ABA burn registry software centers or unknown/missing age or ventilator days)
Table
10
COMPLICATION COUNT FOR AGE CATEGORIES BY DAYS ON VENTILATOR
Ventilator Days
0 Ventilator Days 1-3 Ventilator Days 4 or More Ventilator Days
Total
Complication
Complication
Complication
Complication
Age Categories
No
Yes
No
Yes
No
Yes
No
Yes
0-.9
6,672
326
91
31
102
96
6,865
453
1-1.9
12,194
429
92
32
138
132
12,424
593
2-4.9
10,313
449
153
59
241
183
10,707
691
5-15.9
13,818
654
436
110
404
414
14,658
1,178
16-19.9
6,836
407
342
94
179
251
7,357
752
20-29.9
19,346
1,356
1,144
261
527
871
21,017
2,488
30-39.9
16,127
1,307
1,032
264
627
1,002
17,786
2,573
40-49.9
17,334
1,739
1,220
366
760
1,244
19,314
3,349
50-59.9
13,540
1,599
1,107
385
750
1,332
15,397
3,316
60-69.9
7,105
972
745
295
524
917
8,374
2,184
70-79.9
3,730
646
515
187
362
626
4,607
1,459
80 and over
2,395
586
404
164
250
380
3,049
1,130
Subtotal
129,410 10,470
7,281
2,248
4,864
7,448
141,555 20,166
Missing
0
0
0
0
0
0
0
0
Total
129,410 10,470
7,281
2,248
4,864
7,448
141,555 20,166
Total N=161,721 (Excluding 30,127 cases from non ABA burn registry software centers or unknown/missing ventilator days)
17
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
of All U.S. Records
The data table, in Table 9 on page 15, demonstrated the relationship between death, increasing age, and burn size.
Figure 20 depicts the data shown in Table 11 graphically and demonstrates a similar relationship. The proportion of
patients who died (case fatality) is plotted as a function of the sum of age and the total percentage of BSA burned, the so
called BAUX Score.
There is a strong association between this score and case fatality for both men and women. Overall, women had a higher
case fatality than men (3.9% vs 3.2%) but this difference is less pronounced. The sum of age and burn size (BAUX Score)
associated with a case fatality of 50% (P 50) was 100. There was no significant difference between genders.
ANALYSIS OF
CONTRIBUTING
HOSPITALS
20
100%
Female
Male
80%
% of Patients that Died
1
2
3
4
5
6
Figure
MORTALITY RATE FOR BAUX SCORE CATEGORIES BY GENDER
60%
40%
20%
ANALYSIS OF ALL
U.S. RECORDS
.1-9.9
1019.9
2029.9
3039.9
4049.9
5059.9
6069.9
7079.9
8089.9
9099.9
100- 110- 120- 130109.9 119.9 129.9 139.9
140+
BAUX Score (Age + TBSA)

ANALYSIS
BY AGE
GROUP
Table
11
NUMBER OF CASES IN BAUX SCORE CATEGORIES BY GENDER

Female
Male
Lived
Died
Lived
Died
0-9.9
10-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80-89.9
90-99.9
100-109.9
110-119.9
120-129.9
130-139.9
140 and Over
Total
12,198
6,952
6,184
5,876
6,245
6,292
4,623
3,127
2,173
1,075
305
102
46
18
26
55,242
24
23
34
38
71
103
160
188
259
285
303
203
162
115
188
2,156
17,558
11,958
17,284
16,842
16,897
16,077
11,205
6,471
3,667
1,571
590
231
94
38
44
120,527
29
29
56
74
143
188
282
365
413
494
434
411
337
248
349
3,852
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
18
Analysis
of All U.S. Records
In Figure 21 and Table 12, the relationship between the proportion of patients that died and the sum of age and burn
size (BAUX Score) is shown both for those with and those without inhalation injury. Patients with inhalation injury had
a higher case fatality for a given BAUX score than those with no inhalation injury, but the added risk was not constant.
For patients with an inhalation injury, the sum of age and burn size associated with case fatality of 50% was
approximately 100, compared with approximately 110 for those with no inhalation injury.
Inhalation Injury
Figure
21
MORTALITY RATE FOR BAUX SCORE CATEGORIES BY INHALATION INJURY
No
Yes
100%
80%
60%
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
40%
20%
ANALYSIS OF ALL
U.S. RECORDS
.1-9.9
1019.9
2029.9
3039.9
4049.9
5059.9
6069.9
7079.9
8089.9
9099.9
100- 110- 120109.9 119.9 129.9
130- 140+
139.9

No Inhalation Injury
12
NUMBER OF CASES IN BAUX SCORE CATEGORIES BY INHALATION INJURY
ANALYSIS
BY AGE
GROUP
Table
Inhalation Injury
Lived
Died
Lived
Died
0-9.9
10-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80-89.9
90-99.9
100-109.9
110-119.9
120-129.9
130-139.9
140 and Over
Total
27,655
17,193
20,335
19,586
19,539
18,637
12,839
7,508
4,540
2,024
622
201
91
37
51
150,858
23
27
30
56
107
127
219
278
313
408
365
267
222
142
209
2,793
521
504
1,129
1,411
1,688
2,043
1,773
1,376
849
418
207
113
46
16
16
12,110
28
22
37
44
80
134
176
223
302
315
311
304
237
204
278
2,695
19
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
of All U.S. Records
Major predictors of case fatality in burns include burn size, age, and the presence of inhalation injury. Table 13 shows
the case fatality for several combinations of these variables. There are four categories of burn size: 0.1-19.9%, 20-39.9%,
40-59.9%, and 60 % BSA and greater; two categories of age: under 60 and 60 and older; and two categories of presence
of inhalation injury: No and Yes.
{13
Table
1
2
3
4
5
6
MORTALITY RATES FOR MATRIX OF MAIN PREDICTORS
TBSA Category
Age
Inhalation Injury
Lived
Died
Mortality Rate
0.1-19.9
0-59.9
No
116,514
273
0.2
0.1-19.9
0-59.9
Yes
5,661
218
3.7
0.1-19.9
60 and Over
No
14,365
583
3.9
0.1-19.9
60 and Over
Yes
1,571
298
15.9
20-39.9
0-59.9
No
6,952
210
2.9
20-39.9
0-59.9
Yes
1,490
235
13.6
20-39.9
60 and Over
No
800
436
35.3
20-39.9
60 and Over
Yes
240
284
54.2
40-59.9
0-59.9
No
1,343
221
14.1
40-59.9
0-59.9
Yes
645
295
31.4
40-59.9
60 and Over
No
97
209
68.3
40-59.9
60 and Over
Yes
51
210
80.5
60 and Over
0-59.9
No
641
452
41.4
60 and Over
0-59.9
Yes
361
712
66.4
60 and Over
60 and Over
No
27
172
86.4
60 and Over
60 and Over
Yes
15
245
94.2
TOTAL
150,773
5,053
3.2
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
20
Analysis
of All U.S. Records
Table 14 lists the number and proportion of cases in the NBR that were covered by several forms of payment. Over
10% of the records did not include this information. Of those that did include this data, over one third (37.9%) were
covered by Medicaid or uninsured.
{14
Table
PRIMARY INSURANCE PAYOR
Insurance
Cases
Percent
Government-Medicaid
37,636
19.6
Government-Medicare
19,190
10.0
Other Government
6,763
3.5
Subtotal
63,589
33.1
Private/Commercial Insurance
43,377
22.6
Blue Cross/Blue Shield
13,064
6.8
Other Insurance-Not Named
269
0.1
Private-Foundation or Charity
3,696
1.9
Subtotal
60,406
31.5
Workers Compensation
17,303
9.0
Auto
1,205
0.6
Subtotal
18,508
9.6
No Insurance Information Provided
19,935
10.4
Uninsured, Including Self Pay
27,581
14.4
Subtotal
47,516
24.8
Unidentified Insurance Labels
1,829
1.0
TOTAL
191,848
100.0
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
21
Analysis
of All U.S. Records
Figure 22 and Table 15 show how the proportions of patients covered by Medicaid, Medicare, Workers Compensation,
and Self-pay categories have changed over the decade covered by this years NBR Report. The prevalence of patients
covered by Workers Compensation is still lower than a decade ago, but there has been a steady increase over the last four
years. All other categories have also continued to grow, and the percentage of patients with Medicaid has shown the
largest growth.
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
22
Medicare
Uninsured, including Self Pay
Workers Comp
25
% of Patients (Does not Sum to 100%)
1
2
3
4
5
6
PERCENT OF PATIENTS UTILIZING SELECT INSURANCE Figure

CATEGORIES OVER TIME
Medicaid
20
15
10
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Year of Admission
ANALYSIS
BY AGE
GROUP
Total N=101,710 (Excluding 90,138 Cases)
Table
CASE COUNT FOR SELECT INSURANCE CATEGORIES OVER TIME
15
Select Insurance Categories
ANALYSIS
BY AGE
ETIOLOGY
Medicaid
Medicare
Uninsured,
Including Self Pay
Workers
Compensation
Total
Year of Admission
Cases
Cases
Cases
Cases
Count
2004
1,948
13.2
1,182
8.0
1,585
10.7
1,461
9.9
14,786
2005
2,232
15.5
1,243
8.6
1,667
11.5
1,353
9.4
14,436
2006
2,754
14.5
1,667
8.8
3,044
16.0
1,886
9.9
19,011
2007
2,755
13.9
2,007
10.1
2,952
14.8
1,860
9.4
19,883
2008
3,390
17.7
1,995
10.4
2,573
13.4
1,858
9.7
19,152
2009
4,537
21.5
2,153
10.2
2,962
14.0
1,748
8.3
21,126
2010
5,640
23.1
2,520
10.3
3,762
15.4
1,923
7.9
24,448
2011
5,621
23.9
2,513
10.7
3,458
14.7
2,054
8.7
23,542
2012
5,656
24.3
2,503
10.7
3,647
15.6
2,064
8.9
23,317
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
2013
3,103
25.5
1,407
11.6
1,931
15.9
1,096
9.0
12,147
Total
37,636
19.6
19,190
10.0
27,581
14.4
17,303
9.0
191,848
22
Analysis
of All U.S. Records
Table 16 depicts the average length of hospital stay in days (LOS) for survivors and non-survivors in each decile of
burn size. Non-survivors with burns of 20 %TBSA and greater have shorter LOS compared with survivors. The LOS for
survivors in all categories of burn size was approximately 1 day for each percent BSA burn.
Only 29% of the cases reviewed in this years NBR report included data on hospital charges. Tables 17, 18, and 19 are
based on those records. Table 17 depicts hospital charges for survivors and non-survivors in each burn size decile.
Table
16
HOSPITAL DAYS: LIVED/DIED BY BURN SIZE GROUP

Total
Lived
%TBSA
Cases
Mean +/- SEM
Cases
0.1 - 9.9
10 - 19.9
20 - 29.9
30 - 39.9
40 - 49.9
50 - 59.9
60 - 69.9
70 - 79.9
80 - 89.9
> 90
Subtotal
Missing or 0%
TOTAL
123,884
25,643
7,767
3,667
2,054
1,243
938
606
622
653
167,077
24,771
191,848
5.6+/-0.0
12.8+/-0.0
22.9+/-0.2
34.1+/-0.5
42.1+/-0.8
45.4+/-1.2
49.2+/-1.7
43.9+/-2.3
28.5+/-2.0
13.6+/-1.6
9.4+/-0.0
7+/-0.0
123,097
24,940
7,116
3,059
1,501
782
527
273
197
105
161,597
23,877
185,474
Mean +/SEM
5.5+/-0.0
12.6+/-0.0
23.2+/-0.2
36.9+/-0.5
49.5+/-0.9
60.8+/-1.5
72.3+/-2.3
81.0+/-3.9
61.4+/-4.5
46.3+/-7.9
9.1+/-0.0
6.7+/-0.0
Died
Cases
Mean +/- SEM
787
703
651
608
553
461
411
333
425
548
5,480
894
6,374
16.6+/-0.9
19.6+/-0.9
19.6+/-0.9
20.4+/-1.1
22.1+/-1.6
19.4+/-1.7
19.7+/-1.7
13.5+/-1.5
13.3+/-1.5
7.4+/-1.1
17.4+/-0.4
12.5+/-0.8
Total N=191,848
Table
HOSPITAL CHARGES: LIVED/DIED BY BURN SIZE GROUP
17
%TBSA
Cases
0.1 - 9.9
47,749
10 - 19.9
10,262
20 - 29.9
3,091
30 - 39.9
1,400
40 - 49.9
749
50 - 59.9
446
60 - 69.9
333
70 - 79.9
246
80 - 89.9
229
> 90
253
Subtotal
64,758
Missing or 0% 9,520
TOTAL
74,278
Total
Mean +/- SEM
$42782+/-401
$122891+/-2107
$263076+/-6152
$449142+/-14694
$608572+/-25145
$686349+/-40415
$706449+/-45797
$643805+/-61836
$393205+/-45052
$160247+/-28542
$93147+/-963
$46221+/-1423
$87133+/-861
Cases
47,440
9,965
2,799
1,156
515
248
169
101
51
25
62,469
9,188
71,657
Lived
Mean +/- SEM Cases
$41859+/-385
309
$118739+/-2028
297
$260062+/-6343
292
$470098+/-16445
244
$700876+/-31771
234
$935338+/-59933
198
$1006194+/-66295 164
$1121252+/-115871 145
$977203+/-125218 178
$508344+/-155963 228
$86109+/-912
2,289
$42376+/-1325
332
$80501+/-815
2,621
Died
Mean +/- SEM
$184459+/-16465
$262206+/-24561
$291961+/-23279
$349859+/-31517
$405423+/-36588
$374485+/-42214
$397567+/-53412
$311238+/-51691
$225879+/-37206
$122079+/-25624
$285225+/-10285
$152640+/-16883
$268430+/-9273
Total N=74,278 (Excluding 117,570 cases with Unknown/Missing charge data)
23
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
of All U.S. Records
Table 18 lists the twenty most frequently recorded MS-DRG codes and their associated hospital charges for both
survivors and deaths.
HOSPITAL CHARGES: LIVED/DIED BY TOP 20 MS-DRGS
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
18
Total
Lived
Died
Cases Mean +/- SEM Cases Mean +/- SEM Cases Mean +/- SEM
31,966 $28481+369 31,825 $27933+351
141 $152246+24282
Top 20 MS-DRG Codes

935 Non-extensive burns
929 Full thickness burn w skin graft
6,833 $100487+1709
or inhal inj w/o CC/MCC
$98667+1665
64
$292999+41277
6,348 $183718+3321
234
$329227+31927
3,822
147
$70869+11505
2,533 $473849+11568 2,200 $454557+12107 333
$601305+35955
1,332 $102298+4723
$421846+158542
928 Full thickness burn w skin graft

6,582 $188891+3414
or inhal inj w CC/MCC
934 Full thickness burn w/o skin
grft or inhal inj
927 Extensive burns or full
thickness burns w MV 96+ hrs w
skin graft
507 Major shoulder or elbow joint
procedures w CC/MCC
3,969
$38951+1643
6,769
1,318
$37723+1644
$98904+4395
14
511 Shoulder,elbow or forearm

1,260 $19465+1031 1,259 $19381+1029
1
$124906+
proc,exc major joint proc w CC
933 Extensive burns or full
thickness burns w MV 96+ hrs w/o 883 $111082+8009
264 $177064+20416 619
$82940+7117
skin graft
506 Major thumb or joint
828 $147966+9193
803 $140486+8670 25 $388209+115250
procedures
3 ECMO or trach w MV 96+ hrs
or PDX exc face, mouth & neck w
721 $921564+31602 591 $930191+35232 130 $882343+71349
maj O.R.
923 Other injury, poisoning & toxic
379
$19531+1832
373
$18960+1769
6
$55001+36113
effect diag w/o MCC
918 Poisoning & toxic effects of
drugs w/o MCC
595 Major skin disorders w MCC
596 Major skin disorders w/o MCC
603 Cellulitis w/o MCC
577 Skin graft &/or debrid exc for
skin ulcer or cellulitis w CC
605 Trauma to the skin, subcut tiss
& breast w/o MCC
578 Skin graft &/or debrid exc for
skin ulcer or cellulitis w/o CC/MCC
483 Major joint & limb
reattachment proc of upper
extremity w CC/MCC
998 Principal diagnosis invalid as
discharge diagnosis
Subtotal
Other
Unmappable
Unknown
Total
251
$25832+3225
245
$25702+3256
$31130+25022
151
145
134
$103101+10420
$60278+7435
$31582+9835
112
140
134
$97956+11452
$59805+7689
$31582+9835
39
5
0
$117875+23485
$73509+11960
121
$67863+6246
121
$67863+6246
115
$38412+4219
115
$38412+4219
89
$97099+13760
89
$97099+13760
64
$184528+41443
61
$165999+41492
32
$5078+2087
32
$5078+2087
$561296+171882
58,388
56,621
1,767
4,263 $126477+4205 3,915 $113634+3903 348 $270957+25740
1,062 $141724+8327 1,000 $130222+8231 62 $327252+46522
10,565 $44076+1394 10,121 $38884+1287 444 $162426+14351
74,278
71,657
2,621
Total N=74,278 (Excluding 117,570 cases with Unknown/Missing charge data)
24
Analysis
of All U.S. Records
Table 19 combines several parameters of resource utilization for survivors and non-survivors listed by age category.
These include mean LOS, mean LOS/Burn size (TBSA), mean total charges, and mean daily charges.
DAYS PER %TBSA AND CHARGES PER DAY BY AGE GROUPS AND SURVIVAL
Cases
Days
Age Groups
Lived
Died
Birth - 0.9
4,111
97
+/- SEM
1 - 1.9
4,742
10
+/- SEM
2 - 4.9
4,020
29
+/- SEM
5 - 15.9
5,142
35
+/- SEM
16 - 19.9
3,116
25
+/- SEM
20 - 29.9
9,717
142
+/- SEM
30 - 39.9
8,005
173
+/- SEM
40 - 49.9
8,922
281
+/- SEM
50 - 59.9
7,282
378
+/- SEM
60 - 69.9
3,923
351
+/- SEM
70 - 79.9
2,147
360
+/- SEM
80 or greater
1,297
408
+/- SEM
Total
62,424
+/- SEM
2,289
Lived Died
Hospital Days /
%TBSA
Lived
Died
Table
19
Hospital Charges
Lived
Died
Hospital Charges /
Hospital Days
Lived
Died
9.11
16.84
2.19
0.65
$43,736
$38,079
$4,814
$7,304
0.93
3.35
0.22
0.17
$2,129
$9,020
$93
$1,551
5.02
8.50
1.62
0.25
$36,747 $156,910 $6,460
$24,721
0.14
5.00
0.07
0.11
$1,364
$5,950
6.55
10.55
1.97
1.03
$48,416 $142,562 $6,648
$20,247
0.20
3.21
0.11
0.46
$1,910
$2,610
7.26
7.63
2.05
0.23
$63,051 $229,380 $6,925
$38,789
0.17
3.01
0.09
0.08
$2,567
$6,185
7.90
16.00
1.85
0.41
$70,454 $333,174 $6,729
$30,494
0.28
7.29
0.08
0.16
$3,762
$4,092
8.90
20.66
2.39
0.53
$80,730 $392,625 $7,219
$28,753
0.18
3.54
0.10
0.09
$2,353
$3,170
10.09 15.93
2.60
0.47
$94,818 $362,704 $7,588
$32,363
0.19
2.33
0.13
0.07
$2,806
$4,218
11.40 17.15
2.96
0.74
0.20
1.74
0.14
0.11
12.55 21.51
3.39
1.58
0.23
1.73
0.13
0.32
13.79 17.03
3.88
1.33
0.33
1.23
0.21
0.15
14.62 15.16
4.37
1.30
0.40
1.04
0.41
0.14
14.13 11.22
4.78
1.09
0.46
0.54
0.16
9.83 16.31
2.67
1.07
0.09
0.04
0.07
0.83
0.57
25
$65,440
$38,114
$84,753
$138,753
$55,498
$46,134
$112
$220
$134
$110
$80
$150
$106,788 $339,477 $7,791

