Related Experiment Videos
Burns in patients under 2 and over 70 years of age
H Q Le1, W Zamboni, E Eriksson
1Division of Plastic and Reconstructive Surgery, Southern Illinois University School of Medicine, Springfield 62708.
Insights
Extremely young and elderly burn patients face distinct challenges. While scalds are common in infants, flame burns dominate in seniors, with significantly higher mortality and complication rates in the older group.
Area of Science:
- Trauma Surgery
- Geriatric Medicine
- Pediatric Medicine
Background:
- Burn injuries disproportionately affect vulnerable populations, including pediatric and geriatric patients.
- Understanding age-specific differences in burn etiology, severity, and outcomes is crucial for targeted interventions.
- Retrospective analysis of burn center admissions provides valuable insights into demographic-specific morbidity and mortality.
Purpose of the Study:
- To compare morbidity and mortality patterns in burn patients younger than 2 years versus those older than 70 years.
- To identify specific burn mechanisms, total body surface area (TBSA) involvement, and complication profiles in these extreme age groups.
- To elucidate the primary causes of death and associated complications in pediatric and geriatric burn survivors.
Main Methods:
- Retrospective review of 246 consecutive burn patients admitted to a burn center.
- Patients were categorized into two groups: <2 years (n=165) and >70 years (n=81).
- Data collected included burn mechanism, TBSA, full/partial thickness burns, complications, and mortality.
Main Results:
- The younger group predominantly suffered scald burns (77%), while the older group experienced flame burns (79%).
- Older patients had a higher mean TBSA burned (25% vs. 13.2%) and significantly higher mortality (50.6% vs. 0.6%).
- Burn wound sepsis was the most frequent complication in both groups; cardiovascular and pulmonary issues were most fatal in the elderly.
Conclusions:
- Pediatric (<2 years) and geriatric (>70 years) burn patients exhibit distinct epidemiological and clinical characteristics.
- Mortality and complication rates are substantially higher in elderly burn patients compared to very young children.
- Age-specific management strategies are essential, with a focus on sepsis prevention in the young and cardiorespiratory support in the elderly.
Abstract:
A total of 246 consecutive burn patients younger than 2 years and older than 70 years of age admitted to a burn center were reviewed retrospectively to study morbidity and mortality specific to these two age groups. Of these patients, 165 were less than 2 years of age and 81 were over 70 years of age, representing 16% and 8% of the total patient population respectively. In patients under 2, scald burns occurred in 127 (77%) and flame burns in 18 (11%). In patients over 70, flame was the most common burn mechanism, occurring in 64 (79%) patients, while scalds occurred in 12 (15%). The mean total body surface area (TBSA) burned in the younger age group was 13.2% (2.4% full thickness, 10.8% partial thickness) and in the older age group was 25% (12.8% full thickness, 12.2% partial thickness). Only 1 death occurred in the younger age group (0.6% mortality), while 41 deaths occurred in the older age group (50.6% mortality). If the burn involved a total body surface area greater than 40%, all patients died (100% mortality). A total of 36 complications occurred in the younger age group (0.2 complications per patient) and 111 in the older age group (1.4 per patient). Burn wound sepsis was the most common complication in each group, occurring in 28 patients under 2 and 42 elderly patients, and was responsible for the 1 death in the younger age group. Although burn wound sepsis was the most common complication in those patients over 70, cardiovascular and pulmonary complications were the most deadly, accounting for 68% (28 patients) of total deaths in this group.