• Tina L Palmieri, Sandra Taylor, MaryBeth Lawless, Terese Curri, Soman Sen, and David G Greenhalgh.
• 1Burn Division, Department of Surgery, Shriners Hospital for Children Northern California, Sacramento, CA. 2Department of Surgery, University of California Davis, Sacramento, CA. 3Department of Public Health Sciences, University of California Davis Medical Center, Sacramento, CA.
• Pediatr Crit Care Me. 2015 May 1; 16 (4): 319-24.

ObjectivesDetermine the relationship between the volume of burn admissions and outcomes for children with burns.DesignRetrospective review of the National Burn Repository from 2000-2009 using mixed effect logistic regression modeling.SettingTertiary burn centers in the United States.PatientsAll children <18 years of age admitted with burn injury to a burn center submitting data to the National Burn Repository.InterventionsNone.Measurements And Main ResultsOf the 210,683 records in the NBR from 2000-2009, 33,115 records for children ≤ 18 years of age met criteria for analysis; 26,280 had burn sizes smaller than 10%; only 32 of these children died. Volume of children treated varied greatly among facilities. Age, total body surface area burn, inhalation injury, and burn center volume influenced mortality (p < 0.05) An increase in the median yearly admissions of 100 decreased the odds of mortality by approximately 40%. High volume centers (admitting >200 pediatric patients/year) had the lowest mortality when adjusting for age and injury characteristics (p < 0.05).ConclusionsHigher volume pediatric burn centers had lower mortality, particularly at larger burn sizes. The lower mortality of children a high volume centers could reflect greater experience, resource, and specialized expertise in treating pediatric patients.

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