Burns ITU admissions: Length of stay in specific levels of care for adult and paediatric patients

Prediction of total length of stay (LOS) for burns patients based on the total burn surface area (TBSA) is well accepted. Total LOS is a poor measure of resource consumption. Our aim was to determine the LOS in specific levels of care to better inform resource allocation. We performed a retrospective review of LOS in intensive treatment unit (ITU), burns high dependency unit (HDU) and burns low dependency unit (LDU) for all patients requiring ITU admission in a regional burns service from 2003 to 2011. During this period, our unit has admitted 1312 paediatric and 1445 adult patients to our Burns ITU. In both groups, ITU comprised 20% of the total LOS (mean 0.23 ± 0.02 [adult] and 0.22 ± 0.02 [paediatric] days per %burn). In adults, 33% of LOS was in HDU (0.52 ± 0.06 days per %burn) and 48% (0.68 ± 0.06 days per %burn) in LDU, while in children, 15% of LOS was in HDU (0.19 ± 0.03 days per %burn) and 65% in LDU (0.70 ± 0.06 days per %burn). When considering Burns ITU admissions, resource allocation ought to be planned according to expected LOS in specific levels of care rather than total LOS. The largest proportion of stay is in low dependency, likely due to social issues.