US emergency department (ED) visits for burns and factors associated with inter-facility transfer are unknown and described in this manuscript. We conducted a retrospective analysis of burn-related injuries from 2009–2014 using the Nationwide Emergency Department Sample (NEDS), the largest sample of all-payer datasets. We included all ED visits by adults with a burn related ICD-9 code and used a weighted multivariable logistic regression model to predict transfer adjusting for covariates. Between 2009–2014, 3,047,701 (0.4%) ED visits were for burn related injuries. A total of 108,583 (3.6%) burn visits resulted in inter-facility transfers occurred during the study period, representing approximately 18,097 inter-facility transfers per year. Burns with greater than 10% total body surface area (TBSA) resulted in a 10-fold increase in the probability of transfer, compared to burn visits with less than 10% TBSA burns. In the multivariable model, male sex (adjusted odds ratio [aOR] 2.4, 95% CI 2.3–2.6) was associated with increased odds of transfer. Older adults were more likely to be transferred compared to all other age groups. Odds of transfer were increased for Medicare and self-pay patients (vs. private pay) but there was a significant interaction of sex and payer and the effect of insurance varied by sex. In a national sample of ED visits, burn visits were more than twice as likely to have an inter-facility transfer compared to the general ED patient population. Substantial sex differences exist in U.S. EDs that impact the location of care for patients with burn injuries and warrants further investigation.

中文翻译：

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烧伤相关伤害：美国六年期间成人跨机构转移的全国性分析

美国急诊科 (ED) 因烧伤就诊以及与设施间转移相关的因素未知，并在本手稿中进行了描述。我们使用全国急诊部样本 (NEDS) 对 2009 年至 2014 年的烧伤相关伤害进行了回顾性分析，NEDS 是所有付款人数据集的最大样本。我们将所有具有烧伤相关 ICD-9 代码的成人 ED 就诊包括在内，并使用加权多变量逻辑回归模型来预测协变量的转移调整。2009-2014 年间，3,047,701 (0.4%) 次急诊就诊是因烧伤相关的伤害。在研究期间，共有 108,583 次 (3.6%) 烧伤访问导致设施间转移，相当于每年约 18,097 次设施间转移。与小于 10% TBSA 烧伤的烧伤就诊相比，全身表面积 (TBSA) 大于 10% 的烧伤导致转移概率增加 10 倍。在多变量模型中，男性（调整优势比 [aOR] 2.4, 95% CI 2.3–2.6）与转移几率增加相关。与所有其他年龄组相比，老年人更有可能被转移。医疗保险和自费患者（相对于私人支付）的转移几率有所增加，但性别和付款人之间存在显着的相互作用，并且保险的影响因性别而异。在 ED 就诊的全国样本中，与一般 ED 患者群体相比，烧伤就诊的跨机构转移的可能性是其两倍多。美国存在巨大的性别差异