$2,900
$30,697
$148
$116,949 $397,023 $8,052

$3,163
$32,462
$126
$125,024 $305,835 $8,047

$4,305
$24,452
$136
$131,591 $252,371 $8,085

$5,237
$21,241
$138
$126,665 $159,207 $8,098

$6,467
$13,100
$215
$86,146 $285,225 $7,244

$913
$10,286
$42
$23,845
$1,062
$23,302
$1,058
$22,739
$1,106
$18,018
$924
$16,836
$1,527
$21,926
$585
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
This year encompasses another decade of collected data ranging

from 2004 to 2013. Age of the burn patient continues to be an
important marker, having a dramatic effect on many of the attributes
found in the National Burn Repository. As we improve our collection
of data, it is interesting to note the stability of incidence of burns
in each ten year report. Data continues to be very useful when
contemplating prevention strategies, medical economics, and concerns
about public health.
The figures in this Age Analysis section provide detailed
information for each of the following age categories: Birth to 0.9, 1 to
1.9, 2 to 4.9, 5 to 15.9, 16 to 19.9, 20 to 29.9, 30 to 39.9, 40 to 49.9,
50 to 59.9, 60 to 69.9, 70 to 79.9, and 80-and-over.We have added
an additional section: 0-18.0 years old.These groupings were chosen
based on prior collective experience about the relationship of certain
ages to types of burn injury patterns, with an emphasis on accidental
injuries of the very young. Each age category has four pages of figures
and tables that summarize the data in the National Burn Repository.
Some highlights are abstracted below:
The race of burn victims continues to show a dramatic overrepresentation of minorities in children (age under 5 years) than
would be expected based on national demographics.The same
marked over-representation disappears in young adulthood.This has
continued to perpetuate for the past several years, these minority
communities might be at increased risk and in need of prevention
initiatives.
Furthermore, scald and contact burns are very prevalent in the early
age category when contemplating etiology. Fire/flame continues to
be the consistent, predominant etiology of burns in the adolescent and
adult age groups.There continues to be a large amount of unspecified
burns throughout all age groups, however this year non-burns have
seen a greater reporting value than in years past. Improvement of data
collection may impact these numbers bringing a better appreciation
of the total data set.
Inhalation injury is one of the most lethal characteristic of burn
victims, and somewhat surprisingly increases in incidence with age.
Even though children are exposed to smoke in structure fires and
even with the increase in fire/flame injuries in the lowest age group,
the preponderance of scald and contact injuries continues to crowd
out inhalation injuries in the young.
The most common complications are urinary tract infections
(UTI), pneumonia and cellulitis as the top three complications in
those patients under age 60.Those over age 60, show a shift in the
top three with respiratory failure over stepping cellulitis in the age
60-69.9 age group and arrhythmias in the over 70 population. UTI
was the most frequent infection among children. Pneumonia remains
a very frequent complication in all age groups. Cellulitis continues
to be a common thread in all age groups, while septicemia was less
common. Even with the emphasis on tracking hospital acquired
infections (HAI) and more stringent protocols geared to prevention,
urinary tract infections and pneumonia continue to be our top three
complications all age catagories.This stability with the larger data set
gives credence to our data and suggests that we need to begin looking
at ways to decrease our top three complications as they have been
consistently the same over the years.
As in previous years, the most frequently reported procedures
continue to be excisional debridement of wound, infection, or burn
(ICD-9-CM 86.22) and other skin graft to other site (ICD-9-CM
86.69).This is true of all age groups, and makes good intuitive
sense given that early excision and grafting of burns remains a
durable standard of care. Another absolutely expected finding is the
progression of mortality as a function of increasing age.
Analysis
by Age Group
Birth to .9
Figure
RACE/ETHNICITY
23
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Cases
%Valid
White
4,128
42.1%
Black
2,234
22.8%
Hispanic
2,207
22.5%
Other
644
6.6%
Asian
413
4.2%
Native American
176
1.8%
Unknown
558
TOTAL
10,360
ETIOLOGY
Categories of
Etiology
ANALYSIS
BY AGE
ETIOLOGY
Scald
Contact with
Hot Object
Fire/Flam e
Burn,
Unspecified
Electrical
Chemical
Other, Non Burn
Inhalation Only
Skin Disease
Radiation
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
21
28
Etiology
Cases
% Valid
Scald
5,340
61.5%
Contact with Hot Object
2,046
23.6%
Fire/Flame
791
9.1%
Burn, Unspecified
186
2.1%
Electrical
89
1.0%
Chemical
83
1.0%
Other, Non Burn
58
0.7%
Inhalation Only
35
0.4%
Skin Disease
31
0.4%
Radiation
28
0.3%
Unknown
1,673
TOTAL
10,360
Table
ETIOLOGY
24
20
Race
ANALYSIS
BY AGE
GROUP
Figure
Table
RACE/ETHNICITY
Analysis
by Age Group
Table
22
Birth to .9
HOSPITAL DAYS: LIVED/DIED BY INHALATION INJURY
Inhalation Injury
Total
Mean +/Cases
SEM
9,002
6.31+0.15
No
Yes
322
Subtotal
9,324
Missing
1,036
TOTAL
10,360
Lived
Died
Cases
Mean +/- SEM
Cases
Mean +/- SEM
8,921
6.17+0.15
81
21.37+4.04
269
25+2.05
53
7.74+1.81
22.16+1.77
9,190
8.76+3.58
134
1,030
8.78+3.6
10,220
4.5+1.88
140
Total N=10,360
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
TOP TEN COMPLICATIONS
23
Top Ten Complications
Count
Urinary Tract Infection

Cellulitis
Pneumonia
Wound Infection
Respiratory Failure
Septicemia
Other Blood/Systemic Infection
Bacteremia
Catheter-Related Bloodstream Infection
Skin Graft Loss, Other
Total Complications
74
71
39
36
34
24
21
20
16
16
658
Percent of All
Complications
11.2
10.8
5.9
5.5
5.2
3.6
3.2
3.0
2.4
2.4
Percent of Patients
with Complication
0.9
0.9
0.5
0.5
0.4
0.3
0.3
0.3
0.2
0.2
Table
TOP TEN PROCEDURES

Top Ten Procedure Codes
Count
Percent of All Procedures
86.22 Excisional debridement of wound, infection, or burn
2,806
17.3
86.69 Other skin graft to other sites
2,030
12.5
93.57 Application of other wound dressing
1,608
9.9
86.28 Nonexcisional debridement of wound, infection or burn
1,605
9.9
86.66 Homograft to skin
1,267
7.8
38.93 Venous catheterization, not elsewhere classified
806
5.0
86.67 Dermal regenerative graft
390
2.4
38.91 Arterial catheterization
357
2.2
86.65 Heterograft to skin
329
2.0
86.62 Other skin graft to hand
309
1.9
Total Procedures
16,252
Total N=10,360
29
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
24
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
25
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
26
Lived
Died
%TBSA
Cases
Cases
Mortality Rate
%TBSA
Cases
Mean +/- SEM
0.1 - 9.9
7,315
0.1
0.1 - 9.9
7,322
4.6+0.5
10 - 19.9
1,457
14
1.0
10 - 19.9
1,471
10.0+0.3
20 - 29.9
333
13
3.8
20 - 29.9
346
20.7+1.0
30 - 39.9
156
13
7.7
30 - 39.9
169
32.2+1.9
40 - 49.9
49
13
21.0
40 - 49.9
62
32.8+4.3
50 - 59.9
31
20.5
50 - 59.9
39
45.7+5.9
60 - 69.9
14
18
56.3
60 - 69.9
32
27+5.0
70 - 79.9
17
12
41.4
70 - 79.9
29
52.5+12.8
80 - 89.9
11
12
52.2
80 - 89.9
23
12.3+5.6
> 90
17
85.0
> 90
20
16.6+9.9
Subtotal
9,386
127
1.3
Subtotal
9,513
7.1+0.4
Missing or 0%
834
13
1.5
Missing or 0%
847
5.6+0.3
TOTAL
10,220
140
1.4
TOTAL
10,360
7.0+0.3
Total N=10,360
Table
27
Total N=10,360
MEAN CHARGES FOR TOP FIVE MS-DRGS
MS-DRG Code
Cases
Cases with Valid

Charges
Mean +/- SEM
4,991
2,281
24567+/-968
929 Full thickness burn w skin graft or inhal inj

w/o CC/MCC
589
234
84577+/-5944
934 Full thickness burn w/o skin grft or inhal

inj
346
212
30066+/-2581
928 Full thickness burn w skin graft or inhal inj

w CC/MCC
302
193
135691+/-13506
927 Extensive burns or full thickness burns w

MV 96+ hrs w skin graft
131
57
323201+/-37774
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
HOSPITAL DAYS BY BURN GROUP SIZE

(% TBSA)
LIVED/DIED BY BURN GROUP SIZE

(% TBSA)
1
2
3
4
5
6
Birth to .9
Analysis
by Age Group
Total N=6,359
30
Analysis
by Age Group
Figure
25
Birth to .9
MEAN HOSPITAL DAYS FOR FIRE/FLAME, CONTACT WITH HOT OBJECT,

AND SCALD BY ADMISSION YEAR
Etiology
Mean Hospital Days with 95% Cl
30
Fire/Flame
Scald
Contact with
Hot Object
20
ANALYSIS OF
CONTRIBUTING
HOSPITALS
10
2004
2005
2006
2007
2008
2009
2010
2011
2012
ANALYSIS OF ALL
U.S. RECORDS
2013
Admission Year
Total N=10,360
Figure
MEAN CHARGES FOR ETIOLOGY CATEGORIES WITH GREATER THAN 100 VALID CHARGE CASES
Estimated Mean Hospital Charges with 95% Cl
26
1
2
3
4
5
6
$140,000
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
$120,000
$100,000
$80,000
HOSPITAL
COMPARISONS
$60,000
$40,000
$20,000
Scald
(N= 1,822)
Contact with Hot

Object (N= 653)
Fire/Flame
(N= 540)
Etiology Categories with Greater than 100 Valid Charge Cases

Total N=3,115
31
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
RACE/ETHNICITY
27
RACE/ETHNICITY
Table
28
Figure
1 - 1.9
Race
Cases
% Valid
White
5,234
38.0%
Black
3,474
25.3%
Hispanic
3,363
24.4%
Other
1,002
7.3%
Asian
579
4.2%
Native American
104
0.8%
Unknown
624
TOTAL
14,380
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
28
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Scald
Contact with
Hot Object
Fire/Flam e
Burn,
Unspecified
Chemical
Electrical
Other, Non Burn
Inhalation Only
Radiation
Skin Disease
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
29
32
Etiology
Cases
% Valid
Scald
9,192
67.6%
2,936
21.6%
Fire/Flame
888
6.5%
Burn, Unspecified
208
1.5%
Chemical
169
1.2%
Electrical
109
0.8%
Other, Non Burn
56
0.4%
Inhalation Only
25
0.2%
Radiation
0.1%
Skin Disease
0.0%
Unknown
785
TOTAL
14,380
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
30
1 - 1.9
Inhalation Injury
No
Total
Mean +/Cases
SEM
13,587
4.9+/-0.0
Yes
200
Subtotal
13,787
Missing
593
TOTAL
14,380
Lived
Cases
Died
Mean +/- SEM
Cases
Mean +/- SEM
13,571
4.8+/-0.0
16
22.7+/-6.5
186
16.1+/-1.9
14
14+/-5.0
16.0+/-1.8
13,757
5.2+/-0.4
30
589
5.2+/-0.4
14,346
6.2+/-4.9
34
Total N=14,380
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
31
Count
Cellulitis
Pneumonia
Wound Infection
Respiratory Failure
Surgical Site Infection, Deep
Septicemia
Bacteremia
Fungal Sepsis
Total Complications
187
134
115
82
63
54
50
49
40
37
1,421
Percent of All
Complications
13.2
9.4
8.1
5.8
4.4
3.8
3.5
3.4
2.8
2.6
Percent of Patients
with Complication
1.3
1.0
0.8
0.6
0.5
0.4
0.4
0.4
0.3
0.3
Total N=13,917 (Excluding 463 cases from non ABA burn registry software centers)
Table
TOP TEN PROCEDURES

Count
4,723
16.5
4,336
15.1
3,933
13.7
3,052
10.6
1,866
6.5
1,006
3.5
972
3.4
890
3.1
549
1.9
99.04 Transfusion of packed cells
498
1.7
Total Procedures
28,660
Total N=14,380
33
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
32
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
{
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
10,832
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
34
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
10,833
3.6+/-0.0
0.0
10 - 19.9
1,881
7.8+/-0.1
1,875
0.3
20 - 29.9
314
15.6+/-0.6
20 - 29.9
312
0.6
30 - 39.9
105
1.9
30 - 39.9
107
31.1+/-2.7
40 - 49.9
48
7.7
40 - 49.9
52
31.6+/-3.2
50 - 59.9
16
23.8
50 - 59.9
21
38.6+/-6.0
60 - 69.9
19
20.8
60 - 69.9
24
62.3+/-12.5
70 - 79.9
18.2
70 - 79.9
11
47.8+/-10.5
80 - 89.9
16.7
80 - 89.9
63.8+/-16.6
> 90
66.7
> 90
22+/-17.1
Subtotal
13,222
30
0.2
Subtotal
13,252
5.1+/-0.1
Missing or 0%
1,124
0.4
Missing or 0%
1,128
4.2+/-0.3
TOTAL
14,346
34
0.2
TOTAL
14,380
5.0+/-0.0
Total N=14,380
Table
35
Total N=14,380
MS-DRG Code
Cases
Cases with Valid

Charges
Mean +/- SEM
7,954
3,072
$22027+/-748
929 Full thickness burn w skin graft or inhal

inj w/o CC/MCC
992
275
$88256+/-6007
934 Full thickness burn w/o skin grft or inhal

inj
481
221
$33853+/-2872
928 Full thickness burn w skin graft or inhal

inj w CC/MCC
359
158
$150878+/-10212
927 Extensive burns or full thickness burns w

MV 96+ hrs w skin graft
241
57
$977+/-142
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS

(% TBSA)

(% TBSA)
33
1
2
3
4
5
6
1 - 1.9
Analysis
by Age Group
Total N=10,027
34
Analysis
by Age Group
Figure
29
1 - 1.9

25
Etiology
Fire/Flame
Scald
20
Contact with
Hot Object
15
10
ANALYSIS OF
CONTRIBUTING
HOSPITALS
2004
2005
2006
2007
2008
2009
2010
2011
2012
ANALYSIS OF ALL
U.S. RECORDS
2013
Admission Year
Total N=14,380
Figure
30
$50,000
1
2
3
4
5
6
$40,000
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
$30,000
$20,000
HOSPITAL
COMPARISONS
$10,000
Scald
(N= 3,339)
Contact with Hot

Object (N= 945)
Fire/Flame
(N= 432)
Burn, Unspecified
(N= 122)

Total N=4,838
35
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
RACE/ETHNICITY
31
RACE/ETHNICITY
Table
36
Figure
2 - 4.9
Race
Cases
% Valid
White
5,268
43.4%
Black
3,069
25.3%
Hispanic
2,618
21.6%
Other
702
5.8%
Asian
360
3.0%
Native American
124
1.0%
Unknown
468
TOTAL
12,609
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
32
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Scald
Fire/Flam e
Contact with
Hot Object
Electrical
Burn,
Unspecified
Chemical
Other, Non Burn
Inhalation Only
Radiation
Skin Disease
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
37
36
Etiology
Cases
% Valid
Scald
6,725
57.3%
Fire/Flame
2,137
18.2%
1,918
16.3%
Electrical
277
2.4%
Burn, Unspecified
275
2.3%
Chemical
143
1.2%
Other, Non Burn
128
1.1%
Inhalation Only
113
1.0%
Radiation
21
0.2%
Skin Disease
0.1%
Unknown
863
TOTAL
12,609
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
38
2 - 4.9
Inhalation Injury
No
Yes
Subtotal
Missing
TOTAL
Total
Mean +/Cases
SEM
11,553
6.0+/-0.1
424
23.0+/-1.7
11,977
632
7.3+/-0.7
12,609
Lived
Died
Cases
Mean +/- SEM
Cases
Mean +/- SEM
11,516
359
11,875
623
12,498
6.0+/-0.1
24.4+/-1.9
37
65
102
9
111
9.7+/-2.2
15.2+/-4.6
7.1+/-0.6
22.2+/-21.1
Total N=12,609
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
39
Count

Cellulitis
Pneumonia
Wound Infection
Septicemia
Respiratory Failure
Bacteremia
ARDS
Total Complications
188
143
133
86
79
68
52
47
37
37
1,570
Percent of All
Complications
12.0
9.1
8.5
5.5
5.0
4.3
3.3
3.0
2.4
2.4
Percent of Patients
with Complication
1.5
1.2
1.1
0.7
0.6
0.6
0.4
0.4
0.3
0.3
Table
TOP TEN PROCEDURES

Count
6,084
17.2
4,451
12.6
3,997
11.3
3,716
10.5
2,789
7.9
1,297
3.7
1,141
3.2
1,036
2.9
860
2.4
636
1.8
Total Procedures
35,325
Total N=12,609
37
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
40
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
41
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
8,865
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
42
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
8,875
4.0+/-0.0
10
0.1
10 - 19.9
1,599
9.8+/-0.3
1,596
0.2
20 - 29.9
386
18.8+/-0.8
20 - 29.9
383
0.8
30 - 39.9
179
4.3
30 - 39.9
187
29.1+/-1.6
40 - 49.9
98
7.5
40 - 49.9
106
42.3+/-3.4
50 - 59.9
61
12
16.4
50 - 59.9
73
40.9+/-3.6
60 - 69.9
42
16.0
60 - 69.9
50
55.5+/-6.1
70 - 79.9
18
18.2
70 - 79.9
22
74.0+/-13.6
80 - 89.9
16
17
51.5
80 - 89.9
33
38.7+/-8.7
> 90
13
61.9
> 90
21
33.8+/-14.3
Subtotal
11,266
86
0.8
Subtotal
11,352
6.8+/-0.1
Missing or 0%
1,232
25
2.0
Missing or 0%
1,257
5.1+/-0.3
TOTAL
12,498
111
0.9
TOTAL
12,609
6.7+/-0.1
Total N=12,609
Table
43
Total N=12,609
DRG Code
Cases
Cases with Valid Charges
Mean +/SEM
6,132
2,480
$23198+/-958
929 Full thickness burn w skin graft or inhal inj w/o

CC/MCC
1,020
309
$90369+/4984
934 Full thickness burn w/o skin grft or inhal inj
470
226
$35446+/3393
928 Full thickness burn w skin graft or inhal inj w

CC/MCC
405
197
$197642+/20522
927 Extensive burns or full thickness burns w MV

96+ hrs w skin graft
373
78
$391803+/39376
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
2 - 4.9
Analysis
by Age Group
Total N=8,400
38
Analysis
by Age Group
Figure
33
2 - 4.9

Etiology
20
Fire/Flame
Scald
Contact with
Hot Object
15
10
ANALYSIS OF
CONTRIBUTING
HOSPITALS
2004
2005
2006
2007
2008
2009
2010
2011
2012
ANALYSIS OF ALL
U.S. RECORDS
2013
Admission Year
Total N=12,609
Figure
34
1
2
3
4
5
6
$120,000
$100,000
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
$80,000
$60,000
HOSPITAL
COMPARISONS
$40,000
$20,000
Scald
(N= 2,498)
Fire/Flame
(N= 807)
Contact with Hot

Object (N= 595)
Burn, Unspecified
(N= 155)
Electrical
(N= 110)

Total N=4,165
39
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
Table
44
RACE/ETHNICITY
35
RACE/ETHNICITY
Figure
5 - 15.9
Race
Cases
% Valid
White
9,216
53.2%
Black
4,160
24.0%
Hispanic
2,690
15.5%
Other
743
4.3%
Asian
356
2.1%
Native American
168
1.0%
Unknown
735
TOTAL
18,068
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
36
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Contact with
Hot Object
Electrical
Burn,
Unspecified
Other, Non Burn
Chemical
Inhalation Only
Radiation
Skin Disease
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
45
40
Etiology
Cases
% Valid
Fire/Flame
7,330
44.2%
Scald
6,125
36.9%
1,461
8.8%
Electrical
430
2.6%
Burn, Unspecified
425
2.6%
Other, Non Burn
338
2.0%
Chemical
208
1.3%
Inhalation Only
187
1.1%
Radiation
72
0.4%
Skin Disease
22
0.1%
Unknown
1470
TOTAL
18,068
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
46
5 - 15.9
Inhalation Injury
No
Total
Mean +/Cases
SEM
16,074
6.7+/-0.1
Yes
885
Subtotal
16,959
Missing
1,109
TOTAL
18,068
Lived
Cases
Died
Mean +/- SEM
Cases
Mean +/- SEM
16,039
6.7+/-0.1
35
11.4+/-2.6
809
22.3+/-1.1
76
15.6+/-4.2
21.8+/-1.0
16,848
6.9+/-0.4
111
1,096
6.8+/-0.4
13
17,944
21.4+/-13.1
124
Total N=18,068
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
47
Count

Pneumonia
Cellulitis
Wound Infection
Septicemia
Respiratory Failure
Bacteremia
Fungal Sepsis
Total Complications
296
283
256
209
165
112
112
80
72
61
2,781
Percent of All
Complications
10.6
10.2
9.2
7.5
5.9
4.0
4.0
2.9
2.6
2.2
Percent of Patients
with Complication
3.3
3.1
2.8
2.3
1.8
1.2
1.2
0.9
0.8
0.7
Table
TOP TEN PROCEDURES

