Analysis of Factors Influencing Length of Stay in Hospital among Burns Patients, Pertaining to Blood TransfusionA Cross-sectional Study

Abstract

Introduction: Blood transfusion is an independent risk factor for death and perioperative infection in trauma patients. Hospital Length Of Stay (LOS) is an indicator of morbidity and can be used to assess wound healing in burns patients. Aim: To analyse the factors influencing hospital length of stay in burns patients, with relevance to blood transfusion. Materials and Methods: This was a prospective observational study on burns patients admitted at burns ward, Government Kilpauk Medical College, Tamil Nadu, India, between September 2014 and August 2015. Patients with age more than 16 years with 15-40% Total Burnt Surface Area (TBSA) and had survived treatment were included after obtaining informed consent. Age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, blood component transfusion, storage age of red cells, surgical procedures and wound infection were studied. Results were analysed using Chi-square test, Analysis of Variance (ANOVA) and Pearson correlation. Results: Of the 122 burns patients studied, mean age was 35.38±12.93 years, 54.09% were males, mean LOS was 22.39±1.23 days, mean TBSA was 26.11±0.40%, mean APACHE II score was 5.02±0.06, 69.67% (n=85/122) patients had received red blood cell transfusion, 59 (48.36%) underwent surgical procedures and 103 (84.43%) developed culture proven wound infections. APACHE II score at admission (r-value=0.260, p-value=0.004), blood transfusions (r-value=0.504, p-value <0.0001), surgical procedures (r-value=0.614, p-value <0.0001) and wound infections (r-value=0.468, p-value <0.0001), surgical procedures (r-value=0.614, p=0.000) and wound infections (r=0.468, p=0.000) were the factors which significantly increased length of hospital stay. Age of the patient (r-value=0.102, p-value=0.265) and storage age of red blood cells (p-value=0.193) did not influence length of stay in burns patients. Conclusion: Minimizing wound infection by proper wound care and medications, and rational use of blood components help in early healing of burns wound with reduced hospital stay.