A Single Centre Review of Outcomes of Delayed admission to a Burns Unit

Abstract

Background: Timely admission to a specialized burn unit is considered crucial for optimizing outcomes in burn patients. However, the impact of delayed admission on hospital length of stay and clinical outcomes remains unclear, particularly in resource-constrained settings such as South Africa. This study aimed to determine whether admission to a burn unit more than 24 hours after injury was associated with increased length of stay, sepsis, or mortality. Methods: A retrospective cohort study was conducted at the Chris Hani Baragwanath Academic Hospital Adult Burn Unit, Johannesburg, from January 2018 to December 2022. All adult burn patients admitted during this period were included. Patients were categorized into early (≤24 hours) and delayed (>24 hours) admission groups. The primary outcome was length of stay; secondary outcomes included incidence of sepsis and in-hospital mortality.. Results: We found 134 files, and 123 were complete. Of the patients, 71 (58%) were admitted within 24 hours. The median length of stay was 14 days, and no statistical difference in length of stay between the two groups was discovered (P = .7). The overall mortality rate was 13%, of with 68% in the early admission group. Sepsis occurred in 27% of patients. Conclusion: Delayed admission to a burn unit has no effect on length of stay and no statistically significant association with mortality rate or sepsis. Higher mortality in the early admission group reflects the severity of burns requiring prioritization of critical cases. These findings highlight the importance of further prospective research.