Elderly burns; Our clinical experiences

Yıl 2022, , 227 - 234, 30.09.2022

Ali Emre Akgün , Merve Akın , İsa Sözen , Nihan Turhan , Nermin Damla Okay , Ahmet Çınar Yastı

https://doi.org/10.47482/acmr.1091483

Öz

Background: Though mortality rates have decreased with better understanding of burns’ pathophysiology and advanced monitoring, elderly burn patients are still a challenging health problem. The elderly population is increasing worldwide. The aim of this study is to investigate the outcomes of burns for elderly patients and increase medical, public and governmental awareness of the issue. Elderly people should be trained in preventive measures to diminish the number of burn accidents.

Methods: Hospitalized patients between 2011 and 2019 were retrospectively studied. Age, gender, burned total body surface area (TBSA), burn agent, comorbidities, location of the burn injury, whether a house fire accompanied, and mortality rates were compared between adult patients (18 to 64 years old) and those who were elderly (65 years or older).

Results: Of the 2258 patients, 285 (12.6%) were aged 65 or older. The burned TBSAs of the adult patients were larger than those of the elderly patients (p=0.019). Scalding and contact burns were more frequent among the elderly than the adults (p=0.001). The elderly had greater co-morbidities, were mostly burned at home and more house fires accompanied their injuries than those of the adults (p<0.001). Despite having lesser burned TBSAs, mortality rates were significantly higher in the elderly (p<0.001).

Conclusions: As the elderly population increases worldwide, burn treatment facilities should be prepared for their increase in numbers and co-morbidities. To enforce preventive measures, awareness of the growing issue should be raised and public authorities should be alerted to their need to act.

Anahtar Kelimeler

Burns, Aged, Mortality, Comorbidity

Kaynakça

• 1. TurkStat. İstatistiklerle Yaşlılar. 2020. https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2020-37227. Accessed. September 20, 2021
• 2. Wang W, Zhang J, Lv Y, Zhang P, Huang Y, Xiang F. Epidemiological Investigation of Elderly Patients with Severe Burns at a Major Burn Center in Southwest China. Med Sci Monit. 2020;26:e918537.
• 3. Mahar P, Wasiak J, Bailey M, Cleland H. Clinical factors affecting mortality in elderly burn patients admitted to a burns service. Burns. 2008;34(5):629-36.
• 4. McGill V, Kowal-Vern A, Gamelli RL. Outcome for older burn patients. Arch Surg. 2000;135(3):320-5.
• 5. Huang SB, Chang WH, Huang CH, Tsai CH. Management of Elderly Burn Patients, Int J Gerontol. 2008; 2(3):91-97.
• 6. Jacobson RG, Flowers FP. Skin changes with aging and disease. Wound Repair Regen. 1996;4(3):311-5. doi: 10.1046/j.1524-475X.1996.40305.x. PMID: 17177725.
• 7. Jeschke MG, Patsouris D, Stanojcic M, Abdullahi A, Rehou S, Pinto R, et al. Pathophysiologic Response to Burns in the Elderly. EBioMedicine. 2015;2(10):1536-48.
• 8. Pham TN, Kramer CB, Wang J, Rivara FP, Heimbach DM, Gibran NS, et al. Epidemiology and outcomes of older adults with burn injury: an analysis of the National Burn Repository. J Burn Care Res. 2009;30(1):30-6.
• 9. Mabrouk A, Maher A, Nasser S. An epidemiologic study of elderly burn patients in Ain Shams University Burn Unit, Cairo, Egypt. Burns. 2003;29(7):687-90.
• 10. Lewandowski R, Pegg S, Fortier K, Skimmings A. Burn injuries in the elderly. Burns. 1993;19(6):513-5.
• 11. Vendrusculo TM, Balieiro CR, Echevarría-Guanilo ME, Farina Junior JA, Rossi LA. Burns in the domestic environment: characteristics and circumstances of accidents. Rev Lat Am Enfermagem. 2010;18(3):444- 51.
• 12. Hunt JL, Arnoldo BD, Purdue GF. Prevention Of Burn Injuries. In: Herndon DN, editor. Total Burn Care. Elsevier Health Sciences; 2012. p. 47-55.
• 13. Keck M, Lumenta DB, Andel H, Kamolz LP, Frey M. Burn treatment in the elderly. Burns. 2009 ;35(8):1071-9.
• 14. Sayampanathan AA. Systematic review of complications and outcomes of diabetic patients with burn trauma. Burns. 2016;42(8):1644-1651.
• 15. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care. 2002;25(9):1551-6.
• 16. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169-80.
• 17. Faurie MP, Allorto NL, Aldous C, Clarke DL. A closer look at burn injuries and epilepsy in a developing world burn service. S Afr J Surg. 2015;53(3 and 4):48-50.
• 18. Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the baux score. J Trauma. 2010;68(3):690-7.
• 19. Wibbenmeyer LA, Amelon MJ, Morgan LJ, Robinson BK, Chang PX, Lewis R 2nd, et al. Predicting survival in an elderly burn patient population. Burns. 2001;27(6):583-90.
• 20. Farinas AF, Bamba R, Pollins AC, Cardwell NL, Nanney LB, Thayer WP. Burn wounds in the young versus the aged patient display differential immunological responses. Burns. 2018;44(6):1475-1481.
• 21. Larson CM, Saffle JR, Sullivan J. Lifestyle adjustments in elderly patients after burn injury. J Burn Care Rehabil. 1992;13(1):48-52.