Predictors of Prolonged Length of Stay (LOS) in Adult and Elderly Burn Patients: A Retrospective Review of 2325 Patients

Increased length of stay (LOS) in patients with burn injuries is associated with increased adverse and poorer outcomes. Despite the awareness of the profound risks associated with increased LOS, large studies examining associated variables are lacking. This study aimed to identify pre-existing conditions, injury characteristics, and intrahospital events that influence whether patients meet or exceed the expected LOS based on the LOS:TBSA ratio, 1.5 days for adults aged 18-59 years and 2.0 days for older adults aged ≥ 60 years. A retrospective review of an adult cohort study admitted to a tertiary burn center was conducted. We included all surviving patients with burn injuries admitted from January 2006 to June 2021. Primary outcome was whether patients met or exceeded the expected LOS:TBSA ratio. Median (IQR) age was 45 (31-58) years, 1635 (70%) were male, and median (IQR) %TBSA was 7 (3-14). Median (IQR) LOS was 13 (6-20) days, and LOS:TBSA median (IQR) was 1.65 (0.98-2.95). We found inhalation injury to be a predictor of prolonged LOS in both adults and older adults, while female sex and greater age only contributed to increased LOS in the adult group. In-hospital complications are modifiable factors of prolonged LOS in both adults and older adult patients. We identified that greater age, female sex, inhalation injury along with in-hospital complications affected LOS in adults. Greater age and sex did not affect LOS in older adult patients. Identified risk factors should be adjusted for in future prospective studies.