Count
10,449
17.7
8,344
14.1
5,108
8.6
5,061
8.6
4,379
7.4
2,361
4.0
2,256
3.8
1,748
3.0
1,737
2.9
1,061
1.8
Total Procedures
59,094
Total N=18,068
41
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
48
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
49
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
12,322
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
50
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
12,331
3.9+/-0.0
0.1
10 - 19.9
2,167
10.6+/-0.2
2,161
0.3
20 - 29.9
648
20.7+/-0.6
20 - 29.9
642
0.9
30 - 39.9
303
1.6
30 - 39.9
308
36.4+/-1.5
40 - 49.9
186
4.6
40 - 49.9
195
44.5+/-2.2
50 - 59.9
110
5.2
50 - 59.9
116
53.6+/-4.0
60 - 69.9
78
11
12.4
60 - 69.9
89
63.4+/-4.9
70 - 79.9
49
14.0
70 - 79.9
57
57.9+/-7.1
80 - 89.9
26
21
44.7
80 - 89.9
47
59.7+/-7.3
> 90
12
21
63.6
> 90
33
35.9+/-11.2
Subtotal
15,889
102
0.6
Subtotal
15,991
7.7+/-0.1
Missing or 0%
2,055
22
1.1
Missing or 0%
2,077
5.3+/-0.2
TOTAL
17,944
124
0.7
TOTAL
18,068
7.4+/-0.1
Total N=18,068
Table
51
Total N=18,068
MS-DRG Code
Cases
Mean +/SEM
7,378
2,829
$23410+/-758

CC/MCC
1,995
649
$85380+/3704

CC/MCC
740
307
$169695+/14624

693
154
$468469+/47209
552
264
$31592+/4853
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
5 - 15.9
Analysis
by Age Group
Total N=11,358
42
Analysis
by Age Group
Figure
37
5 - 15.9

Etiology
12.5
Fire/Flame
Scald
10
Contact with
Hot Object
7.5
ANALYSIS OF
CONTRIBUTING
HOSPITALS
2.5
2004
2005
2006
2007
2008
2009
2010
2011
2012
ANALYSIS OF ALL
U.S. RECORDS
2013
Admission Year
Total N=18,068
Figure
38
1
2
3
4
5
6
$100,000
$90,000
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
$80,000
$70,000
$60,000
$50,000
HOSPITAL
COMPARISONS
$40,000
$30,000
$20,000
Fire/Flame
(N= 2,493)
Scald
(N= 2,114)
Contact with Hot

Object (N= 423)
Burn, Unspecified
(N= 201)
Other, Non Burn

(N= 117)
Electrical
(N= 111)

Total N=5,459
43
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
Table
52
RACE/ETHNICITY
39
RACE/ETHNICITY
Figure
16 - 19.9
Race
Cases
% Valid
White
6,275
66.1%
Black
1,515
16.0%
Hispanic
1,159
12.2%
Other
341
3.6%
Asian
125
1.3%
Native American
75
0.8%
Unknown
537
TOTAL
10,027
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
40
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Contact with
Hot Object
Other, Non Burn
Burn,
Unspecified
Chemical
Electrical
Inhalation Only
Radiation
Skin Disease
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
53
44
Etiology
Cases
% Valid
Fire/Flame
4,928
54.1%
Scald
2,389
26.2%
532
5.8%
Other, Non Burn
322
3.5%
Burn, Unspecified
322
3.5%
Chemical
258
2.8%
Electrical
232
2.5%
Inhalation Only
79
0.9%
Radiation
29
0.3%
Skin Disease
19
0.2%
Unknown
917
TOTAL
10,027
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
54
16 - 19.9
Inhalation Injury
Total
Mean +/Cases
SEM
8,464
6.7+/-0.1
No
Yes
623
Subtotal
9,087
Missing
940
TOTAL
10,027
Lived
Died
Cases
Mean +/- SEM
Cases
Mean +/- SEM
8,424
6.6+/-0.1
40
17.5+/-6.1
566
19.2+/-1.2
57
9.2+/-2.3
18.3+/-1.1
8,990
7.6+/-0.5
97
925
7.7+/-0.6
15
9,915
3.6+/-1.4
112
Total N=10,027
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
55
Count
Pneumonia
Cellulitis
Wound Infection
Septicemia
Respiratory Failure
Other Hematologic
Bacteremia
Total Complications
202
184
150
135
105
104
48
48
47
43
1,913
Percent of All
Complications
10.6
9.6
7.8
7.1
5.5
5.4
2.5
2.5
2.5
2.2
Percent of Patients
with Complication
2.2
2.0
1.7
1.5
1.2
1.1
0.5
0.5
0.5
0.5
Table
TOP TEN PROCEDURES

Count
5,172
17.7
3,684
12.6
2,315
7.9
1,910
6.5
1,834
6.3
1,102
3.8
1,024
3.5
823
2.8
817
2.8
707
2.4
Total Procedures
29,225
Total N=10,027
45
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
56
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
57
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
5,691
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
58
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
6,486
4.2+/-0.1
0.1
10 - 19.9
1,299
9.4+/-0.2
1,208
0.4
20 - 29.9
400
20.1+/-0.9
20 - 29.9
377
1.0
30 - 39.9
183
28.5+/-1.5
30 - 39.9
153
3.8
40 - 49.9
112
4.3
40 - 49.9
116
43.2+/-2.9
50 - 59.9
55
11.3
50 - 59.9
67
58.4+/-5.9
60 - 69.9
34
17.1
60 - 69.9
49
68.4+/-9.5
70 - 79.9
23
17.9
70 - 79.9
29
59.7+/-9.3
80 - 89.9
12
15
55.6
80 - 89.9
32
38.4+/-9.3
> 90
10
25
71.4
> 90
36
28.8+/-8.8
Subtotal
7,675
87
1.1
Subtotal
8,697
7.9+/-0.1
Missing or 0%
1,179
19
1.6
Missing or 0%
1,330
4.9+/-0.2
TOTAL
8,854
106
1.2
TOTAL
10,027
7.5+/-0.1
Total N=10,027
Table
59
Total N=10,027
MS-DRG Code
Cases
Mean +/SEM
3,738
1,702
$24477+/3115

CC/MCC
926
354
$84473+/6085

CC/MCC
474
224
$150459+/13399
350
208
$36430+/6903

280
104
$418147+/54099
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
16 - 19.9
Analysis
by Age Group
Total N=5,768
46
Analysis
by Age Group
Figure
41
16 - 19.9

Etiology
12.5
Fire/Flame
Scald
Contact with
Hot Object
10
7.5
ANALYSIS OF
CONTRIBUTING
HOSPITALS
2.5
2004
2005
2006
2007
2008
2009
2010
2011
2012
ANALYSIS OF ALL
U.S. RECORDS
2013
Admission Year
Total N=10,027
Figure
42
1
2
3
4
5
6
$140,000
$120,000
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
$100,000
$80,000
HOSPITAL
COMPARISONS
$60,000
$40,000
$20,000
Fire/Flame
(N= 1,886)
Scald
(N= 914)

(N= 198)
Burn, Unspecified
(N= 129)
Burn, Unspecified
(N= 129)

Total N=3,127
47
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
Table
60
RACE/ETHNICITY
43
RACE/ETHNICITY
Figure
20 - 29.9
Race
Cases
% Valid
White
16,713
62.2%
Black
4,332
16.1%
Hispanic
4,032
15.0%
Other
1,075
4.0%
Asian
503
1.9%
Native American
219
0.8%
Unknown
1,642
TOTAL
28,516
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
44
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Contact with
Hot Object
Electrical
Chemical
Burn,
Unspecified
Other, Non Burn
Inhalation Only
Radiation
Skin Disease
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
61
48
Etiology
Cases
% Valid
Fire/Flame
12,778
49.0%
Scald
7,434
28.5%
1,363
5.2%
Electrical
1,341
5.1%
Chemical
1,051
4.0%
Burn, Unspecified
901
3.5%
Other, Non Burn
786
3.0%
Inhalation Only
336
1.3%
Radiation
76
0.3%
Skin Disease
35
0.1%
Unknown
2415
TOTAL
28,516
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
62
20 - 29.9
No
Total
Mean +/Cases
SEM
23,835
7.2+/-0.1
Yes
2,245
Subtotal
26,080
Missing
2,436
TOTAL
28,516
Inhalation Injury
Lived
Cases
20.1+/-0.7
Died
Mean +/- SEM
Cases
Mean +/- SEM
23,688
7.1+/-0.0
147
23.1+/-4.2
2,012
19.8+/-0.6
233
22.2+/-3.3
25,700
8.5+/-0.4
380
2,385
8.1+/-0.3
51
28,085
26.5+/-8.6
431
Total N=28,516
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
63
Count
Cellulitis
Pneumonia
Respiratory Failure
Wound Infection
Septicemia
Renal Failure
Bacteremia
Total Complications
797
769
494
446
428
400
190
187
178
159
7,147
Percent of All
Complications
11.2
10.8
6.9
6.2
6.0
5.6
2.7
2.6
2.5
2.2
Percent of Patients
with Complication
3.1
3.0
1.9
1.7
1.6
1.5
0.7
0.7
0.7
0.6
Table
TOP TEN PROCEDURES

Count
15,852
18.5
10,345
12.1
6,255
7.3
5,482
6.4
4,852
5.7
3,677
4.3
2,893
3.4
2,234
2.6
2,118
2.5
86.6 Free skin graft
1,585
1.8
Total Procedures
85,772
Total N=28,516
49
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
64
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
65
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
18,340
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
66
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
18,369
4.7+/-0.0
29
0.2
10 - 19.9
3,725
10.9+/-0.2
3,703
22
0.6
20 - 29.9
1,182
19.0+/-0.4
20 - 29.9
1,163
19
1.6
30 - 39.9
520
33.3+/-1.3
30 - 39.9
490
30
5.8
40 - 49.9
242
35
12.6
40 - 49.9
277
49.1+/-3.0
50 - 59.9
136
31
18.6
50 - 59.9
167
60.5+/-4.2
60 - 69.9
100
35
25.9
60 - 69.9
135
56.5+/-4.2
70 - 79.9
48
35
42.2
70 - 79.9
83
66.2+/-7.4
80 - 89.9
40
51
56.0
80 - 89.9
91
56.2+/-7.3
> 90
23
75
76.5
> 90
98
30.2+/-7.2
Subtotal
24,285
362
1.5
Subtotal
24,647
8.6+/-0.1
Missing or 0%
3,800
69
1.8
Missing or 0%
3,869
6.2+/-0.2
TOTAL
28,085
431
1.5
TOTAL
28,516
8.3+/-0.1
Total N=28,516
Table
67
Total N=28,516
MS-DRG Code
Cases
Mean +/SEM
10,510
5,102
$23569+/-650

CC/MCC
2,778
1,176
$96373+/3811

CC/MCC
1,666
844
$181782+/11147
1,071
652
$30377+/1883

816
409
$441328+/28666
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
20 - 29.9
Analysis
by Age Group
Total N=16,841
50
Analysis
by Age Group
Figure
45
20 - 29.9

Etiology
Fire/Flame
20
Scald
Contact with
Hot Object
15
10
ANALYSIS OF
CONTRIBUTING
HOSPITALS
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Admission Year
Total N=28,516
Figure
46
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
$160,000
1
2
3
4
5
6
$140,000
$120,000
ANALYSIS
BY AGE
ETIOLOGY
$100,000
$80,000
$60,000
HOSPITAL
COMPARISONS
$40,000
$20,000
Fire/Flame
(N= 5,318)
Scald
(N= 3,080)
Electrical
(N= 632)
Contact with Hot

Object (N= 540)
Chemical
(N= 442)
Burn, Unspecified Other, Non Burn

(N= 400)
(N= 213)

Total N=10,726
51
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
Table
68
RACE/ETHNICITY
47
RACE/ETHNICITY
Figure
30 - 39.9
Race
Cases
% Vslid
White
14,118
61.1%
Black
4,021
17.4%
Hispanic
3,426
14.8%
Other
842
3.6%
Asian
516
2.2%
Native American
166
0.7%
Unknown
1,322
TOTAL
24,411
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Electrical
Chemical
Contact with
Hot Object
Burn,
Unspecified
Other, Non Burn
Inhalation Only
Skin Disease
Radiation
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
69
52
Etiology
Cases
% Valid
Fire/Flame
10,960
48.9%
Scald
5,896
26.3%
Electrical
1,427
6.4%
Chemical
1,252
5.6%
1,215
5.4%
Other, Non Burn
562
2.5%
Burn, Unspecified
621
2.8%
Inhalation Only
399
1.8%
Skin Disease
50
0.2%
Radiation
43
0.2%
Unknown
1986
TOTAL
24,411
Table
ETIOLOGY
48
ETIOLOGY
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
70
30 - 39.9
No
Total
Mean +/Cases
SEM
20,088
7.7+/-0.1
Yes
2,186
Subtotal
22,274
Missing
2,137
TOTAL
24,411
Inhalation Injury
Lived
Cases
19.1+/-0.6
Died
Mean +/- SEM
Cases
Mean +/- SEM
19,901
7.7+/-0.1
187
18.2+/-3.0
1,921
20.0+/-0.6
265
12.4+/-1.2
21,822
9.5+/-0.4
452
2,076
9.2+/-0.4
61
23,898
20.4+/-5.4
513
Total N=24,411
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
71
Count
Pneumonia
Cellulitis
Respiratory Failure
Wound Infection
Septicemia
Bacteremia
Other Hematologic
Renal Failure
Total Complications
832
741
494
439
422
374
205
202
178
175
7,127
Percent of All
Complications
11.7
10.4
6.9
6.2
5.9
5.2
2.9
2.8
2.5
2.5
Percent of Patients
with Complication
3.7
3.3
2.2
2.0
1.9
1.7
0.9
0.9
0.8
0.8
Table
TOP TEN PROCEDURES

Count
14,245

18.7
9,374
12.3
5,295
6.9
4,964
6.5
3,784
5.0
3,220
4.2
2,813
3.7
1,957
2.6
1,798
2.4
1,435
1.9
Total Procedures
76,233
Total N=24,411
53
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
72
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
73
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
15,000
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
74
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
15,037
5.3+/-0.0
37
0.2
10 - 19.9
3,308
11.3+/-0.2
3,276
32
1.0
20 - 29.9
1,040
21+/-0.5
20 - 29.9
1,012
28
2.7
30 - 39.9
482
37
7.1
30 - 39.9
519
33.8+/-1.7
40 - 49.9
250
31
11.0
40 - 49.9
281
48.5+/-2.1
50 - 59.9
125
34
21.4
50 - 59.9
159
52.2+/-3.2
60 - 69.9
88
51
36.7
60 - 69.9
139
62.2+/-5.0
70 - 79.9
41
46
52.9
70 - 79.9
87
49.2+/-6.4
80 - 89.9
30
57
65.5
80 - 89.9
87
29.6+/-5.8
> 90
90
91.8
> 90
98
11.3+/-4.5
Subtotal
20,312
443
2.1
Subtotal
20,755
9.4+/-0.1
Missing or 0%
3,586
70
1.9
Missing or 0%
3,656
6.1+/-0.2
TOTAL
23,898
513
2.1
TOTAL
24,411
8.9+/-0.1
Total N=24,411
Table
75
Total N=24,411
MS-DRG Code
Cases
Mean +/SEM
8,536
4,051
$26423+/-830

CC/MCC
2,404
983
$93478+/3893

CC/MCC
1,684
880
$173486+/9234
900
539
$37137+/3499

768
392
$457618+/25869
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
30 - 39.9
Analysis
by Age Group
Total N=14,292
54
Analysis
by Age Group
Figure
49
30 - 39.9

Etiology
14
Fire/Flame
Scald
12
Contact with
Hot Object
10
8
ANALYSIS OF
CONTRIBUTING
HOSPITALS
6
4
2
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Admission Year
Total N=24,411
Figure
50
$120,000
1
2
3
4
5
6
$100,000
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
$80,000
$60,000
HOSPITAL
COMPARISONS
$40,000
$20,000
Fire/Flame
(N= 4,522)
Scald
(N= 2,406)
Electrical
(N= 626)
Chemical
(N= 502)
Contact with Hot Burn, Unspecified Other, Non Burn

Object (N= 494)
(N= 275)
(N= 150)

Total N=8,976
55
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
Table
76
RACE/ETHNICITY
51
RACE/ETHNICITY
Figure
40 - 49.9
Race
Cases
% Valid
White
16,332
63.8%
Black
4,864
19.0%
Hispanic
2,867
11.2%
Other
843
3.3%
Asian
495
1.9%
Native American
212
0.8%
Unknown
1,429
TOTAL
27,042
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
52
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Electrical
Contact with
Hot Object
Chemical
Other, Non Burn
Burn,
Unspecified
Inhalation Only
Radiation
Skin Disease
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
77
56
Etiology
Cases
% Valid
Fire/Flame
12,504
50.5%
Scald
6,164
24.9%
Electrical
1,445
5.8%
1,423
5.7%
Chemical
1,288
5.2%
Other, Non Burn
661
2.7%
Burn, Unspecified
659
2.7%
Inhalation Only
477
1.9%
Radiation
71
0.3%
Skin Disease
58
0.2%
Unknown
2292
TOTAL
27,042
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
78
40 - 49.9
No
Total
Mean +/Cases
SEM
22,000
8.9+/-0.1
Yes
2,722
Subtotal
24,722
Missing
2,320
TOTAL
27,042
Inhalation Injury
Lived
Cases
19.2+/-0.5
Died
Mean +/- SEM
Cases
Mean +/- SEM
21,675
8.7+/-0.1
325
21.7+/-1.8
2,322
19.9+/-0.6
400
15.3+/-1.3
23,997
10.0+/-0.4
725
2,236
9.7+/-0.4
84
26,233
17.6+/-2.9
809
Total N=27,042
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
79
Count
Pneumonia
Cellulitis
Respiratory Failure
Wound Infection
Septicemia
Renal Failure
Bacteremia
Other Hematologic
Total Complications
1066
978
672
652
521
520
355
254
242
227
9,874
Percent of All
Complications
10.8
9.9
6.8
6.6
5.3
5.3
3.6
2.6
2.5
2.3
Percent of Patients
with Complication
4.3
3.9
2.7
2.6
2.1
2.1
1.4
1.0
1.0
0.9
Table
TOP TEN PROCEDURES

Count
17,077
18.4
11,549
12.5
5,763
6.2
5,742
6.2
4,485
4.8
3,628
3.9
3,507
3.8
2,305
2.5
1,993
2.2
33.22 Fiber-optic bronchoscopy
1,779
1.9
Total Procedures
92,648
Total N=27,042
57
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
80
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
81
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
16,595
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
82
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
16,672
6.1+/-0.0
77
0.5
10 - 19.9
3,728
13.3+/-0.2
3,680
48
1.3
20 - 29.9
1,229
23.6+/-0.6
20 - 29.9
1,171
58
4.7
30 - 39.9
588
35.9+/-1.2
30 - 39.9
525
63
10.7
40 - 49.9
246
79
24.3
40 - 49.9
325
47.8+/-2.0
50 - 59.9
114
89
43.8
50 - 59.9
203
49.3+/-2.9
60 - 69.9
88
54
38.0
60 - 69.9
142
61.5+/-5.0
70 - 79.9
32
46
59.0
70 - 79.9
78
52.7+/-8.2
80 - 89.9
27
77
74.0
80 - 89.9
104
23.9+/-4.5
> 90
18
101
84.9
> 90
119
4.5+/-0.9
Subtotal
22,496
692
3.0
Subtotal
23,188
10.5+/-0.1
Missing or 0%
3,737
117
3.0
Missing or 0%
3,854
7.1+/-0.2
TOTAL
26,233
809
3.0
TOTAL
27,042
10.0+/-0.1
Total N=27,042
Table
83
Total N=27,042
MS-DRG Code
Cases
Mean +/SEM
8,982
4,221
$32019+/1102

CC/MCC
2,678
1,085
$97781+/4318

CC/MCC
2,334
1,186
$189161+/8790
917
552
$36353+/2209

876
424
$527438+/30842
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
40 - 49.9
Analysis
by Age Group
Total N=15,787
58
Analysis
by Age Group
Figure
53
40 - 49.9

Etiology
Fire/Flame
15
Scald
12.5
Contact with
Hot Object
10
7.5
ANALYSIS OF
CONTRIBUTING
HOSPITALS
5
2
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Admission Year
Total N=27,042
Figure
54
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
$160,000
$140,000
1
2
3
4
5
6
$120,000
ANALYSIS
BY AGE
ETIOLOGY
$100,000
$80,000
HOSPITAL
COMPARISONS
$60,000
$40,000
Fire/Flame
(N= 5,116)
Scald
(N= 2,511)
Electrical
(N= 649)
Contact with Hot

Object (N= 583)
Chemical Burn, Unspecified Other, Non Burn

(N= 525)
(N= 337)
(N= 206)

