Retrospective evaluation of the factors influencing the mortalities of geriatric patients in a burn intensive care unit

Yıl 2019, Cilt: 5 Sayı: 1, 15 - 20, 04.04.2019

Kutlu Hakan Erkal , Salih Günbeği Fatih Doğu Geyik Yücel Yüce Metin Özşeker

Öz

Objectives: This study aims to evaluate the geriatric patients hospitalized in our burn unit in terms of the changes in demographic distributions and treatment outcomes.

Materials and methods: We evaluated 101 geriatric patients (74 males, 27 females; mean age 66.6 years; range, 65 to 89 years) followed-up between January 2015 and December 2017 at University of Health Sciences Kartal Dr. Lütfi Kırdar Training and Research Hospital Burn Intensive Care Unit (BICU), whose data were correctly available, according to years, age, gender, cause and extent of burn, burn degree, month, season, place of residence, first referred health center, interval from injury to arrival at our burn center, treatment modality, treatment outcomes, and mortality reasons.

Results: The mean total body surface area burned was 21%. The most common etiology was scald burn. The most common etiology of mortalities was flame burn. Mortality rate was 20.3% with a statistically significant decrease over the years. The most common mortality reason was sepsis. Deaths due to acute renal failure or gastrointestinal hemorrhage also decreased over the years.

Conclusion: Our findings demonstrated that age, burn percentage, or presence of inhalation injury increased mortality in geriatric patients. The Abbreviated Burn Severity Index and Acute Physiology And Chronic Health Evaluation II scores at the start of treatment in the BICU were directly proportional to mortality.

Anahtar Kelimeler

Yanık, yanık etyolojisi, geriatrik, mortalite, risk faktörü

Kaynakça

• 1. DeSanti L. Pathophysiology and current management of burn injury. Adv Skin Wound Care 2005;18:323-32. 2. Fink MP, Abraham E, Vincent JL, Kochanek PM. Textbook of Critical Care. 5th ed. Philadelphia: Elsevier-Saunders; 2005. 3. Samaras N, Chevalley T, Samaras D, Gold G. Older patients in the emergency department: a review. Ann Emerg Med 2010;56:261-9. 4. Abu-Sittah GS, Chahine FM, Janom H. Management of burns in the elderly. Ann Burns Fire Disasters 2016;29:245-9. 5. Williams FN, Herndon DN, Jeschke MG. The Hypermetabolic Response to Burn Injury and Interventions to Modify This Response. Clin Plast Surg 2009;36:583-96. 6. Türegün M, Sengezer M, Selmanpakoglu N, Celiköz B, Nianci M. The last 10 years in a burn centre in Ankara, Turkey: an analysis of 5264 cases. Burns 1997;23:584-90. 7. Brusselaers N, Juhász I, Erdei I, Monstrey S, Blot S. Evaluation of mortality following severe burns injury in Hungary: external validation of a prediction model developed on Belgian burn data. Burns 2009;35:1009-14. 8. Sadeghi Bazargani H, Arshi S, Ekman R, Mohammadi R. Prevention-oriented epidemiology of burns in Ardabil provincial burn centre, Iran. Burns 2011;37:521-7. 9. Emami SA, Motevalian SA, Momeni M, Karimi H. The epidemiology of geriatric burns in Iran: A national burn registry-based study. Burns 2016;42:1128-32. 10. Mabrouk A, Maher A, Nasser S. An epidemiologic study of elderly burn patients in Ain Shams University Burn Unit, Cairo, Egypt. Burns 2003;29:687-90. 11. Yanculovich N, Perry ZH, Gurfinkel R, Rosenberg L. Objective estimates of the risk factors for death and length of hospitalization following burn injuries, Soroka University Medical Center, 2001-2002. Isr Med Assoc J 2013;15:152-5. 12. Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med 1998;338:362-6. 13. Haberal M, Uçar N, Bilgin N. Epidemiological survey of burns treated in Ankara, Turkey and desirable burn-prevention strategies. Burns 1995;21:601-6. 14. Kurto¤lu M, Alimo¤lu O, Ertekin C, Gülo¤lu R, Tavilo¤lu K. Evaluation of severe burns managed in intensive care unit. [Article in Turkish] Ulus Travma Acil Cerrahi Derg 2003;9:34-6. 15. Tarım MA. Factor affecting mortality in burn patients admitted to intensive care unit. Eastern Journal of Medicine 2013;18:72-5. 16. Greenhalgh DG. Burn resuscitation: the results of the ISBI/ABA survey. Burns 2010;36:176-82. 17. Andel D, Kamolz LP, Niedermayr M, Hoerauf K, Schramm W, Andel H. Which of the abbreviated burn severity index variables are having impact on the hospital length of stay? J Burn Care Res 2007;28:163-6.