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Far Out: Evaluating the Impact of Distance on Acute Burn Outcomes
Alexis M. Henderson, MPH; Hilary Y. Liu, BS; Jos� Antonio Arellano, MD; Christopher J. Fedor, MS; Mare G. Kaulakis, BS; Garth Elias, MD; Alain C. Corcos, MD, FACS; Jenny A. Ziembicki, MD; Francesco M. Egro, MD, MSc, MRCS
University of Pittsburgh School of Medicine
2025-01-10
Presenter: Alexis M. Henderson
Affidavit:
Vu T. Nguyen, MD
Director Name: Vu T. Nguyen, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose: Burn centers are primarily urban, leading to potential healthcare disparities for rural patients due to treatment delays, which may increase hospital stays, complications, healing time, and mortality. This study examines how a patient�s distance from a burn center affects their outcomes.
Methods: A retrospective analysis was conducted on patients presenting to a single burn center from 2016-2023. Data collection included demographics, burn characteristics, and treatment results. Logistic regression and ANOVA were performed to assess effects of patient distance to burn center on outcomes.
Results: 2,777 patients (mean age 41.1�24.4 years; 81.4% Caucasian, 13.7% African American, 2.23% Native Hawaiian/Pacific Islander, 0.97% American Indian/Alaska Native) were included in this study. Average patient residential distance to burn center was 146.0�745.2 km, with a 1.04�2.9-day interval from injury to admission. Ventilator use averaged 0.8�4.0 days, ICU stay 3.2�9.0 days, and hospital stay 9.1�12.15 days, with an average of 0.81�1.5 operations. Most patients (71.7%, n=1992) had deep partial-thickness or full-thickness burns, and mean TBSA of 7.3�12.4%. Native Hawaiians/Pacific Islanders lived the farthest (386.6�1624.1 km); distance was not significantly associated with mortality (χ�=4.32; p=0.825), ventilator days (β=0.234; p=0.968), operations (β=0.822; p=0.966), TBSA (β=0.210; p=0.899), hospital days (β=-1.831; p=0.608), or ICU days (β=-0.165; p=0.959). Greater distance was associated with longer admission delays (β=15.20; p=0.0068), and notable racial disparities in distance were identified (χ�=268.3; p<0.001).
Conclusion: Patients living farther from the burn center experienced longer admission delays, with significant distance variations among racial groups. Interestingly, distance did not significantly affect patient mortality or treatment outcomes.