Total N=10,054
59
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
Table
84
RACE/ETHNICITY
55
RACE/ETHNICITY
Figure
50 - 59.9
Race
Cases
% Valid
White
13,763
65.8%
Black
4,169
19.9%
Hispanic
1,790
8.6%
Other
615
2.9%
Asian
450
2.2%
Native American
124
0.6%
Unknown
1,145
TOTAL
22,056
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
56
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Contact with
Hot Object
Electrical
Chemical
Other, Non Burn
Burn,
Unspecified
Inhalation Only
Skin Disease
Radiation
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
85
60
Etiology
Cases
% Valid
Fire/Flame
10,575
52.3%
Scald
4,824
23.8%
1,266
6.3%
Electrical
882
4.4%
Chemical
881
4.4%
Other, Non Burn
636
3.1%
Burn, Unspecified
554
2.7%
Inhalation Only
488
2.4%
Skin Disease
68
0.3%
Radiation
58
0.3%
Unknown
1824
TOTAL
22,056
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
86
50 - 59.9
Cases
Mean +/- SEM
Cases
Mean +/- SEM
No
Total
Mean +/Cases
SEM
17,394
10.1+/-0.1
16,923
9.7+/-0.1
471
23.4+/-1.6
Yes
2,826
2,313
21+/-0.6
513
18.9+/-1.4
Subtotal
20,220
Missing
1,836
TOTAL
22,056
Inhalation Injury
Lived
20.6+/-0.5
Died
19,236
11.9+/-0.5
984
1,745
11.8+/-0.5
91
20,981
14.9+/-2.6
1,075
Total N=22,056
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
87
Count
Pneumonia
Cellulitis
Respiratory Failure
Wound Infection
Septicemia
Renal Failure
Arrythmia
Other Hematologic
Bacteremia
Total Complications
1057
774
716
635
538
449
369
264
244
222
9,744
Percent of All
Complications
10.8
7.9
7.3
6.5
5.5
4.6
3.8
2.7
2.5
2.3
Percent of Patients
with Complication
5.1
3.8
3.5
3.1
2.6
2.2
1.8
1.3
1.2
1.1
Table
TOP TEN PROCEDURES

Count
14,228
17.7
9,797
12.2
5,004
6.2
4,442
5.5
3,536
4.4
3,350
4.2
2,592
3.2
1,820
2.3
1,428
1.8
1,405
1.8
Total Procedures
80,260
Total N=22,056
61
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
88
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
89
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
13,468
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
90
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
13,596
7.5+/-0.1
128
0.9
10 - 19.9
2,980
16.3+/-0.3
2,883
97
3.3
20 - 29.9
996
27.3+/-0.8
20 - 29.9
892
104
10.4
30 - 39.9
453
39.5+/-1.7
30 - 39.9
358
95
21.0
40 - 49.9
165
109
39.8
40 - 49.9
274
46.8+/-2.4
50 - 59.9
75
81
51.9
50 - 59.9
156
48.9+/-4.1
60 - 69.9
42
80
65.6
60 - 69.9
122
42.1+/-4.5
70 - 79.9
25
68
73.1
70 - 79.9
93
35.5+/-5.3
80 - 89.9
17
79
82.3
80 - 89.9
96
13.8+/-3.2
> 90
14
89
86.4
> 90
103
6.8+/-2.2
Subtotal
17,939
930
4.9
Subtotal
18,869
12.0+/-0.1
Missing or 0%
3,042
145
4.5
Missing or 0%
3,187
8.8+/-0.3
TOTAL
20,981
1,075
4.9
TOTAL
22,056
11.6+/-0.1
Total N=22,056
Table
91
Total N=22,056
MS-DRG Code
Cases
Mean +/SEM
6,787
3,288
$37681+/1426

CC/MCC
2,283
904
$117272+/5298

CC/MCC
2,282
1,130
$197866+/7747
869
494
$45647+/4394

818
385
$535794+/36223
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
50 - 59.9
Analysis
by Age Group
Total N=13,039
62
Analysis
by Age Group
Figure
57
50 - 59.9

Etiology
Fire/Flame
18
Scald
Contact with
Hot Object
16
14
12
ANALYSIS OF
CONTRIBUTING
HOSPITALS
10
8
6
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Admission Year
Total N=22,056
Figure
58
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
$160,000
1
2
3
4
5
6
$140,000
ANALYSIS
BY AGE
ETIOLOGY
$120,000
$100,000
$80,000
HOSPITAL
COMPARISONS
$60,000
$40,000
Fire/Flame
(N= 4,446)
Scald
(N= 1,918)
Contact with Hot

Object (N= 533)
Electrical
(N= 393)
Chemical Burn, Unspecified Other, Non Burn

(N= 370)
(N= 304)
(N= 234)

Total N=8,349
63
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
Table
92
RACE/ETHNICITY
59
RACE/ETHNICITY
Figure
60 - 69.9
Race
Cases
% Valid
White
7,990
68.7%
Black
2,125
18.3%
Hispanic
796
6.8%
Other
359
3.1%
Asian
288
2.5%
Native American
77
0.7%
Unknown
684
TOTAL
12,319
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
60
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Contact with
Hot Object
Other, Non Burn
Chemical
Burn,
Unspecified
Inhalation Only
Electrical
Skin Disease
Radiation
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
93
64
Etiology
Cases
% Valid
Fire/Flame
6,278
56.0%
Scald
2,555
22.8%
709
6.3%
Other, Non Burn
404
3.6%
Chemical
334
3.0%
Burn, Unspecified
317
2.8%
Inhalation Only
300
2.7%
Electrical
239
2.1%
Skin Disease
45
0.4%
Radiation
35
0.3%
Unknown
1103
TOTAL
12,319
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
94
60 - 69.9
Cases
Mean +/- SEM
Cases
Mean +/- SEM
No
Total
Mean +/Cases
SEM
9,518
11.5+/-0.1
9,076
11.1+/-0.1
442
20.0+/-1.2
Yes
1,813
1,373
19.2+/-0.6
440
14.9+/-1.1
Subtotal
11,331
Missing
988
TOTAL
12,319
Inhalation Injury
Lived
18.2+/-0.5
Died
10,449
12.7+/-0.6
882
915
12.5+/-0.6
73
11,364
14.3+/-3.1
955
Total N=12,319
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
95
Count
Pneumonia
Respiratory Failure
Cellulitis
Renal Failure
Septicemia
Wound Infection
Arrythmia
Bacteremia
Total Complications
713
580
474
391
322
319
305
281
150
148
6,699
Percent of All
Complications
10.6
8.7
7.1
5.8
4.8
4.8
4.6
4.2
2.2
2.2
Percent of Patients
with Complication
6.2
5.1
4.1
3.4
2.8
2.8
2.7
2.5
1.3
1.3
Table
TOP TEN PROCEDURES

Count
7,901
16.4
5,579
11.6
2,865
5.9
2,375
4.9
2,245
4.7
1,919
4.0
1,413
2.9
1,096
2.3
931
1.9
87.44 X-ray of chest
879
1.8
Total Procedures
48,189
Total N=12,319
65
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
96
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
97
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
7,403
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
98
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
7,554
8.5+/-0.1
151
2.0
10 - 19.9
1,731
18.8+/-0.4
1,621
110
6.4
20 - 29.9
576
32+/-1.1
20 - 29.9
469
107
18.6
30 - 39.9
165
110
40.0
30 - 39.9
275
43.1+/-2.2
40 - 49.9
66
89
57.4
40 - 49.9
155
35.2+/-3.0
50 - 59.9
37
77
67.5
50 - 59.9
114
32.6+/-3.9
60 - 69.9
61
88.4
60 - 69.9
69
17.5+/-3.1
70 - 79.9
47
87.0
70 - 79.9
54
11.2+/-2.8
80 - 89.9
33
94.3
80 - 89.9
35
4.4+/-1.6
> 90
51
92.7
> 90
55
2.7+/-0.6
Subtotal
9,782
836
7.9
Subtotal
10,618
13.1+/-0.1
Missing or 0%
1,582
119
7.0
Missing or 0%
1,701
9.6+/-0.4
TOTAL
11,364
955
7.8
TOTAL
12,319
12.6+/-0.1
Total N=12,319
Table
99
Total N=12,319
MS-DRG Code
Cases
Mean +/SEM
3,480
1,643
$42218+/2243

CC/MCC
1,472
659
$218868+/12070

CC/MCC
1,204
461
$130090+/11364

497
246
$468363+/34623
457
253
$62274+/19499
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
60 - 69.9
Analysis
by Age Group
Total N=7,110
66
Analysis
by Age Group
Figure
61
60 - 69.9

Etiology
Fire/Flame
30
Scald
Contact with
Hot Object
25
20
15
ANALYSIS OF
CONTRIBUTING
HOSPITALS
10
5
2004
2005
2006
2007
2008
2009
2010
2011
2012
ANALYSIS OF ALL
U.S. RECORDS
2013
Admission Year
Total N=12,319
Figure
62
1
2
3
4
5
6
$300,000
$250,000
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
$200,000
$150,000
HOSPITAL
COMPARISONS
$100,000
$50,000
Fire/Flame
(N= 2,657)
Scald
(N= 998)
Contact with Hot

Object (N= 281)
Burn, Unspecified
(N= 169)
Other, Non Burn

(N= 140)
Chemical
(N= 139)
Electrical
(N= 112)

Total N=4,492
67
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
RACE/ETHNICITY
63
RACE/ETHNICITY
Table
100
Figure
70 - 79.9
Race
Cases
% Valid
White
4,859
71.8%
Black
1,105
16.3%
Hispanic
392
5.8%
Other
187
2.8%
Asian
182
2.7%
Native American
39
0.6%
Unknown
386
TOTAL
7,150
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
64
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Contact with
Hot Object
Other, Non Burn
Inhalation Only
Burn,
Unspecified
Chemical
Electrical
Skin Disease
Radiation
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
101
68
Etiology
Cases
% Valid
Fire/Flame
3,867
59.4%
Scald
1,359
20.9%
395
6.1%
Other, Non Burn
305
4.7%
Burn, Unspecified
168
2.6%
Inhalation Only
198
3.0%
Chemical
108
1.7%
Electrical
52
0.8%
Skin Disease
32
0.5%
Radiation
22
0.3%
Unknown
644
TOTAL
7,150
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
102
70 - 79.9
No
Total
Mean +/Cases
SEM
5,404
13.5+/-0.2
Yes
1,133
Subtotal
6,537
Missing
613
TOTAL
7,150
Inhalation Injury
Lived
Died
Cases
Mean +/- SEM
Cases
Mean +/- SEM
4,895
12.8+/-0.2
509
19.8+/-1.1
763
17.2+/-0.7
370
11.1+/-0.9
15.2+/-0.6
5,658
13.9+/-1.0
879
511
13.5+/-0.9
102
6,169
16.1+/-4.1
981
Total N=7,150
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
103
Count

Pneumonia
Respiratory Failure
Arrythmia
Septicemia
Cellulitis
Renal Failure
Wound Infection
Cardiac arrest
Other Cardiovascular
Total Complications
506
505
383
272
227
215
214
175
127
122
4,991
Percent of All
Complications
10.1
10.1
7.7
5.4
4.5
4.3
4.3
3.5
2.5
2.4
Percent of Patients
with Complication
7.6
7.6
5.8
4.1
3.4
3.2
3.2
2.6
1.9
1.8
Table
TOP TEN PROCEDURES

Count
4,657
16.1
3,296
11.4
1,689
5.8
1,451
5.0
1,245
4.3
1,009
3.5
732
2.5
648
2.2
96.04 Insertion of endotracheal tube
593
2.0
590
2.0
Total Procedures
28,938
Total N=7,150
69
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
104
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
105
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
3,992
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
106
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
4,160
9.9+/-0.2
168
4.0
10 - 19.9
1,001
22.0+/-0.6
847
154
15.4
20 - 29.9
359
33.0+/-1.6
20 - 29.9
233
126
35.1
30 - 39.9
87
121
58.2
30 - 39.9
208
30.7+/-2.3
40 - 49.9
31
91
74.6
40 - 49.9
122
24.1+/-3.2
50 - 59.9
11
54
83.1
50 - 59.9
65
12.4+/-3.2
60 - 69.9
41
89.1
60 - 69.9
46
10.1+/-3.0
70 - 79.9
25
89.3
70 - 79.9
28
3.0+/-0.7
80 - 89.9
24
80.0
80 - 89.9
30
2.3+/-0.5
> 90
30
88.2
> 90
34
1.4+/-0.2
Subtotal
5,219
834
13.8
Subtotal
6,053
14.2+/-0.2
Missing or 0%
950
147
13.4
Missing or 0%
1,097
11.6+/-0.6
TOTAL
6,169
981
13.7
TOTAL
7,150
13.8+/-0.2
Total N=7,150
Table
107
Total N=7,150
MS-DRG Code
Cases
Mean +/SEM
1,713
802
$50103+/3100

CC/MCC
976
484
$217712+/11212

CC/MCC
666
255
$134485+/11202
325
181
$48750+/5031

283
139
$538615+/48848
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
70 - 79.9
Analysis
by Age Group
Total N=3,963
70
Analysis
by Age Group
Figure
65
70 - 79.9

Etiology
40
Fire/Flame
Scald
Contact with
Hot Object
30
20
ANALYSIS OF
CONTRIBUTING
HOSPITALS
10
2004
2005
2006
2007
2008
2009
2010
2011
2012
ANALYSIS OF ALL
U.S. RECORDS
2013
Admission Year
Total N=7,150
Figure
66
1
2
3
4
5
6
$160,000
$140,000
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
$120,000
$100,000
HOSPITAL
COMPARISONS
$80,000
$60,000
Fire/Flame
(N= 1,669)
Scald
(N= 536)
Contact with Hot

Object (N= 186)
Other, Non Burn

(N= 100)

Total N=2,391
71
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Age Group
Table
108
RACE/ETHNICITY
67
RACE/ETHNICITY
Figure
80 and over
Race
Cases
% Valid
White
3,414
73.7%
Black
721
15.6%
Hispanic
217
4.7%
Other
138
3.0%
Asian
131
2.8%
Native American
11
0.2%
Unknown
278
TOTAL
4,910
Race
1
2
3
4
5
6
White
Black
Hispanic
Other
Asian
Native American
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Figure
ETIOLOGY
68
ETIOLOGY
ANALYSIS
BY AGE
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Contact with
Hot Object
Other, Non Burn
Inhalation Only
Burn,
Unspecified
Chemical
Electrical
Skin Disease
Radiation
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
109
72
Etiology
Cases
% Valid
Fire/Flame
2,409
53.3%
Scald
1,096
24.3%
359
7.9%
Other, Non Burn
237
5.2%
Inhalation Only
177
3.9%
Burn, Unspecified
129
2.9%
Chemical
64
1.4%
Electrical
23
0.5%
Skin Disease
18
0.4%
Radiation
0.1%
Unknown
392
TOTAL
4,910
Table
ANALYSIS
BY AGE
GROUP
Analysis
by Age Group
Table
110
80 and over
Inhalation Injury
No
Total
Mean +/Cases
SEM
3,746
13.9+/-0.4
Yes
730
Subtotal
4,476
Missing
434
TOTAL
4,910
Lived
Died
Cases
Mean +/- SEM
Cases
Mean +/- SEM
3,129
13.9+/-0.5
617
#VALUE
347
17.5+/-1.2
383
7.2+/-0.5
12.1+/-0.6
3,476
12.4+/-0.7
1,000
345
12.4+/-0.8
89
3,821
12.5+/-1.9
1,089
Total N=4,910
Table
ANALYSIS OF
CONTRIBUTING
HOSPITALS
111
Count

Pneumonia
Respiratory Failure
Cellulitis
Arrythmia
Septicemia
Renal Failure
Wound Infection
Cardiac arrest
Other Cardiovascular
Total Complications
420
304
271
174
171
151
138
113
103
93
3,371
Percent of All
Complications
12.5
9.0
8.0
5.2
5.1
4.5
4.1
3.4
3.1
2.8
Percent of Patients
with Complication
9.2
6.7
5.9
3.8
3.7
3.3
3.0
2.5
2.3
2.0
Table
TOP TEN PROCEDURES

Count
3,121

16.1
2,237
11.6
1,000
5.2
996
5.1
796
4.1
710
3.7
474
2.4
87.44 Routine chest x-ray, so described
443
2.3
425
2.2
421
2.2
Total Procedures
19,350
Total N=4,910
73
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
112
1
2
3
4
5
6
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
113
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
%TBSA
Cases
Cases
0.1 - 9.9
2,486
10 - 19.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Table
114
%TBSA
Cases
Mean +/- SEM
Mortality Rate
0.1 - 9.9
2,649
11.5+/-0.6
163
6.2
10 - 19.9
753
23.1+/-0.7
546
207
27.5
20 - 29.9
291
22.4+/-1.3
20 - 29.9
111
180
61.9
30 - 39.9
32
118
78.7
30 - 39.9
150
16.6+/-1.9
40 - 49.9
80
89.9
40 - 49.9
89
8.6+/-1.6
50 - 59.9
60
95.2
50 - 59.9
63
3.7+/-0.9
60 - 69.9
38
92.7
60 - 69.9
41
4.6+/-2.5
70 - 79.9
34
97.1
70 - 79.9
35
1.2+/-0.1
80 - 89.9
36
94.7
80 - 89.9
38
1.1+/-0.0
> 90
33
100.0
> 90
33
1.7+/-0.5
Subtotal
3,193
949
22.9
Subtotal
4,142
14.1+/-0.4
Missing or 0%
628
140
18.2
Missing or 0%
768
10.5+/-0.6
TOTAL
3,821
1,089
22.2
TOTAL
4,910
13.5+/-0.3
Total N=4,910
Table
115
Total N=4,910
MS-DRG Code
Cases
Mean +/SEM
1,029
495
$51342+/3604

CC/MCC
692
320
$202771+/12317

CC/MCC
453
148
$119831+/10596
330
167
$58647+/5681

96+ hrs w/o skin graft
285
145
$47261+/7770
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS

(% TBSA)

(% TBSA)
1
2
3
4
5
6
80 and over
Analysis
by Age Group
Total N=2,789
74
Analysis
by Age Group
Figure
69
80 and over

Etiology
Fire/Flame
Scald
40
Contact with
Hot Object
30
ANALYSIS OF
CONTRIBUTING
HOSPITALS
20
10
2004
2005
2006
2007
2008
2009
2010
2011
2012
ANALYSIS OF ALL
U.S. RECORDS
2013
Admission Year
Total N=4,910
Figure
70
$160,000
1
2
3
4
5
6
$140,000
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
$120,000
$100,000
HOSPITAL
COMPARISONS
$80,000
$60,000
Fire/Flame
(N= 1,031)
Scald
(N= 446)
Contact with Hot

Object (N= 169)

Total N=1,646
75
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
The etiology of thermal injury has a significant impact on the

morbidity and mortality of patients admitted to a burn center.
As you will observe in this section of the 2014 National Burn
Repository Report, different burns have different rates across the
varying categories of complications. Likely through differences
in size and severity of injury, the cause of the burn wound has an
impact on hospital length of stay. The demographics of the patients
suffering from burns from various etiologies is also different.
With different mechanisms of injury, there are differences in
the circumstances and environment in which the burn occurs.
Differences in gender also emerge when demographics are analyzed.
Understanding these patterns of different burn etiologies is a key
component in focusing burn prevention strategies.
The reader is reminded that the information in this section
pertains only to inpatient admissions for burns at burn centers.Valid
conclusions regarding the demographics of outpatient burns and
their etiologies cannot be drawn from this report. For example, the
most common surgical procedure performed on all these patients
is excision and skin grafting. This finding clearly suggests that these
patients had a burn severe enough to warrant admission to a burn
center, regardless of the etiology. Burns managed in the outpatient
setting are not currently reported with a central tracking mechanism

in the United States. The NBR report may eventually grow to
include the outpatient burn population in the future.
Analysis
by Etiology
Fire/Flame Injuries
Flame burns continue to be one of the most severe etiologies of thermal injury. They are typically associated with
the highest risk of death and complications compared to all other burn etiologies. The percentage of burn patients with
flame injuries admitted to burn centers in this ten year data set is 46.4%. The circumstances surrounding flame burns
are most commonly non-work related accidents (72.1%), followed by work related injuries (13.2%). Recreational flame
burns are the next most common circumstance occurring in 6.7% of instances (Figure 71, Table 116). Burns caused by
fire most commonly occur in the home (71.8%). The next most common places of occurrence are recreational events
(7.4%) and from industrial accidents (6.8%), depicted in Figure 72 and Table 117.

