Changes in epidemiology and care strategies at the Norwegian National Burn Centre over 35 years (1986–2020)
Henning Onarheim,
Ragnvald Ljones Brekke,
Fatemeh Zamanzad Ghavidel,
Anne Berit Guttormsen,
Stian Kreken Almeland
Affiliations
Henning Onarheim
Norwegian National Burn Centre, Department of Plastic, Hand, and Reconstructive Surgery, Haukeland University Hospital, Bergen, Norway; Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Corresponding author at: Department of Anaesthesia and Intensive Care, Haukeland University Hospital, N-5021 Bergen, Norway.
Ragnvald Ljones Brekke
Norwegian National Burn Centre, Department of Plastic, Hand, and Reconstructive Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
Fatemeh Zamanzad Ghavidel
Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
Anne Berit Guttormsen
Norwegian National Burn Centre, Department of Plastic, Hand, and Reconstructive Surgery, Haukeland University Hospital, Bergen, Norway; Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
Stian Kreken Almeland
Norwegian National Burn Centre, Department of Plastic, Hand, and Reconstructive Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
Introduction: We evaluated trends in admissions, % TBSA (total body surface area) burnt, age, and outcomes over a 35-year period at the national burn centre in Norway. Methods: Relevant data were extracted from the departmental quality registry covering all acute admissions for burns during 1986–2020. Results: In 1986–2020 there were 2.889 admissions for burns (67.6 % males), with a 110 % increase in 2016–20 when compared to 1986–90. Admissions of children <2 years increased by 400 %. In 2011–20, 66.5 % of patients were transferred from other hospitals.The median area injured declined markedly, from 16.5% TBSA in 1986–90 to 4.5% TBSA in 2016–20.Changes in care included an increased focus on non-delayed referrals and transfers, an explicit intent to achieve early excision within 48 h, and a transition from a highly frequent to a less frequent dressing changes scheme.Mortality declined from 10.9 % to 3.0 %. In 2011–20 the mortality among actively treated patients was 2.4 %. For patients with Baux scores 80–119, mortality declined from 36.0 % (1991–2010) to 18.2 % (2011–20) (P < 0.001). Discussion: Since 1986, more patients have been referred to the burn centre, many of younger ages and with more minor burns. Survival of patients with Baux scores 80–119 increased significantly.
