Factors affecting mortality in patients with burns

Yıl 2015, Cilt: 6 Sayı: 3, 240 - 243, 25.10.2015

Halil Erbiş , İbrahim Aliosmanoglu Bünyamin Öztürk Burak Ülger Hüseyin Timucin Mehmet Türkoğlu Veli Vural

https://doi.org/10.5799/ahinjs.01.2015.03.0526

Öz

Objective: The increase in life quality and expectancy causes an increase in the elderly population. Improvements in burn treatment resulted in decreased mortality in children and young adults but in elderly patients burns are still an important trauma that should be handed differently than other age groups. The aim of this study was to evaluate the factors effecting mortality in patients with burns over 45 years old.

Methods: Fifty-eight patients over 45 years of age, who were treated in our burns unit in the last 3 years were included in our study. Their age, burn percentage and depth, coexisting diseases and mortality rates were examined retrospectively.

Results: The average age of surviving patients was 57.4 years while it was 70 years for nonsurviving patients (p=0.002). The width of burn area was 21.1 % in surviving and 50 % in nonsurviving patients (p<0.01). The effect of additional coexistent diseases on mortality was significant (p=0.001). The most common reasons of mortality were sepsis and congestive heart failure.

Conclusion: We found out that the age, percentage of burns and coexistent diseases had a negative effect on success of treatment and mortality. Mortality rates will decrease in these cases with careful follow-up and a multidisciplinary approach. J Clin Exp Invest 2015; 6 (3): 240-243

Key words: burns, coexisting, mortality, elderly patient

Anahtar Kelimeler

burns, coexisting, mortality, elderly patient

Yanıklı hastalarda mortaliteye etkili faktörler

Öz

Amaç: Yaşam kalitesi ve tıbbi tedavi imkanlarının artması, yaşlı hasta nüfusunda bir artışa neden olmuştur. Yanık tedavisindeki gelişmeler çocuklarda ve genç erişkinlerde yanığa bağlı mortalitede azalmaya neden olmuştur, ancak yaşlılardaki yanıklar, diğer yaş gruplarından farklı şekilde ele alınması gereken önemli bir travmadır. Bu çalışmanın amacı 45 yaşın üzerindeki yanıklı hastalarda mortalite üzerine etkili faktörleri değerlendirmektir. Yöntemler: Son 3 yıl içerisinde yanık ünitemizde tedavi edilen 45 yaş üzerindeki 58 hasta çalışmaya dahil edildi. Hastaların yaşları, yanık oranları ve yanıklarının derinliği, eşlik eden hastalıklar ve mortalite oranları retrospektif olarak değerlendirildi.Bulgular: Mortalite gelişmeyen hastaların ortalama yaşı 57,4 yıl iken, mortalite gelişenlerinki 70 yıl idi (p=0,002). Ortalama yanık genişliği mortalite gelişmeyenlerde % 21,1 iken, mortalite gelişenlerde % 50 idi (p<0,01). Yanıklı hastalarda eşlik eden hastalık bulunmasının mortalite üzerine anlamlı etkisi olduğu saptandı (p=0,001). Mortalitenin en önemli nedeni sepsis ve konjestif kalp yetmezliği idi. Sonuç: Çalışmamızın sonuçları yanık alanının yüzdesinin ve eşlik eden hastalıkların varlığının tedavi başarısı ve mortalite üzerine olumsuz etkileri olduğunu gösterdi. Bu hastalarda multidisipliner yaklaşım ve yakın takip ile mortalite oranlarının düşeceğini düşünmekteyiz

Anahtar Kelimeler

Yanıklar, eşlik eden hastalıklar, mortalite, yaşlı hastalar

Kaynakça

• Masud D, Norton S, Smailes S, et al. The use of a frailty scoring system for burns in the elderly. Burns 2013;39:30-36.
• Aliosmanoğlu C, Aliosmanoğlu İ, Kapan M, et al. Treatment and follow-up results of children with electrical burn who observed in burn intensive care unit. Dicle Medical Journal 2011;38:170-173.
• Barret P. The Small Burn. In: Barret P, Herndon N. Principles
• and practices in burns surgery. New York: Marcel Dekker 2005;187-220.
• Saffle JR, Larson CM, Sullivan J, Shelby J. The continuing challenge of burn care in the elderly. Surgery 1990;108:534-543.
• Redlick F, Cooke A, Gomez M, et al. A survey of risk factors for burns in the elderly and prevention strategies. J Burn Care Rehabil 2002;23:351-356.
• Kara M, Peters WJ, Douglas LG, Morris SF. An early surgical approach to burns in the elderly. J Trauma 1990;30:430-432.
• Wibbenmeyer LA, Amelon MJ, Morgan LJ, et al. Predicting survival in an elderly burn population. Burns 2001;27:583-590.
• Colohan SM. Predicting prognosis in thermal burns with associated inhalational injury: a systematic review of prognostic factors in adult burn victims. J Burn Care Res 2010;31:529-539.
• Ryan CM, Schoenfeld DA, Thorpe WP, et al. Objective estimates of the probability of death from burn injuries. N Engl J Med 1998;338:362-366.
• Godwin Y, Wood SH. Major burns in Cape Town: a modified burns score for patient triage. Burns 1998;24:58-63.
• McGill V, Kowal-Vern A. Gamelli RL. Outcome for older burn patients. Arch Surg 2000;135:320-325.
• Porro LJ, Demling RH, Pereira CT, Herndon DN. Care of geriatric patients. In: Herndon D. Total Burn Care (Fourth Edition). London: Saunders 2012;415-419.
• O’Neill A, Rabbits A, Hamel H, Yurt R. Burns in the elderly;our burn centers experience with patients over 75 years old. J Burn Care Rehabil 2000;21:183.
• Rao K, Ali SN, Moiemen NS. Aetiology and outcome of burns in the elderly. Burns 2006;32:802-805.
• Ho WS, Ying SY, Chan HH. A study of burn injuries in the elderly in a regional burn centre. Burns 2001;27:382-385.
• Yolcu S, Beceren NG, Timuçin H, Uludağ U. Emergency service admissions of patients with burn injury. J Clin Exp Invest 2013;4:285-288.