Delayed Healing and Infection in Elderly Intermediate-Severity Burns: Clinical Predictors and Implications for Care

Burn injuries in elderly patients within resource-limited settings represent a major therapeutic challenge due to increased vulnerability associated with age-related physiological changes and prevalent comorbidities. This study focuses on intermediate-severity burns and aims to identify clinical predictors of delayed wound healing and burn wound infection in elderly patients in Central Tunisia. We conducted a retrospective study including patients aged 65 years and older who were hospitalized for thermal burns between January 2013 and December 2022. Demographic, clinical and outcome data were analyzed using SPSS v26. Prognostic factors for delayed healing and infection were identified through multivariate logistic regression. Among 414 burn admissions, 31 patients (7.48%) were aged ≥65 years. Flame burns were predominant (77.4%). Key predictors of poor outcomes included: total body surface area burned (TBSA) >10% (OR 3.2; 95% CI 1.4-7.1); full-thickness burns (OR 2.8; 95% CI 1.2-6.5); delayed admission >24 hours (OR 2.1; 95% CI 1.1-4.3). In elderly patients with intermediate-severity burns, early specialized intervention and optimal management of comorbidities are essential to reduce the risk of delayed healing and infection.