Accident, Work
Related
Accident,
Recreation
Accident,
Unspecified
Suspected Self
Inflicted
Other
Suspected
Assault/Abuse
Suspected
Arson
Suspected Child
Abuse
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Figure
72
ANALYSIS
BY AGE
ETIOLOGY

Categories of
Place of
Occurrence
Home
Recreation and
Sport
Industrial
Other Specified
Place
Street/Highway
Public Building
Residential
Institution
Farm
Mine/Quarry
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
78
Circumstance of Injury
Cases
Accident, Non-Work Related 49,921
% Valid
72.1%
Accident, Work Related
9,158
13.2%
4,613
6.7%
2,012
2.9%
1,321
1.9%
Other
1,045
1.5%
Suspected Assault/Abuse
787
1.1%
Suspected Arson
210
0.3%
138
0.2%
Unknown
6,240
Total
75,445
Table
117
Place of Occurrence
Cases
% Valid
Home
47,330
71.8%
4,898
7.4%
Industrial
4,474
6.8%
3,940
6.0%
Street/Highway
3,057
4.6%
Public Building
1,094
1.7%
Farm
670
1.0%
414
0.6%
Mine/Quarry
57
0.1%
Unspecified
9,511
Total
75,445
116
{
Categories of
Circumstance
of Injury
ANALYSIS OF
CONTRIBUTING
HOSPITALS
Table
71
1
2
3
4
5
6
Figure
Analysis
by Etiology
Fire/Flame Injuries
Burns caused by flames are typically associated with the highest rate of complications. The complication rate captured
in this report at participating burn centers over the past ten years is 17% (Table 118). As expected, with increasing age,
the rate of complications also increases (Figure 73). Although infants have a slightly higher rate of complications (13.4%),
children over age 1 and young adults under the age of 20 have a reported complication rate that ranges from 7.7-11.3%.
The rate of complications in patients above the age of 20 increases between each age group in a linear fashion (Figure
73). Patients older than 50 have the highest incidence of complications, ranging from 21 to 27.6% as the age groups
increase (Table 118).
Figure
% of Patients with a Clinically Related

Complication
73
PERCENT OF PATIENT WITH CLINICALLY RELEVANT COMPLICATIONS BY AGE GROUP

30%
20%
ANALYSIS OF
CONTRIBUTING
HOSPITALS
10%
ANALYSIS OF ALL
U.S. RECORDS
0-.9
1-1.9
2-4.9
5-15.9
16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
80+
Age Categories
Total N=71,423 (Excluding 4,022 cases from non ABA burn registry software centers or missing/unknown age)
Table
COMPLICATION RATE BY AGE GROUP
118
1
2
3
4
5
6
Age Category
0-.9
1-1.9
2-4.9
5-15.9
16-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80 and Over
Subtotal
Missing
Total
No Complication
# of Cases
376
791
1,848
6,288
4,109
10,409
8,769
9,729
7,967
4,576
2,731
1,666
59,259
0
59,259
Complication
# of Cases
58
66
213
791
523
1,590
1,640
2,142
2,112
1,433
960
636
12,164
0
12,164
Complication Rate
13.4
7.7
10.3
11.2
11.3
13.3
15.8
18.0
21.0
23.8
26.0
27.6
17.0
17.0
79
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
Fire/Flame Injuries
The most common complications reported in patients with flame burns are of an infectious nature. Pneumonia is
the most common infection, occurring at an incidence of 5.8% of all patients and represents approximately 12% of
total complications in this group (Table 119). The next most common complications are urinary tract infections (3.8%)
and cellulitis (3.2%). Catheter-related blood stream infections were reported in only 1.2% of the data set. Despite the
infectious complications, septicemia was only reported in 2.7% of the population.
The most commonly performed procedures on patients with flame burns are excision (17.3%) and grafting (12.1%).
The use of homograft is reported in 6.6% of the procedures. Heterografts make up 3.5% of procedures and dermal
regenerative templates comprise 2.2% of reported procedures. Skin grafts to the hand compose only 2.3% of the
population (Table 120).
119
Count
Percent of All
Complications
Percent of Patients
with Complication
Pneumonia
4,128
11.8
5.8
2,691
7.7
3.8
Respiratory Failure
2,420
6.9
3.4
Cellulitis
2,269
6.5
3.2
Septicemia
1,947
5.6
2.7
Wound Infection
1,685
4.8
2.4
Renal Failure
1,217
3.5
1.7
Arrythmia
989
2.8
1.4
Bacteremia
872
2.5
1.2
862
2.5
1.2
Total Complications
35,049
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Table
120
TOP TEN PROCEDURES
ANALYSIS
BY AGE
ETIOLOGY
1
2
3
4
5
6
Table
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Count
Percent of All
Procedures
59,365
17.2
41,926
12.1
22,777
6.6
20,054
5.8
16,060
4.6
15,507
4.5
12,282
3.5
8,052
2.3
7,508
2.2
99.04 Packed cell transfusion
7,265
2.1
Total Procedures
345,983
Total N=75,445
80
Analysis
by Etiology
Fire/Flame Injuries
Smoke inhalation continues to have a significant impact on the morbidity and mortality of flame burns. Inhalation
injury is present in 16% of patients with flame burns (excluding patients with missing data field). The presence of
smoke inhalation is associated with an overall mortality rate of 22% over the past decade, while the mortality is 3% in
those patients without smoke inhalation. Patients with inhalation injury had almost a 2.2 times longer length of stay
compared to those without inhalation injury (24 days vs. 10 days). With a sub-group analysis of survivors, those with
smoke inhalation have an average length of stay of 24 days, while those without it have an average hospital stay of 10
days. Non-survivors with smoke inhalation injury have a length of stay of 15 days before succumbing to the injury.
Non-survivors of flame burns without inhalation injury have a length of stay of 20 days before death occurs (Table 121).
As expected, the length of hospital stay increases with burn size (%TBSA). The old adage, length of stay is
approximated by %TBSA only holds true in the current data set for all survivors with up to 40% TBSA. The ratio of
length of stay to burn size increases up to 1.3 in the group with 50-80% TBSA, and then evens out to a ratio of 1:1 in
patients with >80% TBSA. For non-survivors, the length of stay is approximately 2.5- 3 weeks those with flame burns
in the 10 -70% TBSA group. Non-survivors with flame burns <10% had a 13 day length of stay. Those who died with
burns > 70% TBSA had an average length of stay of less than two weeks (Table 122).
Table
121
ANALYSIS OF
CONTRIBUTING
HOSPITALS
Total
Lived
Died
Inhalation Injury
Cases
Mean +/- SEM
Cases
Mean +/- SEM
Cases
Mean +/- SEM
No
58,688
10.2+/-0.0
56,945
9.9+/-0.0
1,743
19.9+/-0.8
Yes
10,915
21.9+/-0.3
8,579
23.9+/-0.3
2,336
14.8+/-0.6
Subtotal
69,603
Missing
5,842
TOTAL
75,445
65,524
12.6+/-0.3
4,079
5,450
12.5+/-0.3
70,974
392
14.7+/-1.6
4,471
Total N=75,445
Table
HOSPITAL DAYS: LIVED/DIED BY BURN SIZE GROUP (%TBSA)
% TBSA
0.1 - 9.9
10 - 19.9
20 - 29.9
30 - 39.9
40 - 49.9
50 - 59.9
60 - 69.9
70 - 79.9
80 - 89.9
> 90
Subtotal
Missing or 0%
TOTAL
Cases
42,795
13,164
4,828
2,480
1,513
919
705
446
460
480
67,790
7,655
75,445
Total
Mean +/- SEM
6.0+/-0.0
14.5+/-0.1
25.3+/-0.3
36.1+/-0.6
45.8+/-1.0
48.5+/-1.5
52.3+/-2.0
42.1+/-2.7
28.6+/-2.2
14.1+/-2.1
12.5+/-0.0
7.9+/-0.2
Cases
42,381
12,689
4,339
2,015
1,071
552
362
166
111
38
63,724
7,250
70,974
Lived
Mean +/- SEM
5.9+/-0.0
14.3+/-0.1
25.9+/-0.3
39.6+/-0.7
55.1+/-1.1
67.9+/-1.8
82.1+/-2.8
91.6+/-4.7
82.5+/-6.2
96.9+/-18.0
12.3+/-0.0
7.6+/-0.1
Cases
414
475
489
465
442
367
343
280
349
442
4,066
405
4,471
Died
Mean +/- SEM
13.3+/-0.9
20.1+/-1.1
19.9+/-1.0
20.8+/-1.3
23.3+/-2.0
19.2+/-2.1
20.8+/-2.0
12.7+/-1.7
11.5+/-1.3
7.2+/-1.3
17.1+/-0.4
12.9+/-1.4
Total N=75,445
81
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
122
1
2
3
4
5
6
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
ANALYSIS OF
CONTRIBUTING
HOSPITALS
In Table 123, the mortality of flame burn patients is stratified by age (less than 60 and greater than 60 years old) and
the presence of inhalation injury. For younger patients with burns <20 %TBSA, the presence of smoke inhalation is
associated with a 14 fold increase in mortality (Age < 60: 0.3% mortality without smoke inhalation, 4.1% with smoke
inhalation). For older patients (age > 60), the mortality increases from 4.1% without smoke inhalation to 16.9% with
smoke inhalation, a four-fold increase in mortality.
As burn size increases to 20-40 %TBSA, inhalation injury in the age < 60 years is associated with almost a five fold
increase in mortality (3 vs. 14%). In patients over the age of 60, flame burns are more lethal with an average mortality of
36%. If accompanied by inhalation, the mortality in this age group increases to 57%.
Mortality continues to increase with burn size in the 40 to 60 %TBSA group. In those under the age of 60, the
presence of smoke inhalation doubles the mortality (14.8 vs. 31.1%). In those over the age of 60, the prognosis is grave
with mortality rates of 72.2% without smoke inhalation and 82.5% with smoke inhalation.
As overall mortality rates increase in patients with >60% TBSA burns, the presence of smoke inhalation injury results
in less of a relative increase, as prognosis is worse irrespective of inhalation injury. In patients <60 years old, mortality
increase from 48.7% to 69.0% with inhalation injury. Patients with flame burns > 60% in the age > 60 category are
almost uniformly fatal despite the presence of inhalation injury.
Table
123
MORTALITY RATE FOR MATRIX OF MAIN PREDICTORS
1
2
3
4
5
6
Fire/Flame Injuries
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
TBSA Category
Age
Inhalation Injury
Lived
Died
Mortality Rate
0.1-19.9
0-59.9
No
39,049
112
0.3
0.1-19.9
0-59.9
Yes
3,897
165
4.1
0.1-19.9
60 and Over
No
6,861
297
4.1
0.1-19.9
60 and Over
Yes
1,187
242
16.9
20-39.9
0-59.9
No
3,948
118
2.9
20-39.9
0-59.9
Yes
1,236
198
13.8
20-39.9
60 and Over
No
549
312
36.2
20-39.9
60 and Over
Yes
185
249
57.4
40-59.9
0-59.9
No
858
149
14.8
40-59.9
0-59.9
Yes
552
249
31.1
40-59.9
60 and Over
No
62
161
72.2
40-59.9
60 and Over
Yes
39
184
82.5
60 and Over
0-59.9
No
349
331
48.7
60 and Over
0-59.9
Yes
278
619
69.0
60 and Over
60 and Over
No
136
95.8
60 and Over
60 and Over
Yes
211
97.7
TOTAL
59,061
3,733
5.9
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
82
Analysis
by Etiology
Fire/Flame Injuries
The BAUX score (Age + %TBSA burned) has been a standard to estimate the mortality of burn patients for decades.
Figure 74 demonstrates that an increasing BAUX score is associated with a higher mortality. The effect of gender is also
depicted in this chart. Although there is no statistical analysis, in nearly every BAUX category, there is a higher mortality
in women compared to men. Analyzing Table 124, there is a nearly two fold higher mortality for women with flame
burns (8.8%) compared to men (5.0%). This difference is statistically significant (Chi-squared, p < 0.0001).
Traditionally, a BAUX score > 100 was associated with a mortality of > 50%. This holds true in this table, however, a
BAUX score of 100 to 110 in woman has a mortality rate of 58% vs. a mortality rate of 44.5% in men. This difference is
also statistically different (Chi-squared, p < 0.001). This finding has been previously reported, but the role of gender, sexhormones, and immune response have not been fully defined.
Although it appears that men have a survival advantage, men are more likely to be admitted with a flame-burn injury.
Men are responsible for 76.4% of burn center admissions for flame burns.
Female
Figure
Male
74
100%
80%
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
60%
40%
ANALYSIS OF ALL
U.S. RECORDS
20%
.1-9.9
1019.9
2029.9
3039.9
4049.9
5059.9
6069.9
7079.9
8089.9
9099.9
100109.9
110- 120- 130119.9 129.9 139.9
140+

Table
124
ANALYSIS
BY AGE
GROUP
Female
Male
Lived
Died
Lived
Died
0-9.9
10-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80-89.9
90-99.9
100-109.9
110-119.9
120-129.9
130-139.9
140 and Over
Total
1,073
1,124
1,636
1,820
2,145
2,532
2,008
1,474
982
509
156
55
13
5
5
15,537
9
9
12
24
36
59
98
125
187
188
223
159
124
94
155
1,502
1,899
4,203
8,029
7,930
8,038
8,126
6,257
3,918
2,357
1,056
437
163
60
20
15
52,508
9
12
18
31
72
97
176
222
307
363
351
347
273
210
300
2,788
83
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
Scald Injuries
In Figure 75 and Table 125, the majority of scald burns occur as non-work related accidents (79%). The next most
common etiology is work related accidents (11%). The location of these injuries, as expected, occurs at home (84%) and
the workplace (6%). Approximately 2.4 % of scald admissions are suspect for child abuse and 1.5% is the result of an
assault (Figure 75, Table 125).
1
2
3
4
5
6
Categories of
Circumstance
of Injury
Accident, Work
Related
Accident,
Unspecified
Suspected Child
Abuse
Other
Suspected
Assault/Abuse
Accident,
Recreation
Suspected Self
Inflicted
Suspected
Arson
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Figure
76
Categories of
Place of
Occurrence
ANALYSIS
BY AGE
ETIOLOGY
Home
Industrial
Public Building
Other Specified
Place
Street/Highway
Residential
Institution
Recreation and
Sport
Farm
Mine/Quarry
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
84
125
Cases
% Valid
79.4%
6,025
11.0%
1,759
3.2%
1,301
2.4%
Other
927
1.7%
814
1.5%
385
0.7%
61
0.1%
Suspected Arson
0.0%
Unknown
4,320
Total
59,099
Table
126
Place of Occurrence
Cases
% Valid
Home
45,545
83.8%
Industrial
3,286
6.0%
Public Building
1,989
3.7%
1,615
3.0%
Street/Highway
927
1.7%
466
0.9%
389
0.7%
Farm
105
0.2%
Mine/Quarry
31
0.1%
Unspecified
4,746
Total
59,099
Table
75
Figure
Analysis
by Etiology
Scald Injuries
The overall complication rate of admitted scald burns (7.8%) is less than half of patients admitted with flame burns
(17%, Table 127 & 118). As with flame burns, the incidence of complications increases with age of the patient burned
(Figure 77). For patients admitted with scald burns under 30 years of age, the complication rate is approximately 5 to
6%. In patients with scald burns between 30 and 80 years of age, the incidence of complications is between 8 and 18%.
Patients with scalds over 80 %TBSA have a complication rate of 26% (Table 127).
Figure

Complication
77

30%
20%
ANALYSIS OF
CONTRIBUTING
HOSPITALS
10%
ANALYSIS OF ALL
U.S. RECORDS
0-.9
1-1.9
2-4.9
5-15.9 16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
80+
Age Categories
Total N=56,956 (Excluding 2,143 cases from non ABA burn registry software centers or missing/unknown age)
Table
127
1
2
3
4
5
6
Age Category
0-.9
1-1.9
2-4.9
5-15.9
16-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80 and Over
Subtotal
Missing
Total
No Complication
# of Cases
4,466
8,552
6,211
5,697
2,149
6,699
5,252
5,377
4,105
2,111
1,089
801
52,509
0
52,509
Complication
# of Cases
325
436
366
228
128
462
459
592
574
368
235
274
4,447
0
4,447
Complication Rate
6.8
4.9
5.6
3.8
5.6
6.5
8.0
9.9
12.3
14.8
17.7
25.5
7.8
7.8
85
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
The top complications of scald burn admissions are also infections.The most common infection is cellulitis occurring at a
reported incidence of 2.6% and making up 18% of all scald complications.The next most common infection is urinary tract
infections occurring at a rate of 1.6%. Septicemia is a rare complication, occurring at a rate of 0.4%.
The most common surgical procedure performed on patients with scald injuries is still excision and skin grafting reported
in 20% and 14% of cases, respectively.This number is similar to the incidence of excision and grafting for flame burns
(18%, 13%,Table 120).This is not surprising, since these are scalds requiring admission to a burn center. Non-excisional
debridement of burn injuries and application of dressings is the third most common procedure performed on these patients,
reported approximately 12% of the time.The use of homograft in scald burns is reported at a rate of 6% (Table 129), which
is similar to the utilization in flame burn patients (6.5%,Table 120).The use of heterografts is reported in 4.7% of procedures
and dermal regenerative templates are reported in 2.9% of procedures on scald burn patients.This is higher than that of flame
burn patients (3.6% heterografts; 2.3% dermal templates,Table 120). Also, the use of skin grafts to the hand also is reported at
a rate of approximately 2.2%, which is similar to flame burn patients with a procedural rate of 2.3% (Table 120).
Table
128
1
2
3
4
5
6
Scald Injuries
Count
Percent of All
Complications
Percent of Patients with

Complication
Cellulitis
1500
17.8
2.6
927
11.0
1.6
Pneumonia
552
6.6
1.0
Wound Infection
523
6.2
0.9
Respiratory Failure
322
3.8
0.6
Septicemia
240
2.9
0.4
Arrythmia
224
2.7
0.4
217
2.6
0.4
Renal Failure
211
2.5
0.4
Bacteremia
191
2.3
0.3
Total Complications
8,413
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Table
TOP TEN PROCEDURES
129
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Count
Percent of All
Procedures
25,441
19.4
17,274
13.2
15,641
11.9
13,746
10.5
8,309
6.3
6,115
4.7
3,805
2.9
3,784
2.9
2,846
2.2
2,057
1.6
Total Procedures
131,109
Total N=59,099
86
Analysis
by Etiology
Scald Injuries
The overall mortality of scald burn patients admitted to participating burn centers is 0.7%. This is significantly less
with flame burns with (31%) and without (3%) smoke inhalation injury (Table 121 & 122). As with flame burns, hospital
length of stay also increases with burn size. In patients that survive their injury, the rule of thumb of hospital stay equal
to the %TBSA burned does not apply for burn sizes > 10 %TBSA. For patients with scalds covering between 10 to 30
%TBSA, the length of stay is 0.6 days per %TBSA. For patients with scalds between 30 and 70 %TBSA, the length of
stay is approximately 0.8-0.9 days per %TBSA. There are too few patients with burn sizes greater than 70 %TBSA to
draw any conclusions about the relationship between burn size and LOS.
Non-survivors of scald injuries involving < 10 %TBSA have a length of stay of one month. The non-survivors of
scald injuries between 10 and 30 %TBSA survive approximately 3 weeks prior to succumbing to their injury. The length
of stay for non-survivors of scald burns from 30 to 60% TBSA ranges from one to two weeks. Interestingly, the length of
hospital stay for non-survivors of scald burns from 30 to 60 %TBSA is shorter than than the same size burn in patients
with flame burns.
Table
130
Total
Lived
ANALYSIS OF
CONTRIBUTING
HOSPITALS
Died
% TBSA
Cases
Mean +/- SEM
Cases
Mean +/- SEM
Cases
Mean +/- SEM
0.1 - 9.9
44,275
4.9+/-0.0
44,193
4.9+/-0.0
82
28.9+/-4.4
10 - 19.9
7,882
9.8+/-0.1
7,793
9.6+/-0.1
89
21.2+/-2.2
20 - 29.9
1,579
17.2+/-0.3
1,527
17.1+/-0.3
52
21.2+/-3.3
30 - 39.9
502
28.6+/-1.0
458
30.0+/-1.1
44
14.1+/-2.9
40 - 49.9
180
32.3+/-2.0
147
35.7+/-2.2
33
17.1+/-3.2
50 - 59.9
76
35.3+/-3.2
59
40.0+/-3.7
17
19+/-5.4
60 - 69.9
52
50.6+/-7.1
42
58+/-8.1
10
19.9+/-10.1
70 - 79.9
26
48.4+/-12.2
17
66.3+/-16.8
14.5+/-7.4
80 - 89.9
31
15.2+/-6.3
22
9.3+/-3.1
29.7+/-20.3
> 90
20
12.1+/-5.6
13
17.5+/-8.4
2+/-0.5
Subtotal
54,623
6.4+/-0.0
54,271
6.3+/-0.0
352
21.3+/-1.5
Missing or 0%
4,476
4.5+/-0.1
4,452
4.4+/-0.1
24
16.1+/-4.0
TOTAL
59,099
58,723
1
2
3
4
5
6
376
Total N=59,099
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
87
Analysis
by Etiology
Scald Injuries
In Figure 78, as with flame burns admissions, a higher BAUX score is associated with a higher mortality. Again, there
appears to be a higher mortality in women with BAUX scores > 100 that were admitted with scalds.
Scald injuries are much less lethal than flame burns. The overall mortality is 0.7%. When stratified by gender, again,
there is a survival advantage of men over women. The mortality for woman admitted with scald burns is 0.73% whereas
the observed mortality in men admitted with scalds is 0.56%. In scald injuries, a BAUX score of 100 to 110 is associated
with a similar mortality rate in both men and women (31.3% men vs. 33% women).
Interestingly, the gender ratio of scald burn admissions is different than flame burn admissions. The percentage of men
admitted with scald burns is 59%, while the percentage of women is 41%. This ratio is nearly one to one, where as it is
approximately three to one (male to female) for flame burns.
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
78
Male

