Palliative Care in Patients Admitted with Primary Burn Injury

Burns are associated with significant morbidity and mortality. Palliative care (PC) has been shown to improve patients' comfort, clinical decision-making, and overall satisfaction in the burn unit. The purpose of this paper is to describe the frequency of PC utilization after burn injury and to understand the patient characteristics that affect whether they are seen by PC. We conducted a retrospective study by querying the Healthcare Cost and Utilization Project National Inpatient Sample, identifying patients admitted with a primary burn diagnosis from 2016 to 2021. Patient characteristic differences were assessed between patients who did and did not receive PC using chi-square analyses and multi-variable regression, weighted to represent the national population. Revised Baux (rBaux) scores were calculated. Of 146 455 patients admitted with a primary burn diagnosis, 3535 (2.4%) received PC consultation. Of 5205 patients who died prior to discharge (3.6% of total), 2370 (45.5% of deaths) had a PC encounter. Older patients, patients with larger burns, and patients with higher rBaux scores were most likely to receive PC. White patients were more likely to receive PC than Black and Hispanic patients. Patients in teaching hospitals were more likely to receive PC than those in rural, nonteaching hospitals. Patients in northern regions received PC more often than those in other regions. More than half of patients with burn injuries who died prior to discharge did not receive PC. Older patients and those with higher rBaux scores received PC most often. Further research is necessary to identify burn patients most likely to benefit from and receive PC.