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The Impact of Infection on Length of Stay in Burns: A Scoping Review Introduction: Infections are a common complication in burns injury patients, associated with significant morbidity and mortality. Burns patients are particularly susceptible to infection; the burn injury itself destroys skin barrier defence, and colonisation of skin defects can lead to subsequent systemic infection. Compounding this, systemic changes induced from burn trauma such as hypermetabolism and immunosuppression, heighten the susceptibility to infection. Additionally, burns patients often have multiple invasive devices, mechanical ventilation, repeat operations, and extended hospital admissions, which increase the risk of hospital-acquired infections. According to the National Health and Medical Research Council (NHMRC), healthcare associated infections are the most common complication affecting hospitalised patients (1). This fact, superimposed onto one of the most complex immunosuppressed hospitalised patient groups, stresses the importance of further research into the field. Furthermore, the international rise in antimicrobial resistant organisms, is also reflected in multidrug resistant blood stream infections in burn injury patients (2). Burn patient hospital admission length is determined by a multifaceted number of factors including type of burn, TBSA, pre-existing comorbidities, operations or interventions required, recovery and response to supportive care. The length of hospital stay can be easily prolonged by complications such as infection. Increased length of stay (LOS) heightens patient risk of hospital acquired infections as well as non-infection related complications such as deep vein thrombosis, delirium, or deconditioning. This eventuates in a higher cost to the healthcare system and community. This scoping review assesses the existing literature to determine the direct correlation between infection in the burn injury patient and length of hospital stay. This review is a first step in analysing the range of heterogeneous data on such a significant topic, which is imperative if there is to be improvement in the burn patient morbidity and survival outcomes. References 1. National Health and Medical Research Council. (2020). Preventing infection. Retrieved from https://www.nhmrc.gov.au/health-advice/public-health/preventing-infection 2. Egozi D, Hussein K, Filson S, Mashiach T, Ullmann Y. Raz-Pasteur A. Bloodstream infection as a predictor for mortality in severe burn patients: an 11 year study. Epidemiology & Infection. 2014;142(10):2172-2179. 3. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine. 2018;169(7):467-73. |
