Burn vs. Referral Physicians' TBSA Estimation Errors: A Cross-Sectional Study at the National Burn Center

Abstract

Background: The percentage of the total body surface area (TBSA) is a simplified way to address the magnitude and severity of a thermal injury. The burn care providers recognize the relationship between burn size, prognosis, and number of required interventions. This study aims to identify the prevalence and magnitude of TBSA estimation inconsistencies between referring hospitals and the National Burn Center in Mexico and introduce new telemedicine and mobile applications for effectively estimating burn areas for non-burn-trained personnel. Methods: We included patients with any thermal injury at the National Rehabilitation Institute in Mexico City referred from any other hospital in the country. Data was collected from the referral email and our medical records, and the burn estimation error was calculated using the following formula: (TBSA referral Hospital – TBSA Burn Center) / TBSA Burn Center multiplied by 100. Results: Seventy-eight patients were transferred to the institute; the mean age was 27 years, 55 were male. The mean %TBSA from the referring hospital was 36 %, and in our Burn Center was 28 %, with a mean difference of 8.8 %. There were 59 cases with overestimated %TBSA, and ten were underestimated; the rest were similar in percentage. Conclusions: Our study highlights substantial discrepancies between the estimated %TBSA by referring hospitals and the actual %TBSA, consistently tending towards overestimation.

Keywords

• Burns
• Total body surface area
• Accuracy
• Estimation
• Length of stay
• Error