{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:17:34Z","timestamp":1792099054937,"version":"4.4.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T00:00:00Z","timestamp":1525132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Anaesth Intensive Care"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:p>The New South Wales (NSW) Statewide Burn Injury Service Database was reviewed to identify variations in clinical practice with respect to care of severely burn-injured patients in intensive care. We compared differences in practice relating to duration of endotracheal intubation and surgical grafting. In this retrospective observational study, we reviewed all intensive care unit (ICU) admissions to the two NSW adult burns centres, ICU A and ICU B, between January 2008 and December 2015. Data were analysed for association between duration of intubation and outcome. There were 855 admissions to adult ICU, with a significant difference in the percentage total body surface area (% TBSA) of burn and inhalation injury between patients in the two units. There was a significant difference in duration of intubation and ICU length of stay (LOS) between the units, which persisted when adjusted for age, % TBSA and inhalational injury. When analysing patients with more severe burns (&gt;20% TBSA or intubated), the difference in duration of intubation remained significant (median of three days [interquartile range, IQR, 1\u201311 days] in A and 2 days [IQR 1\u20136 days] in B, P=0.003) as did ICU LOS (median 3 days [IQR 2\u201311 days] for A and 2 days [IQR 1\u20136 days] for B, P &lt;0.0005). There was no significant difference in mortality between the two units for the severe or the more severe subgroup of burns when adjusted for age, % TBSA and inhalational injury (adjusted odds ratio, OR, for mortality 1.17 [95% confidence intervals 0.6 to 2.3, P=0.65]). There were significant differences in clinical practice, including duration of intubation, between the two ICUs. Longer intubation was associated with a longer ICU LOS, but was not associated with a difference in mortality. Large collaborative, prospective multicentre studies in severe burns are needed to identify best practice and variations in practice to determine if they are associated with increased mortality and\/or cost.<\/jats:p>","DOI":"10.1177\/0310057x1804600310","type":"journal-article","created":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T00:52:21Z","timestamp":1547081541000},"page":"321-325","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical Practice Variation in Acute Severe Burn Injury"],"prefix":"10.1177","volume":"46","author":[{"given":"T. L.","family":"Garside","sequence":"first","affiliation":[{"name":"Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, New South Wales"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. P.","family":"Lee","sequence":"additional","affiliation":[{"name":"Intensivist, Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, New South Wales"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Delaney","sequence":"additional","affiliation":[{"name":"Intensivist, Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, New South Wales"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Milliss","sequence":"additional","affiliation":[{"name":"Intensivist and Former Director, Intensive Care Services, Concord Hospital, Sydney, New South Wales"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,5,1]]},"reference":[{"key":"bibr1-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2013.08.002"},{"key":"bibr2-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2010.tb04021.x"},{"key":"bibr3-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3965"},{"key":"bibr4-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2016.02.025"},{"key":"bibr5-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1968.tb14738.x"},{"key":"bibr6-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1097\/BCR.0B013E318053D3A1"},{"key":"bibr7-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2004.01.021"},{"key":"bibr8-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2013.07.006"},{"key":"bibr9-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.23.100901.140546"},{"key":"bibr10-0310057X1804600310","volume-title":"Care, ACoSaQiH, Medical Practice Variation: Background Paper, ACoSaQiH Care, Editor.","year":"2013"},{"key":"bibr11-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.5694\/mja15.00989"},{"key":"bibr12-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000438"},{"key":"bibr13-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2011.07.017"},{"key":"bibr14-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000075341.43956.E4"},{"key":"bibr15-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000252572.50684.49"},{"key":"bibr16-0310057X1804600310","unstructured":"DysonK.B., GabbeB., and ThomasT. eds. Burns Registry of Australia and New Zealand (BRANZ) Annual Report, BRANZ, 2015, Burns Registry of Australia and New Zealand: Victoria."},{"key":"bibr17-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2012.05.016"},{"key":"bibr18-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2007.12.011"},{"key":"bibr19-0310057X1804600310","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.013"}],"container-title":["Anaesthesia and Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X1804600310","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X1804600310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:10:34Z","timestamp":1777367434000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0310057X1804600310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1177\/0310057X1804600310"],"URL":"https:\/\/doi.org\/10.1177\/0310057x1804600310","relation":{},"ISSN":["0310-057X","1448-0271"],"issn-type":[{"value":"0310-057X","type":"print"},{"value":"1448-0271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5]]}}}