80%
1
2
3
4
5
6
Female
Figure
60%
40%
20%
0-9.9
1019.9-
20.29.9
3039.9
4049.9
5059.9
6069.9
7079.9
8089.9
9099.9
100109.9

ANALYSIS
BY AGE
GROUP
Table
131
ANALYSIS
BY AGE
ETIOLOGY
Female
Male
Lived
Died
Lived
Died
0-9.9
10-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80-89.9
90-99.9
100-109.9
110- and Over
Total
6,839
4,358
2,880
2,449
2,366
2,083
1,456
937
627
323
69
12
24,399
1
2
2
6
11
4
16
10
9
44
34
41
180
8,964
4,982
4,438
3,790
3,524
3,197
1,921
989
485
197
46
29
32,562
2
4
3
2
9
11
20
27
25
25
21
36
185
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
88
110+
Analysis
by Etiology
Contact with Hot Object Injuries
Contact burns from touching a hot object are extremely common, but only make up 9% of all the data in the registry for this
decade of reporting burn centers.Again, this injury is typically managed as an outpatient, so the reader is reminded to keep that fact
in mind when interpreting the demographics of this patient population. Contact burns, as with flame and scald burns, are frequently
non-work related accidents (79%).The next most common circumstances of contact burns are work related accidents and accidents
involving recreational activities, each approximately 7% (Figure 79,Table 132).The majority of these injuries occur at home (75%,
Figure 80,Table 133) with the second most common frequency associated with sports and recreation (8%). Contact burns can be
commonly associated with motor vehicle and motor cycle accidents (6%) or occur in the workplace (4.6%).
Categories of
Circumstance
of Injury
Accident,
Recreation
Accident, Work
Related
Other
Accident,
Unspecified
Suspected Child
Abuse
Suspected
Assault/Abuse
Suspected Self
Inflicted
80
Cases
Figure
Table
132
79
Home
Recreation and
Sport
Street/Highway
Industrial
Other Specified
Place
Public Building
Residential
Institution
Farm
Mine/Quarry
89
78.9%
1,012
7.0%
976
6.8%
Other
354
2.5%
326
2.3%
202
1.4%
113
0.8%
62
0.4%
Unknown
1,177
Total
15,623
Categories of
Place of
Occurrence
% Valid
Table
133
Figure
Place of Occurrence
Cases
% Valid
Home
10,521
74.6%
1,118
7.9%
Street/Highway
819
5.8%
Industrial
650
4.6%
572
4.1%
Public Building
283
2.0%
79
0.6%
Farm
57
0.4%
Mine/Quarry
0.1%
Unspecified
1,516
Total
15,623
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
As with both flame and scald injuries, the risk of complications increase as the patient gets older. The overall incidence
of complications in contact burn admissions is 7.4%. This is similar to the rate observed in scald burns (7.8%, Table
127). The incidence of complications is 3 to 4% in patients under the age of 16. From age 16 to 40, the incidence of
complications increases to 6 to 10%. The complication rate continues to increase exponentially from a rate of 12.7%
for contact burns in the 40 to 49 year old group up to a rate of 23% in patients over 80 years of age (Table 134). This
progression is very similar to that observed in patients with scald burns (Table 127).
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
81
{
Complication
1
2
3
4
5
6
Figure
30%
20%
10%
0-.9
1-1.9
2-4.9
5-15.9 16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
80+
Age Categories
ANALYSIS
BY AGE
GROUP
Total N=14,848 (Excluding 775 cases from non ABA burn registry software centers or missing/unknown age)
Table
134
ANALYSIS
BY AGE
ETIOLOGY
Age Category
0-.9
1-1.9
2-4.9
5-15.9
16-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80 and Over
Subtotal
Missing
Total
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
No Complication
# of Cases
1,753
2,799
1,807
1,355
469
1,188
1,037
1,187
1,037
558
297
264
13,751
0
13,751
Complication
# of Cases
60
73
62
48
30
109
109
173
165
106
84
78
1,097
0
1,097
Complication Rate
3.3
2.5
3.3
3.4
6.0
8.4
9.5
12.7
13.7
16.0
22.0
22.8
7.4
7.4
90
Analysis
by Etiology
The complications reported with contact burns are very similar to those of scald burns. The most frequent complication
is cellulitis with a reported incidence of 2.5% of admitted contact burns and represents 17.3% of all complications. The
next most common infection is a urinary tract infection with a reported incidence of 1.3% of contact burn patients. As
with scalds, sepsis is a rare complication occurring 0.4% of the time.
The most commonly reported procedure for contact burns, as with both flame burns and scalds, is excision and grafting
(20%, 13% respectively). Again, as in the previous two sections, homograft has a reported use of 6%, heterograft use of
2.5% and dermal templates have a procedural incidence of 3%. Skin grafts to the hand are, expectedly, more common
occurring at a rate of 2.3%. Of note, full thickness skin grafts make up approximately one-third of hand grafts reported.
Table
135
Count
Percent of All
Complications
Percent of Patients
with Complication
Cellulitis
368
17.3
2.5
197
9.2
1.3
Wound Infection
134
6.3
0.9
Pneumonia
118
5.5
0.8
Respiratory Failure
84
3.9
0.6
Skin Graft Loss, Other
69
3.2
0.5
68
3.2
0.5
Renal Failure
60
2.8
0.4
Septicemia
56
2.6
0.4
Surgical Site Infection, Deep
50
2.3
0.3
Total Complications
2,131
TOP TEN PROCEDURES
136
Count
Percent of All
Procedures
7,514
20.2
4,878
13.1
3,874
10.4
3,505
9.4
2,368
6.4
1,034
2.8
942
2.5
849
2.3
833
2.2
532
1.4
Total Procedures
37,250
Total N=15,623
91
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Table
1
2
3
4
5
6
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
Although there are many similarities in the demographics of scald and contact burns, contact burns are significantly
smaller in size. The most frequent size reported is < 10%, compromising 96% of all contact burns. This is also the most
common size category of scald burns, but only 80% of the reported scald burns fall into the 0 to 10 %TBSA category. As
with scalds, the mortality rate of contact burns is extremely small, reported at 0.7%.
The estimated length of stay of contact burn survivors based on burn size approximates one day for each %TBSA burned
for burn sizes up to 30%. There are too few numbers to draw meaningful conclusions for contact burns greater than 30
%TBSA. Non-survivors with contact burns measuring < 10% spend approximately three weeks in the hospital. This is one
week shorter than the scald burn non-survivors and one week longer than the flame injury non-survivors. This difference
in length of stay for non survivors of flame, scald and contact burns with burn sizes less than 10 %TBSA merits further
investigation. Non-survivors of contact burns with a 10 to 40 %TBSA involvement survive an average of one to two weeks.
This is less than either flame or scald burn non-survivors.
Table
137
1
2
3
4
5
6
Total
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Lived
Died
% TBSA
Cases
Mean +/- SEM
Cases
Mean +/- SEM
Cases
Mean +/- SEM
0.1 - 9.9
13,736
5.6+/-0.1
13,669
5.5+/-0.1
67
23.1+/-3.4
10 - 19.9
460
18.7+/-0.8
439
18.9+/-0.9
21
15.5+/-4.3
20 - 29.9
56
23.5+/-3.1
49
26.1+/-3.4
5+/-1.8
30 - 39.9
21
29+/-6.2
13
39+/-8.5
12.7+/-5.3
40 - 49.9
26.3+/-12.8
35.5+/-15.5
50 - 59.9
93+/-17
93+/-17
60 - 69.9
70 - 79.9
67+/-4
67+/-4
80 - 89.9
1.5+/-0.5
1.5+/-0.5
> 90
Subtotal
14,283
6.1+/-0.1
14,179
6.0+/-0.1
104
19.4+/-2.5
Missing or 0%
1,340
4.9+/-0.2
1,334
4.9+/-0.2
12.8+/-5.2
TOTAL
15,623
15,513
110
Total N=15,623
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
92
Analysis
by Etiology
Electrical Injuries
Although one of the most devastating and debilitating injuries cared for in burn centers, electrical injuries only
compromise 4% of all the reported etiologies in this years review. Also, the reader is reminded that all types of electrical
injuries are pooled into this analysis making broad interpretation of these findings difficult. The low voltage contact
burn will obviously behave much differently than an electrical flash or electrical conduction burn. The majority of these
burns occur in industry (39.5%) with the second most common place of occurrence being the home (30.2%). Similar to
chemical burns, the majority of these injuries were reported under work-related circumstances (61%), with only 33%
of these accidents occurring in a non-work related scenario.
Accident, Work
Related
Accident,
Unspecified
Accident,
Recreation
Other
Suspected Self
Inflicted
Suspected
Assault/Abuse
Suspected Child
Abuse
83
138
{
Categories of
Circumstance
of Injury
Figure
Table
82
Cases % Valid
3,638
61.1%
Accident, Non-Work Related
1,960
32.9%
163
2.7%
106
1.8%
Other
66
1.1%
18
0.3%
0.1%
0.0%
Unknown
591
Total
6,546
Categories of
Place of
Occurrence
Industrial
Home
Other Specified
Place
Street/Highway
Public Building
Recreation and
Sport
Farm
Residential
Institution
Mine/Quarry
93
Table
139
Figure
Place of Occurrence
Cases
% Valid
Industrial
2,160
39.5%
Home
1,652
30.2%
670
12.2%
Street/Highway
348
6.4%
Public Building
313
5.7%
176
3.2%
Farm
81
1.5%
53
1.0%
Mine/Quarry
21
0.4%
Unspecified
1,072
Total
6,546
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
Electrical Injuries
Unlike flame, scald, and contact burns (Figures 73, 77 & 81), there is no correlation between age and risk of
complication (Figure 84). The overall complication rate (10.6%) is higher in electrical burns than either scalds (7.8%,
Table 127) and contact burns (7.4%, Table 134), but less than flame burns (17%, Table 118). The complication rate in
patients over the age of 60 is approximately 12%. The lowest rates of complications are in 1 to two year olds (2%) and
2 to 5 year olds (1.9%). It is possible that the complications are lower in these children since they most likely represent
electrical contact burns and not electrical conduction burns. The electrical burn admissions in the 16 to 60 year old
group are more likely to have electrical conduction injuries since this age compromises the demographic of the work
force. Still, there is likely a great deal of variability in this population because electrical shocks, electrical contacts, and
electrical conduction injuries are all pooled in this section.
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
84
{
1
2
3
4
5
6
Figure
15%
10%
0-.9
1-1.9
2-4.9
5-15.9
16-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60+
Age Categories
ANALYSIS
BY AGE
GROUP
Table
140
ANALYSIS
BY AGE
ETIOLOGY
5%
Age Category
0-.9
1-1.9
2-4.9
5-15.9
16-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60 and Over
Subtotal
Missing
Total
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
No Complication
# of Cases
40
100
265
380
195
1,108
1,200
1,243
768
262
5,561
0
5,561
Complication
# of Cases
4
2
5
37
24
169
164
141
77
36
659
0
659
Complication Rate
9.1
2.0
1.9
8.9
11.0
13.2
12.0
10.2
9.1
12.1
10.6
10.6
94
Analysis
by Etiology
Electrical Injuries
The most common complication reported in patients with electrical injuries is pneumonia (2.5%). This is followed
by cellulitis (1.8%) and wound infection (1.7%). Septicemia is less common in this burn etiology subset (1.5%) than in
flame burns (2.7%, Table 119), but more common than scald burns, and contact burns ( both 0.4%, Table 128 and 135).
Renal failure remains an infrequent complication in electrical burns (0.9%) but again, this may be due to the fact that
minor electrical injuries are included in this analysis.
As with all other burn etiologies, excisional debridement and skin grafting remain the most commonly performed
surgical procedure after electrical burn, encompassing 17% and 10% of all procedures, respectively. The use of homograft
is also similar to other burn types and is reported in 6.0% of procedures. The reported operative use of heterografts is
2.6% and dermal templates is 1.9%. Skin grafts to the hand represent 2.2% of procedures.
Table
141
Count
Pneumonia
Cellulitis
Wound Infection
Septicemia
Respiratory Failure
Renal Failure
Arrythmia
ARDS
Total Complications
157
111
103
91
77
66
54
52
34
33
1,498
Percent of All
Complications

Complication
10.5
7.4
6.9
6.1
5.1
4.4
3.6
3.5
2.3
2.2
2.5
1.8
1.7
1.5
1.2
1.1
0.9
0.8
0.5
0.5
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
Table
TOP TEN PROCEDURES
142
Count
4,107
Percent of All
Procedures
16.7
2,382
9.7
1,471
6.0
1,324
5.4
1,158
4.7
849
3.5
629
2.6
551
2.2
473
1.9
99.04 - Transfusion of packed cells
402
1.6
Total Procedures
24,594
Total N=6,546
95
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
Electrical Injuries
Figure 85 is a graphical representation of the distribution of gender for each age category from electrical injuries
in this data set. It is clear that this injury is seen nearly exclusively in men in all age groups. The most common age
represented is from the ages 20 and 60. Again, this represents the work force demographic that will likely sustain and
electrical injury.
ANALYSIS OF
CONTRIBUTING
HOSPITALS
85
Male
1,250
1,000
750
Cases
ANALYSIS OF ALL
U.S. RECORDS
Female
Figure
1
2
3
4
5
6
FREQUENCY OF RECORDS BY AGE CATEGORIES AND GENDER
500
250
ANALYSIS
BY AGE
GROUP
0-.9
1-1.9
2-4.9
5-15.9
16-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
Age Categories
Total N=6,546
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
96
70-79.9
80+
Analysis
by Etiology
Chemical Injuries
The chemical burn etiology section has only been included in the National Burn Repository Annual Report for a few
years.The demographics of these patients mirror those of electrical burns. This category also consists of pooled data of
varying types of chemical agents.The caustic injuries of acids are combined with the liquefaction destruction of alkali burns
as well as other different types of chemical irritants. Again the reader is reminded of this fact when reviewing this data.This
important injury represents 3.6% of the data set. Chemical injuries tend to most commonly occur at home (41.2%), while
37.3% of them are industrial. Injuries from chemical burns are work related accidents in 47.4% of reported instances and
non-work related in 43.4% of the data population.
Accident, Work
Related
Suspected
Assault/Abuse
Accident,
Unspecified
Suspected Self
Inflicted
Other
Suspected Child
Abuse
Accident,
Recreation
Suspected
Arson
87
143
{
Categories of
Circumstance
of Injury
Figure
Table
86
Cases % Valid
2,516
47.4%
Accident, Non-Work Related
2,303
43.4%
143
2.7%
92
1.7%
91
1.7%
Other
66
1.2%
50
0.9%
41
0.8%
Suspected Arson
0.0%
Unknown
535
Total
5,839
Categories of
Place of
Occurrence
Home
Industrial
Other Specified
Place
Public Building
Street/Highway
Farm
Recreation and
Sport
Residential
Institution
Mine/Quarry
97
Table
144
Figure
Place of Occurrence
Cases
% Valid
Home
2,026
41.2%
Industrial
1,834
37.3%
347
7.1%
Public Building
261
5.3%
Street/Highway
198
4.0%
Farm
82
1.7%
77
1.6%
70
1.4%
Mine/Quarry
24
0.5%
Unspecified
920
Total
5,839
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
Chemical Injuries
As depicted in Figure 88, there is a predictable increase in the rate of reported complications in chemical burns with
increasing age. The complication rate in patients under the age of 20 ranges from 2.4-6.4%; between the age of 20 and
60, the range increases to 6.6-9.3%. Above the age of 60, the complication rate reported is 11.8 to 19.7%. Even though
the chemical burn category pools different types of chemical injuries, the population is likely more homogeneous
than the electrical burn category. A possible explanation is that the anatomic distribution, burn depth and medical care
required for different chemical injuries is relatively consistent when compared to the vast array of potential electrical
injury manifestations.
Figure
ANALYSIS OF
CONTRIBUTING
HOSPITALS
20%

1
2
3
4
5
6
88
15%
10%
5%
ANALYSIS OF ALL
U.S. RECORDS
1-1.9
2-4.9
5-15.9 16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
80+
Age Categories
Table
145
ANALYSIS
BY AGE
GROUP
0-.9
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
No Complication
Complication
Age Category
# of Cases
# of Cases
Complication Rate
0-.9
74
5.1
1-1.9
160
2.4
2-4.9
129
5.1
5-15.9
191
13
6.4
16-19.9
231
14
5.7
20-29.9
930
66
6.6
30-39.9
1,091
86
7.3
40-49.9
1,125
94
7.7
50-59.9
758
78
9.3
60-69.9
283
38
11.8
70-79.9
86
15
14.9
80 and over
49
12
19.7
Subtotal
5,107
431
7.8
Missing
Total
5,107
431
98
7.8
Analysis
by Etiology
Chemical Injuries
Cellulitis is the most common complication reported after a chemical burn, reported after 2.3% of injuries. This
rate of cellulitis is similar to those injuries seen with scalds (2.6%, Table 128). Pneumonia and wound infection are
the next two most common infectious complications, each occurring a rate of 1.1%. This rate has decreased for both
complications over the past several years. Sepsis is rare with after chemical burn, being reported at a rate of 0.8%.
Table
146
Count
Cellulitis
Pneumonia
Wound Infection
Respiratory Failure
Septicemia
Renal Failure
Arrythmia
Other Hematologic
Total Complications
125
60
59
57
51
43
25
22
22
22
820
Percent of All
Complications

Complication
15.2
7.3
7.2
7.0
6.2
5.2
3.0
2.7
2.7
2.7
2.3
1.1
1.1
1.0
0.9
0.8
0.5
0.4
0.4
0.4
ANALYSIS
BY AGE
GROUP
TOP TEN PROCEDURES
147
Count
Percent of All
Procedures
2,445
21.5
1,772
15.6
1,072
9.4
952
8.4
791
7.0
460
4.0
428
3.8
314
2.8
197
1.7
33.22 fiberoptic bronchoscopy
194
1.7
Total Procedures
11,375
Total N=5,839
99
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
Table
1
2
3
4
5
6
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
by Etiology
Chemical Injuries
In this gender stratified histogram, depicted in Figure 89, chemical burns occur predominantly in men. The peak
frequency is between the ages of 20 and 60. This also parallels what is observed in patients with electrical burns. It is also
the age demographic of the work force population. In children under the age of 16 and adults greater than 70, the male
to female ratio of chemical injuries is closer to 1:1.
ANALYSIS OF
CONTRIBUTING
HOSPITALS
89
Female
Male
1,000
800
600
Cases
1
2
3
4
5
6
Figure
FREQUENCY OF RECORDS BY AGE CATEGORIES AND GENDER
400
200
ANALYSIS OF ALL
U.S. RECORDS
0-.9
1-1.9
2-4.9
5-15.9
16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
Age Categories
Total N=5,839
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
100
80+
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
THIS PAGE INTENTIONALLY LEFT BLANK
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
101
Hospital
Comparisons
The analyses on the next three pages provide

comparisons for treatment of fire/flame injuries
in participating burn centers.The figures compare
unadjusted mortality, charges and length of stay across
participating centers.
The centers are grouped into three categories based
on the annual volume of submitted cases in 2010-2013.
Low volume centers reported an average of less than
100 initial admissions per year (n=15); medium volume
centers reported an average of 100-300 initial admissions
per year (n=50) and high volume centers reported
greater than 300 initial admissions per year (n=23).
Ninety-three hospitals are represented in total. All data
are de-identified to protect against direct comparison
between centers.The data are unadjusted, and thus, do
not take into consideration other patient characteristics
that have been widely accepted to impact outcomes.
Without risk adjustment, comparative analysis may have
limited value.
The nature of the registry is such that data is
not strictly standardized and the data entry is not

