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ROCKVILLE, MD – With so many fire hazards to avoid this time of year – from Christmas trees to chestnuts roasting on an open fire – emergency physicians might be gratified to know that ED visits for burns have decreased over time.
A new report from the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ) finds that the rate of burn-related ED visits not leading to hospital admission declined 17.2% between 2006 and 2013.
At the same time, the rate of burn-related inpatient stays decreased 34.6% between 1993 and 2013.
According to the report, in the mid-1970s in the United States, approximately 9,000 people died from injuries related to burns. The deaths related to burns now have decreased by more than 50%.
Even though those injuries have declined, the AHRQ maintains that rates remain much too high, noting that the national Centers for Disease Control and Prevention reported that 486,000 patients received emergency medical treatment for burns in 2011. Estimated medical costs associated with burn-related injuries in 2010 were about $1.5 billion, with another nearly $5 billion in costs associated with lost work.
The highest rate of ED visits for burns, 208.9 per 100,000 population, was among infants, who also had the highest rates of burn-related inpatient stays – 29.6 per 100,000 population.
Others with a relatively high risk of needing burn-related emergency care and admission were men, those with low median family income, those living in rural areas, and those living in southern states, AHRQ notes.
The most common burn sites associated with ED visits, 38.5%, were the wrists and hands, according to the brief, while lower limb burns most often led to inpatient hospital stays, 38.5%. For both emergency care and admission, second-degree burns were the most common level of severity, making up 52.9% of inpatient stays and 58.4% of ED visits.
Interestingly, fire itself was not the most common cause of burn-related inpatient stays and ED visits. Instead, those were accidents caused by hot liquids and steam, or other hot substances.
“Accidents involving hot or caustic substances or explosives were the cause of more than one-third of burn-related inpatient stays, with accidents involving hot liquids or vapors (15.1 percent of all burn-related stays) and other hot substances or objects (12.8 percent of stays) being the most common,” according to the report. “Accidents caused by fire and flames accounted for 22.8 percent of burn-related inpatient stays, with ignition of highly inflammable material being the most common (7.9 percent of stays).”
Wound debridement was the most common procedure associated with burn-related ED visits, while skin graft was the most common procedure associated with burn-related inpatient stays.