A Retrospective Analysis of Neurocognitive Impairment in Older Patients With Burn Injuries

Older adults comprise a growing proportion of the United States population that is at risk for burns. However, few studies have examined cognitive function in this patient population.

The purpose of this study was to measure the prevalence and incidence of dementia and delirium in older adults admitted for burn injuries.

This was an Institutional Review Board-approved, retrospective study of all patients 65 years and older admitted to the University of North Carolina Jaycee Burn Center from 2005-2015. Data extracted from the medical records included patient demographics, characteristics of the burn injury, incidence of delirium, incidence of psychiatric consultation, diagnosis of dementia, disposition, and mortality. The primary outcomes of interest were the prevalence and incidence of dementia and delirium. Secondary outcomes included length of stay and cost of hospitalization.

A total of 392 patients were included. These patients had a median age of 74 years and a median total body surface area burn of 7%. On admission, 44 patients (11%) had a diagnosis of dementia. An additional 28 patients were diagnosed with dementia during hospitalization for a total of 72 patients (18%); 154 patients (39%) were diagnosed with delirium. After controlling for burn severity, dementia and delirium were significantly associated with length of stay, incidence of psychiatry consultation, and discharge to a skilled nursing facility.

Physicians should have high suspicion for dementia and delirium in older patients admitted for burn injuries. Dementia and delirium are associated with morbidity in older patients with burn injuries.