Changes in epidemiology and care strategies at the Norwegian National Burn Centre over 35 years (1986–2020)

Abstract

Introduction: We evaluated trends in admissions, % TBSA (total body surface area) burnt, age, and outcomes over a 35-year period at the national burn centre in Norway.

Methods: Relevant data were extracted from the departmental quality registry covering all acute admissions for burns during 1986–2020.

Results: In 1986–2020 there were 2.889 admissions for burns (67.6 % males), with a 110 % increase in 2016–20 when compared to 1986–90. Admissions of children <2 years increased by 400 %. In 2011–20, 66.5 % of patients were transferred from other hospitals. The median area injured declined markedly, from 16.5% TBSA in 1986–90 to 4.5% TBSA in 2016–20. Changes in care included an increased focus on non-delayed referrals and transfers, an explicit intent to achieve early excision within 48 h, and a transition from a highly frequent to a less frequent dressing changes scheme. Mortality declined from 10.9 % to 3.0 %. In 2011–20 the mortality among actively treated patients was 2.4 %. For patients with Baux scores 80–119, mortality declined from 36.0 % (1991–2010) to 18.2 % (2011–20) (P < 0.001).

Discussion: Since 1986, more patients have been referred to the burn centre, many of younger ages and with more minor burns. Survival of patients with Baux scores 80–119 increased significantly.