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The elderly burn patient.

J L Hunt1, G F Purdue

  • 1Parkland Memorial Hospital, Dallas, Texas.

American Journal of Surgery
|November 1, 1992
PubMed
Summary
This summary is machine-generated.

This study analyzed 547 elderly burn patients, finding high mortality (50%) with pulmonary sepsis as the leading cause. Burn excision did not improve survival but reduced hospital length of stay for smaller burns.

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Area of Science:

  • Geriatric Burn Medicine
  • Trauma Surgery
  • Critical Care

Background:

  • Elderly patients (over 64 years) with severe burns (mean 25% total body surface area) present unique treatment challenges.
  • Flame/flash injuries were the predominant etiology (81%) in this geriatric burn cohort.
  • Inhalation injury significantly increased mortality, with a 100% fatality rate in affected patients.

Purpose of the Study:

  • To evaluate the outcomes of severe burn management in elderly patients.
  • To assess the impact of burn excision on survival and length of stay.
  • To identify factors influencing mortality and complications in this demographic.

Main Methods:

  • Retrospective analysis of 547 elderly burn patients treated over 16 years.
  • Data collection included burn etiology, total body surface area (TBSA), inhalation injury, surgical interventions (excision), complications, and mortality.

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  • Outcomes were analyzed based on burn size, presence of inhalation injury, and surgical treatment.

    • Main Results:

    • Overall mortality was 50%, with a mean age of 77 years and 40% TBSA in non-survivors. No patients with >47% TBSA survived.
    • Burn excision in patients with 0-10% TBSA burns did not improve survival but reduced length of stay (LOS) from 21 to 9 days.
    • Patients with 11-20% TBSA burns showed no significant difference in LOS or survival between excised and non-excised groups.
    • Pulmonary sepsis was the leading cause of death.
    • 28% of patients experienced postburn complications.

    Conclusions:

    • Severe burns in the elderly have a high mortality rate, with pulmonary sepsis being the primary cause of death.
    • Burn excision may reduce length of stay for smaller burns in elderly survivors but does not impact overall survival.
    • Aggressive management and prevention of pulmonary sepsis are critical for improving outcomes in geriatric burn patients.