independently audited.This also limits the comparative
value of the data. However, this data suggests that
significant variability in practice, mortality and cost
of care may exist and should provide impetus to
investigators to explore the causes of such variability.
Much work remains to bring the collection of data
into a context where risk adjustment is possible and
definitions are standardized, to allow reliable comparisons
as well as benchmarking of the performance of
individual centers.These analyses are a beginning, and
they point the way to the delivery of more precise and
actionable information in the future.
Hospital
Comparisons
Figure 90 compares the raw mortality rates for fire/flame cases admitted from 2010-2013. Each blue bar
represents the mean percent TBSA for fire/flame burns from one burn center. The left y-axis depicts the percent
TBSA. The right y-axis provides depicts the percent mortality scale. The red dots represent the mortality rate for
each burn center. The red lines represent the 95% confidence interval for the mortality rate. Although the data is
not risk-adjusted, it suggests that while mean percent TBSA does not significantly differ between the thee groups
of hospitals (low, medium and high volume hospitals) a significant difference in mortality rates does exist. The
data suggests an inverse relationship, lower mortality rates are seen in hospitals with higher volume of admissions.
In addition, higher volume hospitals have less variability in mortality rates when compared to medium and low
volume hospitals.
0%
5%
10%
15%
20%
25%
30%
90
Figure
ANALYSIS
BY AGE
ETIOLOGY
10
20
30
40
50
60
70
80
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
90
100
LOW VOLUME
HOSPITAL
COMPARISONS
Mean Percent Total Burn Surface Area
104
Total N=31,257
Facilities
ANALYSIS
BY AGE
GROUP
ANALYSIS OF ALL
U.S. RECORDS
MEDIUM VOLUME
2010-2013 FIRE/FLAME INJURIES -- MORTALITY RATE
ANALYSIS OF
CONTRIBUTING
HOSPITALS
HIGH VOLUME
Mean TBSA
Mortality Rate
1
2
3
4
5
6
Mortality Percentage with 95% Cl
Hospital
Comparisons
Figure 91 depicts hospital charges for fire/flame cases admitted from 2010-2013. Since some centers do not
report charge information a smaller size is present (i.e., fewer blue bars) . The left y-axis depicts the mean percent
TBSA scale. The right y-axis depicts total charges. Red dots represent the mean total charges per case. The red
lines depict the 95% confidence interval for mean charges. Outliers are not shown in this graph, but were used in
the calculation of estimated means for each center. Charges are not adjusted for mean burn size. The data suggests
that significant differences in charges may exist between hospital group (low, medium and high volume hospital);
and charges may be independent of mean percent TBSA.
$0
$50,000
$100,000
$150,000
$200,000
$250,000
$300,000
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
Total N=13,571
MEDIUM VOLUME
Facilities
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
91
Figure
2010-2013 FIRE/FLAME INJURIES -- MEAN CHARGES
HIGH VOLUME
Mean TBSA
Mean Charges
Mean Hospital Charges with 95% Cl
10
20
30
40
50
60
70
80
90
100
LOW VOLUME
HOSPITAL
COMPARISONS
105
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Hospital
Comparisons
Figure 92 depicts mean (hospital) length of stay (LOS) for fire/flame cases admitted between 2010-2013. The left
y-axis depicts mean percent TBSA. The right y-axis depicts LOS. Red dots represent mean LOS for each facility. Red
bars represent the 95% confidence interval for each mean LOS.
LOS varies significantly more amongst low volume burn centers when compared to medium and high volume burn
centers. Outliers may have significant impact on estimated mean LOS. The effect of outliers may be more pronounced
in centers with lower reported admission volumes. Outliers are not shown in this graph.
10
15
20
25
30
10
20
30
40
50
60
70
80
90
100
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
106
Total N=31,257
Facilities
92
LOW VOLUME
HOSPITAL
COMPARISONS
Figure
ANALYSIS
BY AGE
ETIOLOGY
35
40
ANALYSIS
BY AGE
GROUP
ANALYSIS OF ALL
U.S. RECORDS
MEDIUM VOLUME
2010-2013 FIRE/FLAME INJURIES -- MEAN LENGTH OF STAY
ANALYSIS OF
CONTRIBUTING
HOSPITALS
HIGH VOLUME
Mean TBSA
Mean LOS
1
2
3
4
5
6
Mean Length of Stay with 95% Cl
Hospital
Comparisons
0%
10%
20%
30%
40%
50%
60%
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
Total N=71,423
Facilities
MEDIUM VOLUME
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
93
Figure
HIGH VOLUME
Mean TBSA
Percent of Cases with a Complication
2010-2013 FIRE\FLAME INJURIES COMPLICATION RATE
Complication Rate
Figure 93 depicts complication rates for fire/flame cases submitted between 2010-2013. The left y-axis depicts
mean percent TBSA. The right y-axis depicts the complication rate. Red dots represent the complication rate
for each center. Red bars represent the 95% confidence interval for complication rates. Since the reporting
of complications is unaudited it may be the least valid and reliable reported data. Standard definitions of
complication and rigorous application of those definitions are warranted to ensure comparable data and broad
comparisons. In spite of these limitations, there appears to be significant variability in reported complication rates
that is largely independent of both mean burn size and admission volume.
10
20
30
40
50
60
70
80
90
100
LOW VOLUME
HOSPITAL
COMPARISONS
107
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
of International Records
61
This years NBR report includes 2,569 International records which represents the cumulative admissions
between 2004 and 2013 that met all ABA edit check criteria. This number of records is compared to 191,848
records from the United States.
Four Canadian and two Swedish centers have submitted data to the NBR. These International centers are
typically smaller than U.S. centers and have an average volume of 120 admissions annually. Additionally, not all
international burn centers have submitted on a yearly basis.
ABA has members throughout the world and the NBR encourages all participating burn centers to submit
their data to the registry.
Analysis
Figure 94 and Table 148 show the number of admissions by age and gender. The male/female distribution is fairly
even in those younger than five or older than 80 years of age, however males outnumber females in all other age
categories (73% of all records are male).
ANALYSIS OF
CONTRIBUTING
HOSPITALS
Male
300
200
100
0-.9
ANALYSIS OF ALL
U.S. RECORDS
1-1.9
2-4.9
5-15.9
16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9
80+
Age Categories
Table
148
AGE GROUP BY GENDER
ANALYSIS
BY AGE
GROUP
94
Female
400
Cases
1
2
3
4
5
6
Figure
AGE GROUP BY GENDER
Age Categories
0-.9
1-1.9
2-4.9
5-15.9
16-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80 and over
Subtotal
Missing
Total
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Count
72
105
63
135
139
422
360
418
356
242
157
100
2,569
0
2,569
Total
Column N %
2.8
4.1
2.5
5.3
5.4
16.4
14.0
16.3
13.9
9.4
6.1
3.9
100.0
0.0
100.0
Gender
Female
Count
Column N %
Count
31
4.5
41
42
6.0
63
34
4.9
29
40
5.7
95
25
3.6
114
85
12.2
337
73
10.5
287
106
15.2
312
92
13.2
264
71
10.2
171
49
7.0
108
48
6.9
52
696
100.0
1,873
0
0.0
0
696
100.0
1,873
Total N=2,569
110
Male
Column N %
2.2
3.4
1.5
5.1
6.1
18.0
15.3
16.7
14.1
9.1
5.8
2.8
100.0
0.0
100.0
Analysis
Etiology is similar to the United States as shown in Figure 95 and Table 149. Fire/flame is the cause of over half of all
burns, and scalds account for an additional 25%.
Figure 96 and Table 150 depict the distribution of known cases in the NBR by race. White patients are the
predominate group, this is similar to the United States population. There are a higher percentage of Native American
admissions in the Canadian/International group than in United States (4.0% vs. 0.8%).
95
ETIOLOGY
ETIOLOGY
Categories of
Etiology
Fire/Flam e
Scald
Electrical
Contact with Hot
Object
Chemical
Other, Non Burn
Burn,
Unspecified
Inhalation Only
Skin Disease
Radiation
Cases
% Valid
Fire/Flame
1378
55.2%
Scald
631
25.3%
Electrical
146
5.8%
116
4.6%
Chemical
89
3.6%
Other, Non Burn
60
2.4%
Burn, Unspecified
42
1.7%
Inhalation Only
18
0.7%
Skin Disease
14
0.6%
Radiation
0.1%
Unknown
72
TOTAL
2,569
Table
150
RACE/ETHNICITY
96
149
Etiology
Figure
Table
Figure
RACE/ETHNICITY
Race
White
Other
Native American
Asian
Black
Hispanic
Race
Cases
% of Valid
White
1,947
82.6%
Other
149
6.3%
Native American
95
4.0%
Asian
85
3.6%
Black
59
2.5%
Hispanic
22
0.9%
Unknown
212
Total
2,569
111
1
2
3
4
5
6
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Analysis
Figure 97 and Table 151 show the distribution of cases by the place of occurrence. The table shows that 6% of records
did not specify a place of occurrence. The figure is based on those records in which a place of occurrence was specified.
The vast majority of injuries occurred in the home.
Figure 98 and Table 152 depict the distribution of cases by the circumstances surrounding the injury. Seventy cases
did not denote injury circumstance and were excluded.
97
1
2
3
4
5
6
PLACE OF OCCURRENCE
- E849 CODE
Categories of
Injury Site
Home
Industrial
Recreation and
Sport
Street/Highway
Other Specified
Place
Public Building
Farm
Residential
Institution
Mine/Quarry
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
PLACE OF OCCURRENCE
- E849 CODE
Cases
% of Valid
Home
1,322
54.9%
Industrial
381
15.8%
340
14.1%
Street/Highway
129
5.4%
119
4.9%
Public Building
48
2.0%
Farm
40
1.7%
25
1.0%
Mine/Quarry
0.1%
Unspecified
163
Total
2,569
Categories of
Circumstance
of Injury
ANALYSIS
BY AGE
ETIOLOGY

Accident, Work
Related
Accident,
Recreation
Other
Suspected Self
Inflicted
Suspected
Assault/Abuse
Accident,
Unspecified
Suspected
Arson
Suspected Child
Abuse
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
112
152
Cases % of Valid
46.0%
503
20.1%
484
19.4%
Other
190
7.6%
95
3.8%
40
1.6%
16
0.6%
Suspected Arson
11
0.4%
10
0.4%
Unknown
70
Total
2,569
Table
98
151
Place of Occurrence
Figure
Table
Figure
Analysis
Mortality rate by %TBSA is detailed in Table 154, the overall mortality was 4.8%. The BAUX score (Age + %TBSA
burned) has been a standard to estimate the mortality of burn patients for decades. Table 153 demonstrate that increasing
BAUX score is associated with a higher mortality. The effect of gender is also depicted in this table.
MORTALITY RATE FOR

BAUX SCORE CATEGORIES
BY GENDER
Table
153
Female
Male
BAUX Score
(Age + TBSA)
Lived
Died
Mortality Rate
Lived
Died
Mortality
Rate
0-9.9
10-19.9
20-29.9
30-39.9
40-49.9
50-59.9
60-69.9
70-79.9
80-89.9
90-99.9
100-109.9
110 and Over
Total
66
58
68
65
77
85
68
67
41
26
13
10
644
0
0
0
0
0
1
1
4
6
5
11
12
40
0.0
0.0
0.0
0.0
0.0
1.2
1.4
5.6
12.8
16.1
45.8
54.5
5.8
79
108
222
253
252
260
205
161
114
61
26
22
1,763
0
0
1
0
0
4
4
4
7
8
11
44
83
0.0
0.0
0.4
0.0
0.0
1.5
1.9
2.4
5.8
11.6
29.7
66.7
4.5
Total N=2530 (Excluding 39 Unknown/Missing)
Table
154
ANALYSIS OF
CONTRIBUTING
HOSPITALS
ANALYSIS OF ALL
U.S. RECORDS
ANALYSIS
BY AGE
GROUP
LIVED/DIED BY BURN
GROUP SIZE (%TBSA)
Lived
Died
%TBSA
Cases
Cases
Mortality Rate
0.1 - 9.9
1,393
10
0.7
10 - 19.9
459
15
3.2
20 - 29.9
174
17
8.9
30 - 39.9
103
17
14.2
40 - 49.9
50
14
21.9
50 - 59.9
41
14.6
60 - 69.9
26
23.5
70 - 79.9
11
45.0
80 - 89.9
12
85.7
> 90
90.0
Subtotal
2,260
118
5.0
Missing or 0%
185
3.1
TOTAL
2,445
124
4.8
ANALYSIS
BY AGE
ETIOLOGY
HOSPITAL
COMPARISONS
ANALYSIS OF
CANADIAN AND
INTL. RECORDS
Total N=2,569
113
1
2
3
4
5
6
Appendix
Appendix A
Minimum Data Set and Data Quality
Improving the data quality in the NBR has been a focal point for the past few years. The launch of ABA
burn registry software Version 5.0 and the subsequent v5.11 upgrade has done a great deal toward standardizing
the data submitted to the NBR. Furthermore, a Minimum Data Standard has been established that should
improve the completeness of the records submitted. The Minimum Data Standard requires the records included
in the NBR, must have known values for the variables listed below.
Reporting hospital number
Number of operating room visits
Number of procedures performed
Patient sex (gender)
Cause of death
State in which injury occurred
Patient age (for patients younger than 90 years)
Year of injury
Year of arrival at reporting hospital
Description of event (free text)
Site at which injury occurred (E 849 code)
Etiology of injury code (E-code)
Body areas injured (Lund and Browder 19 areas x 6 age categories)
Total burn size
Total deep burn
Inhalation injury
ICD-9 diagnosis codes
Total hospital days
Hospital discharge disposition
Primary payor source
MS-DRG code
Circumstances of injury
Discharge status (alive or dead)
Year of discharge or death
Total ICU days
Interhospital transfer to your hospital
The italicized variables were not included in the analysis of missing variables on cases used in this Annual
Report on the subsequent pages. Age, gender, hospital disposition and reporting hospital number are required
fields for a case to be included in the Annual Report. The remaining italicized variables were excluded from
analysis because they are not uniformly reported by non ABA burn registry software centers.
116
Appendix A
This table represents the common data elements missing from submitted burn center records. The most common
missing information, in over 50% of cases, is the state where the patient was injured. Registrars cannot assume that
the answer to this inquiry is obvious since many burn centers care for patients outside of their own state. This data is
potentially important if the NBR is going to be used as a reference to determine future funding from state Medicaid
plans. Also, data is frequently missing from the total percent of deep burs, ICU days and cause of death. If the goal is to
use the NBR as a foundation for burn quality indicators, this information is crucial to have reliable information. Finally,
description of the burn as well as circumstances and site of injury are important in devising prevention strategies.
DATA COMPLETENESS BY VARIABLE
Table
155
Valid
Missing
Pct. Missing
Last Report Pct. Missing
Description of Event
105,055
86,793
45.2
51.2
Cause of Death
4,197
2,177
34.2
35.7
State in Which Injury Occurred
127,476
64,372
33.6
40.7
Total Deep Burn
133,746
58,102
30.3
34.1
MS-DRG Code
138,682
53,166
27.7
28.6
Interhospital Transfer to Hospital
154,404
37,444
19.5
22.2
Total ICU Days
165,183
26,665
13.9
15.8
Site at Which Injury Occurred (E 849 code)
168,604
23,244
12.1
12.8
Circustances of Injury
174,406
17,442
9.1
10.6
Primary Payor Source
176,039
15,809
8.2
10.1
Inahaltion Injury
176,774
15,074
7.9
8.1
Total Burn Size
177,202
14,646
7.6
8.5
Year of Injury
184,159
7,689
4.0
3.5
Year of Discharge or Death
185,280
6,568
3.4
3.2
Discharge Status (Alive or Dead)
186,687
5,161
2.7
1.7
Etiology of injury Code (E-code)
188,107
3,741
1.9
2.1
Total Hospital Days
190,506
1,342
0.7
0.6
117
Appendix A
This is a graphic representation of the improvement of submitted data by year. This last call for data had the lowest
percentage (<2%) of missing data per record compared to previous years. It is possible that the emphasis on having more
accurate patient care data in the United States has driven this improvement in data. It would be interesting to determine
whether there has been an increase in medical center providing financial support for burn registrars.
DATA QUALITY EXPRESSED AS MEAN PERCENT OF MISSING VARIABLES Figure

FROM MINIMUM DATA SET PER RECORD BY ADMISSION YEAR
99
25
Percent of Missing Variables
20
15
10
2004
2005
2006
2007
2008
2009
2010
2011
2012
Admission Year
Total N=191,848
118
2013
Appendix A
Facilities
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
Figure
100
Total N=191,848
0%
10%
20%
30%
40%
50%
60%
Percent Missing
DATA QUALITY EXPRESSED AS MEAN PERCENT OF MISSING VARIABLES OF THE MINIMUM

DATA STANDARD PER RECORD BY FACILITY
Case Volume
The graph depicts the individual burn centers submission volume and the percent of missing records. Over two thirds
of burn centers have less than 10% of key variables missing.Volume does not appear to have linear relationship with data
quality.
No. of Cases
119
Appendix A
Although the actual percent of records with less than 5 percent of key variables missing is low as shown in Figure 99,
the absolute number of records that are incomplete is large from records submitted before 2013. The number of records
affected number greater than 100,000. Hopefully the trend in improving accuracy in completing the data elements will
continue over the next decade.
PERCENT OF RECORDS WITH NUMBER OF MISSING VARIABLES
COMPARED BETWEEN DATA SUBMITTED IN 2013 AND BEFORE
101}
Before 2013
Figure
2013
Percent
60.0%
40.0%
20.0%
.00
1.00 2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
11.00
12.00
Number of Missing Variables per Record

Total N=191,848
120
13.00
14.00
Appendix A
Since there has been variation in the database software used by submitting burn centers, this year a comparison was
made between data completion and the version of software used.Version 5 of the ABA burn registry software is the most
commonly used software and therefore it will appear that it has the most incomplete data.
{102
Figure
Before 2013
COUNT OF RECORDS WITH NUMBER OF MISSING VARIABLES

COMPARED BETWEEN 2013 AND BEFORE
2013
Count
30,000
20,000
10,000
.00
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
11.00
12.00
13.00
Number of Missing Variables per Record

Total N=191,848
121
14.00
Appendix B
The following list of hospitals have contributed to the NBR in any given year. We extend our thanks for their
contribution and ongoing support of this significant endeavor.
Alabama
Childrens Hospital, Birmingham
UAB Burn Center
University of South Alabama Regional Burn and Wound Center
Arizona
Arizona Burn Center at Maricopa Medical Center
Arkansas
The Burn Center at Arkansas Childrens Hospital
California
Bothin Burn Center, St. Francis Memorial Hospital
Community Regional Leon S. Peters Burn Center
Inland Counties Regional Burn Center at Arrowhead Regional Medical Center
Santa Clara Valley Medical Center Regional Burn Center
Shriners Hospital for Children-Northern California
Southern California Regional Burn Center at LAC & USC Medical Center
Torrance Memorial Burn Center
UC Davis Regional Burn Center
UCI Regional Burn Center
UCSD Regional Burn Center
The Grossman Burn Center at San Joaquin Community Hospital
The Grossman Burn Center - West Hills
Colorado
The Childrens Hospital Burn Center
University of Colorado Hospital Burn Center
Western States Burn Center
Connecticut
Connecticut Burn Center, Panettieri
District of Columbia
Childrens National Medical Center
The Burn Center at Medstar Washington Hospital Center
Florida
Orlando Regional Medical Center
Shands Burn Center at the University of Florida
Tampa General Hospital Regional Burn Center
University of Miami/Jackson Memorial Burn Center
Georgia
Grady Memorial Hospital Burn Center
The Joseph M. Still Burn Center at Doctors Hospital
Illinois
Loyola University Medical Center
Memorial Medical Center Regional Burn Center
Sumner L. Koch Burn Center, Stroger Hospital
University of Chicago Burn Center
Indiana
Indiana University
St. Josephs Burn Center
Wishard Health Services
122
Appendix B
Iowa
University of Iowa Burn Center
Kansas
KUHA-Burnett Burn Center
Via Christi Regional Medical Center
Louisiana
Baton Rouge General Adult Burn Center Mid-City
Louisiana State University Health Sciences Center-Shreveport
Maryland
Johns Hopkins Bayview Medical Center Burn Center
Massachusetts
Brigham and Womens Hospital Burn Center
MGH Sumner Redstone Burn Center
Shriners Hospital for Children-Boston
University of Massachusetts Memorial
Michigan
Childrens Hospital of Michigan
Detroit Receiving Hospital Burn Center
Spectrum Health Regional Burn Center
University of Michigan Health Systems
Minnesota
Dwan Burn Center
Hennepin County Medical Center Burn Center
The Burn Center-Regions Hospital
Mississippi
Delta Regional Medical Center
Missouri
George David Peak Memorial Burn and Wound Center
Nebraska
St. Elizabeth Regional Burn Center
The Nebraska Medical Center
Nevada
Lions Burn Center
New Jersey
The Burn Center at St. Barnabas
New Mexico
New Mexico Regional Burn Center
New York
Clark Burn Center
Nassau University Medical Center Burn Center
Roger W. Seibel MD Burn Treatment Center
Kessler Burn Center, University of Rochester Medical Center
Westchester Medical Center Burn Center
William R. Hearst Burn Center, New York Presbyterian Hospital, Weill Cornell Medical Center
North Carolina
North Carolina Jaycee Burn Center
Wake Forest Baptist Medical Center Burn Center
123
Appendix B
Ohio
Childrens Hospital Medical Center of Akron
MetroHealth Medical Center
Nationwide Childrens Hospital
Shriners Hospital for Children-Cincinnati
The Ohio State University Wexner Medical Center
The University Hospital Burn Center-Cincinnati
Oregon
Oregon Burn Center, Legacy Emmanuel Medical Center
Pennsylvania
Lehigh Valley Hospital Burn Center
St. Christophers Hospital for Children
Temple University Hospital Burn Center
The Nathan Speare Regional Burn Treatment Center, Crozer Chester Medical Center
The Western Pennsylvania Hospital Burn Center
UPMC Mercy
Rhode Island
Rhode Island Hospital Burn Center
South Carolina
Medical University of South Carolina Childrens Hospital
Tennessee
Erlanger Health Systems Burn Center
Firefighters Regional Burn Center
Vanderbilt Regional Burn Center
Texas
John S. Dunn, Sr. Burn Center
Parkland Memorial Hospital Regional Burn Center
Shriners Hospital for Children-Galveston
Timothy J. Harnar Burn Center
University of Texas Medical Branch
U.S. Army Institute of Surgical Research
Utah
University of Utah Hospital Burn Center
Virginia
VCU Evans-Haynes Burn Center
Washington
UW Medicine Regional Burn Center at Harborview Medical Center
Wisconsin
Columbia St. Marys Hospital Regional Burn Center
University of Wisconsin Hospitals and Clinics
International Contributors
Firefighters Burn Treatment Unit, Edmonton, Alberta, Canada
Hamilton Firefighters Burn Unit Hamilton Health Sciences, Hamilton, Ontario
Hospital for Sick Children, Toronto, Ontario
Hotel-Dieu du CHUM, Montreal, Quebec
Linkoping University Hospital, Linkoping, Sweden
Ross Tilley Burn Centre, Sunnybrook and Womens College Health Sciences Centre, Toronto, Ontario
Uppsala University Hospital, Uppsala, Sweden
124
Appendix C
Selected List of Peer-Reviewed Publications Utilizing NBR Data
Blaisdell LL, Chace R, Hallagan LD, Clark DE. A half-century of burn epidemiology and burn care in a rural state. J Burn Care Res.
2012 May-Jun;33(3):347-53
Bloemsma GC, Dokter J, Boxma H, Oen IMMH. Mortality and causes of death in a burn centre. Burns. 2008 Dec; 34 (8): 1103-1107.
Burton KR, Sharma VK, Harrop R, Lindsay R. Burns. A population-based study of the epidemiology of acute adult burn injuries in the
Calgary Health Region and factors associated with mortality and hospital length of stay from 1995 to 2004. Burns. Jun 2009; 35 (4): 572-579.
Carpenter AM, Hollett LP, Jeng JC, Wu J, Turner DG, Jordan MH. How long a shadow does epidemic obesity cast in the burn unit?
A dietitians analysis of the strengths and weaknesses of the available data in the National Burn Repository. J Burn Care Res. 2008 JanFeb;29(1):97-101.
Carr JA, Phillips BD, Bowling WM. The Utility of Bronchoscopy After Inhalation Injury Complicated by Pneumonia in Burn Patients:
Results From the National Burn Repository. J Burn Care Res. 2009 Nov-Dec; 30(6):967-974.
Chung JY, Kowal-Vern A, Latenser BA, Lewis RW 2nd.Cement-related injuries: review of a series, the National Burn Repository, and
the prevailing literature. J Burn Care Res. 2007 Nov-Dec;28(6):827-34.Review.
Edelman LS, Cook L, Saffle JR. Using Probabilistic Linkage of Multiple Databases to Describe Burn Injuries in Utah. J Burn Care Res.
2009; 30: 983-992.
Engrav LH, Heimbach DM, Rivara FP, Kerr KF, Osler T, Pham TN, Sharar SR, Esselman PC, Bulger EM, Carrougher GJ, Honari S,
Gibran NS. Harborview burns--1974 to 2009. PLoS One. 2012;7(7):e40086.
Guagliardo MF, Jeng JC, Browning S, Bilodeau ME, Dimick A, HickersonW, Miller S, Peck M. Admissions across state lines: harnessing
the insight of the National Burn Repository for the healthcare accessibility, fiscal, and legislative concerns facing the American Burn
Association. J Burn Care Res. 2008 Jan-Feb;29(1):151-7.
Harpole BG, Wibbenmeyer LA, Erickson BA. Genital burns in the national burn repository: incidence, etiology, and impact on
morbidity and mortality. Urology. 2014 Feb; 83(2):298-303.
Holmes JH. Critical Issues in Burn Care. J Burn Care Res. 2008 Nov-Dec; 29(6):S180-S187.
Howard PA, Jeng JC, Miller SF. Is the glass really half empty? A closer look at the TBSA data in the National Burn Repository. J Burn
Care Res. 2007 Jul-Aug;28(4):542-3.
Hranjec T, Turrentine FE, Stukenborg G,Young JS, Sawyer RG, Calland JF. Burn-center quality improvement: are burn outcomes
dependent on admitting facilities and is there a volume-outcome sweet-spot? Am Surg. 2012 May;78(5):559-66.
Jaskille AD, Shupp JW, Pavlovich AR, Fidler P, Jordan MH, Jeng JC. Outcomes from Burn Injury-Should Decreasing Mortality
Continue to be Our Compass? Clinics in Plastic Surgery. 2009 Oct; 36 (4): 701.
Jeng JC; Advisory Committee to the National Burn Repository. Open for business! a primer on the scholarly use of the National Burn
Repository. J Burn Care Res. 2007 Jan-Feb;28(1):143-4.
Jeng JC. Patrimonie de Docteur BAUX--BAUX scores >> 100 gleaned from 170,791 admissions: a glimmer from the National Burn
Repository. J Burn Care Res. 2007 May-Jun;28(3):380-1.
Jeng JC. From qualitative contemplation to relational database: one approach to harnessing the National Burn Repository. J Burn Care
Res. 2008 Jan-Feb;29(1):267-8.
Jeng JC. Growth rings of a tree: progression of burn care charges abstracted from a decade of the National Burn Repository. J Burn Care
Res. 2007 Sep-Oct;28(5):659-60.
Jeng JC,Miller SF. From the burn units perspective, its lethal not being gainfully employed outside the home! A glimmer from the
National Burn Repository. J Burn Care Res. 2007 Jan-Feb;28(1):142.
Jeng JC,Miller SF. How patients enter the burn care system is changing: a glimmer from the National Burn Repository. J Burn Care Res.
2007 Mar-Apr;28(2):220-1.
Jeng JC, Parks J, Phillips BL. Warding Off Burn Injuries, Warding Off Database Fishing Expeditions: The ABA Burn Prevention
Committee Takes a Turn With a Glimmer From the National Burn Repository. J Burn Care Res. 2008 Apr.
Jeng JC, Phillips B. Improving on It Is What It Is: Stepping Up the Quality as a Consequence of New Version 5 Collection Software-A
Glimmer From the National Burn Repository. J Burn Care Res. 2008 Mar-Apr;29(2):291-292.
Jeng JC, Phillips B. Dead-Reckoning the Distance Between the National Burn Repository and a True Population-Based Registry: A
Challenge and an Opportunity. J Burn Care Res. 2009 Jan-Feb; 30(1):139-140.
125
Appendix C
Jeng JC, Phillips B. Title: From Psychedelic Data Visualization to Hypothesis: All-At-Once Contemplation of Vast Amounts of
Information From the National Burn Repository. J Burn Care Res. 2008; 29 (6): 872-873.
Jeng JC, Shoham S. Leveraging the Unique Expertise of Our Clinical Colleagues: A Real-World Example for Collaborative Harnessing
of the National Burn Repository. J Burn Care Res. 2008 Sep-Oct; 29(5):704-705.
Jeng JC, Schurr MJ, Phillips B. The Noise Floor, Signal-to-Noise Ratio, and Demonstrating That Burn Care is Getting Better: A
Glimmer from the National Burn Repository. J Burn Care Res. 2008 July-Aug; 29(4):572-573.
Johnson LS, Shupp JW, Pavlovich AR, Pezzullo JC, Jeng JC, Jordan MH. Hospital length of stay--does 1% TBSA really equal 1 day? J
Burn Care Res. 2011 Jan-Feb;32(1):13-9.
Kagan RJ, Edelman L, Solem L, Saffle JR, Gamelli R.DRG 272: Does it Provide Adequate Burn Center
Reimbursement for the Care of Patients with Stevens. J Burn Care Res. 2007 Jul.
Kagan RJ, Edelman L, Solem L, Saffle JR, Gamelli R.DRG 272: does it provide adequate burn center reimbursement for the care of
patients with Stevens-Johnson syndrome and toxic epidermal necrolysis? J Burn Care Res. 2007 Sep-Oct;28(5):669-74.
Kagan RJ, Gamelli R, Kemalyan N, Saffle JR. Tracheostomy in thermally injured patients: does diagnosis-related group 483 adequately
estimate resource use and hospital costs? J Trauma. 2004 Oct;57(4):861-6.
Kagan RJ, Gamelli R, Saffle JR.DRG 504: the effect of 96 hours of mechanical ventilation on resource utilization. J Burn Care Res.
2007 Sep-Oct;28(5):664-8.
Kahn SA, Bell DE, Hutchins P, Lentz CW. Outpatient burn data: an untapped resource. Burns. 2013 Nov; 39(7):1351-4.
Kerby JD, McGwin G Jr, George RL, Cross JA, Chaudry IH, Rue LW 3rd. Sex differences in mortality after burn injury: results of
analysis of the National Burn Repository of the American Burn Association. J Burn Care Res. 2006 Jul-Aug;27(4):452-6.
Kramer B, Rivara F, Klein M.Variations in U.S. Pediatric Burn Injury Hospitalizations Using the National Burn Repository Data. J Burn
Care Res. 2010 Sept-Oct; (5): 734-9.
Krieger Y, Shoham Y, Levi A, Bogdanov-Beresovsky A, Silberstien E, Sagi A. Burn treatment framework in Israel. Ann Burns Fire
Disasters. 2011 Dec 31;24(4):199-202.
Latenser BA, Miller SF, Bessey PQ, Browning SM, Caruso DM, Gomez M, Jeng JC, Krichbaum JA, Lentz CW, Saffle JR, Schurr MJ,
Greenhalgh DG, Kagan RJ. National Burn Repository 2006 Report Dataset Version 3.0. J Burn Care Res. 2007 Jul.
Latenser BA, Miller SF, Bessey PQ, Browning SM, Caruso DM, Gomez M, Jeng JC, Krichbaum JA, Lentz CW, Saffle JR, Schurr MJ,
Greenhalgh DG, Kagan RJ. National Burn Repository 2006: a ten-year review. J Burn Care Res. 2007 Sep-Oct;28(5):635-58.
Lezotte DC, Hills RA, Heltshe SL, Holavanahalli RK, Fauerbach JA, Blakeney P, Klein MB, Engrav LH. Assets and liabilities of the Burn
Model System data model: a comparison with the National Burn Registry.Arch Phys Med Rehabil. 2007 Dec;88(12 Suppl 2):S7-17.
Light TD, Latenser BA, Heinle JA, Stolpen MS, Quinn KA, Ravindran V, Chacko J. Demographics of Pediatric Burns in Vellore, India. J
Burn Care Res. 2009 Jan-Feb; 30(1):50-54.
Light TD, Latenser BA, Kealey GP, Wibbenmeyer LA, Rosenthal GE, Sarrazin MV. The Effect of Burn Center and Burn Center Volume on
the Mortality of Burned Adults-An Analysis of the Data in the National Burn Repository. J Burn Care Res. 2009 Sept-Oct; 30(5):776-782.
Mason AD. Invited Critique: The 2007 NBR Report: A Synopsis of the 2007 Call for Data. J Burn Care Res. 2008 Nov-Dec; 29(6):871.
Mandell SP, Robinson EF, Cooper CL, Klein MB, Gibran NS. Patient safety measures in burn care: do National reporting systems
accurately reflect quality of burn care? J Burn Care Res. 2010 Jan-Feb;31(1):125-9.
Matt SE, Shupp JW, Carter EA, Shaw JD, Jordan, MH. Comparing a Single Institutions Experience with Electrical Injuries to the Data
Recorded in the National Burn Repository. J Burn Care Res. 2012 Sept-Oct; 33(5):606-611.
Matt SE, Shupp JW, Carter EA, Flanagan KE, Jordan MH. When a Hero Becomes a Patient:Firefighter Burn Injuries in the National
Burn Repository. J Burn Care Res. 2012 Jan-Feb; 33(1):147-151.
McKibben JBA, Bresnick MG, Wiechman A, Shelley A, Fauerbach JA. Acute Stress Disorder and Posttraumatic Stress Disorder: A Prospective
Study of Prevalence, Course, and Predictors in a Sample With Major Burn Injuries. J Burn Care Res. 2008 Jan-Feb; 29(1):22-35.
McGwin G Jr,George RL,Cross JM,Rue LW. Improving the ability to predict mortality among burn patients. Burns. 2008
May;34(3):320-327. Epub 2007 Sep 14.
Miller SF, Bessey PQ, Schurr MJ, Browning SM, Jeng JC,Caruso DM,Gomez M, Latenser BA, Lentz CW, Saffle JR, Kagan RJ, Purdue
GF, Krichbaum JA. National Burn Repository 2005: a ten-year review. J Burn Care Res. 2006 Jul-Aug;27(4):411-36.
Miller SF, Bessey P, Lentz CW, Jeng JC, Schurr M, Browning S. National Burn Repository 2007 Report: A Synopsis of the 2007 Call for
Data. J Burn Care Res. 2008 Nov-Dec; 29(6):862-870.
Moss LS. Outpatient management of the burn patient. Crit Care Nurs Clin North AM. 2004 Mar;16(1):109-17.Review.
126
Appendix C
Modjarrad K,McGwin G Jr,Cross JM,Rue LW 3rd.The descriptive epidemiology of intentional burns in the United States: an analysis
of the National Burn Repository. Burns. 2007 Nov;33(7):828-32. Epub 2007 May 24.
Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the BAUX
score. J Trauma. 2010 Mar;68(3):690-7.
Pannucci CJ, Diaz JA, Wahl WL. Temporal changes in deep venous thrombosis risk after electrical injury. J Burn Care Res. 2011 MayJun;32(3):442-6.
Pannucci, CJ, Osborne NH, Wahl WL. Creation and Validation of a Simple Venus Thromboembolism Risk Scoring Tool for Thermally
Injured Patients: Analysis of the National Burn Repository. J Burn Care Res. 2012 Jan-Feb; 33(1):20-25.
Pannucci C, Osborne N, Jaber R, Cederna P, Wahl Wendy. Early Fasciotomy in Electrically Injured Patients as a Marker for Injury
Severity and Deep Venous Thrombosis Risk: An Analysis of the National Burn Repository. J Burn Care Res. 2010 Nov-Dec; (6): 882-7.
Pannucci CJ, Osborne NH, Wahl WL.Venous thromboembolism in thermally injured patients: analysis of the National Burn Repository.
J Burn Care Res. 2011 Jan-Feb;32(1):6-12.
Pavlovich, AR, Shupp JW, Jeng JC. A Novel Approach to Discerning Burn Mortality: A Glimmer From the National Burn Repository. J
Burn Care Res. 2009 Jul-Aug; 30(4):574-575.
Pavlovich AR, Shupp JW, Jeng JC. Is Length of Stay Linearly Related to Burn Size? A Glimmer From the National Burn Repository. J
Burn Care Res. 2009 Mar-Apr; 30(2):229-230.
Pham TN, Kramer CB, Wang J, Rivara FP, Heimbach DM, Gibran NS, Klein MB. Epidemiology and Outcomes of Older Adults With
Burn Injury: An Analysis of the National Burn Repository. J Burn Care Res. 2009 Jan-Feb; 30(1):30-36.
Price LA,Thombs B,Chen CL,Milner SM. Liver disease in burn injury: evidence from a national sample of 31,338 adult patients. J
BurnsWounds. 2007 Jun 12;7.
Roberts G, Lloyd M, Parker M, Martin R, Philp B, Shelley O, Dziewulski P. The BAUX score is dead. Long live the BAUX score: a 27year retrospective cohort study of mortality at a regional burns service. J Trauma Acute Care Surg. 2012 Jan;72(1):251-6.
Saffle JR. Invited Critique: Burn Unit Size and Census: Too Much of a Good Thing? J Burn Care Res. 2009 Sept-Oct; 30(5):783-784.
Santaniello JM, Luchette FA, EspositoTJ, Gunawan H, Reed RL, Davis KA, Gamelli RL. Ten year experience of burn, trauma, and
combined burn/trauma injuries comparing outcomes. J Trauma. 2004 Oct;57(4):696-700; discussion 700-1.
Shupp J, Pavlovich A, Jeng J, Pezzullo J, Oetgen W, Jaskille A, Jordan M, Shoham S, Epidemiology of Bloodstream Infections in BurnInjured Patients: A Review of the National Burn Repository. J Burn Care Res. 2010 Jul-Aug; (4):521-8.
Swanson JW, Otto AM, Gibran NS, Klein MB, Kramer CB, Heimbach DM, Pham TN. Trajectories to death in patients with burn injury.
J Trauma Acute Care Surg. 2013 Jan;74(1):282-8.
Taylor S, Jeng J, Saffle JR, Sen S, Greenhalgh DG, Palmieri TL. Redefining the outcomes to resources ratio for burn patient triage in a
mass casualty. J Burn Care Res. 2014 Jan-Feb; 35(1):41-5.
Taylor SL, Lee D, Nagler T, Lawless MB, Curri T, Palmieri TL. A Validity Review of the National Burn Repository. J Burn Care Res. 2012 Nov.
Taylor SL, Lee D, Nagler T, Lawless MB, Curri T, Palmieri TL. A validity review of the National Burn Repository. J Burn Care Res. 2013
Mar-Apr; 34(2):274-80.
Thombs BD. Patient and injury characteristics, mortality risk, and length of stay related to child abuse by burning: evidence from a
national sample of 15,802 pediatric admissions. Ann Surg. 2008 Mar;247(3):519-23.
Thombs BD, Bresnick MG. Mortality risk and length of stay associated with self-inflicted burn injury: evidence from a national sample
of 30,382 adult patients. Crit Care Med. 2008 Jan;36(1):118-25.
Thombs BD, Bresnick MG, Magyar-Russell G. Who attempts suicide by burning? An analysis of age patterns of mortality by selfinflicted burning in the United States. Gen Hosp Psychiatry. 2007 May-Jun;29(3):244-50.
Thombs BD, SinghVA, Halonen J,Diallo A,Milner SM.The effects of preexisting medical comorbidities on mortality and length of
hospital stay in acute burn injury: evidence from a national sample of 31,338 adult patients. Ann Surg. 2007 Apr;245(4):629-34.
Villaveces A, Peck M, Faraklas I, Hsu-Chang N, Joe V, Wibbenmeyer L. Process evaluation of software using the international
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2014

FIRE/FLAME INJURIES REPRESENT 43% OF THE CASES IN

SCALD INJURIES REPRESENT 34% OF THE CASES IN THIS

CONTACT WITH HOT OBJECT INJURIES REPRESENT 9%

ELECTRICAL INJURIES REPRESENT 4% OF THE CASES IN THIS

CHEMICAL INJURIES REPRESENT 3% OF THE CASES IN THIS

National Burn Repository 2014 Report

Bruce M. Potenza, MD, FACS

Palmer Q. Bessey, MD, FACS, MS, Ad Hoc

Iris Faraklas, RN, BSN

Margaret A. Finocchiaro, BA, Ad Hoc

M. Anwarul Huq Mian, MD, PhD, MPH

Matthew B. Klein, MD, MS, FACS, Ex Officio

Michael J. Mosier, MD, FACS

Sidney F. Miller, MD, FACS, Ad Hoc

John Myers, PhD

American Burn Association Staff

Table 24: Top Ten Procedures

Table 60: Race/Ethnicity

Table 99: Mean Charges for Top Five MS-DRGs

laterality of the injury. This will certainly improve queries

Do not have burn centers

BURN CENTER LOCATION AND PARTICIPATION BY REGION

U.S. Burn Care

U.S. Facilities in the

VOLUME OF RECORD SUBMISSION BY GEOGRAPHIC REGION

ARRIVAL/ADMISSION YEAR, ACUTE BURN ADMISSIONS

CONTRIBUTING U.S. HOSPITALS BY HOSPITAL BED SIZE CATEGORY

Hospital Bed Size

CONTRIBUTING U.S. HOSPITALS BY HOSPITAL OWNERSHIP TYPE

THIS PAGE INTENTIONALLY LEFT BLANK

AGE GROUP BY GENDER

5-15.9 16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9

AGE GROUP BY GENDER

Total N=182,040 (Excluding 9,808 Unknown/Missing)

AGE GROUP BY WHITE VERSUS NON-WHITE

5-15.9 16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9

BURN SIZE GROUP (% TBSA)

% TBSA (Full+ Partial Thickness)

LIVED/DIED BY BURN GROUP SIZE (%TBSA)

Other, Non Burn

Total N=175,484 (Excluding 16,364 Unknown/Missing)

FREQUENCY OF CONTACT WITH HOT OBJECT,

5-15.9 16-19.9 20-29.9 30-39.9 40-49.9 50-59.9 60-69.9 70-79.9

PLACE OF OCCURRENCE E849 CODE

Total N=168,604 (Excluding 23,244 Unknown/Missing)

Total N=174,406 (Excluding 17,442 Unknown/Missing)

Other Specified Place

Recreation and Sport

Suspected Assault/Abuse 2,314

Suspected Child Abuse

Suspected Self Inflicted

Place of Occurrence Cases

PLACE OF OCCURRENCE E849 CODE

Discharged Home, No Home Health

Discharged Home, With Home Health

Nursing Home/Skilled Nursing Facility (SNF)

Transfer to Another Hospital

Discharged to Extended Care Facility (ECF)

Transfer to Another Service

Discharged to Foster Care

Unable to Complete Treatment

Discharged to Alternate Caregiver