Burn Injuries in Elderly—A Retrospective Analysis of a Ten Year Period

Abstract

Objective: Geriatric patients represent a separate group in the treatment of burn injury regarding pathogenesis, pathophysiology and therapeutic procedure. Methods: From 2000 to 2010 on our burn unit 53 patients aged over 60 years were treated. The mean age of the 27 women and 26 men was 76 years (60 - 102 years), with an average of 33.2% of total burn surface area. 25 patients (47.2%) had severe inhalation injury, 77.4% of the patients suffered full thickness burn injuries. Mean ABSI Score was 12. Relevant additional diseases were coronary heart disease, heart insufficiency, hypertension, COPD, adiposity and chronic alcoholism. Results: 22 patients were treated by early operative intervention (day 0 - 4), 13 of these patients survived further process. In 17 cases first operative procedure could take place only at a later date, 14 patients deceased before operation. 26 patients developed pneumonia. The total morbidity amounted to 26 of 53 patients (49%). A total of 19 injured with a burn index over 80 survived. 9 of them had an index of more than 100. Usual indices as the “Zellweger Index” and the ABSI-Score are not adequate to determine the prognosis of thermal injuries in the elderly. Conclusion: The treatment of elderly with burn trauma is affected by many factors. Compared to younger patients the increased incidence of an inhalation injury is decisive for the prognosis of older patients. The frequency of pre-existing diseases is clearly largely than with younger burn injured patients. These prognostically relevant parameters were not sufficiently considered by established score systems.

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F. Siemers, E. Liodaki, K. L. Mauss, F. H. Stang, T. von Wild and P. Mailaender, "Burn Injuries in Elderly—A Retrospective Analysis of a Ten Year Period," Modern Plastic Surgery, Vol. 2 No. 2, 2012, pp. 13-19. doi: 10.4236/mps.2012.22004.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] G. Zellweger, “Die Behandlung der Verbrennungen, Praktische Hinweise für Diagnose, Therapie, Rehabilitation,” German Medical Company, 2nd Edition, Auflage, Colognia, 1985.
[2] J. Tobiasen, J. M. Hiebert and R. F. Edlich, “The Abbreviated Burn Severity Index,” Annals of Emergency Medicine, Vol. 11, No. 5, 1982, pp. 260-262. doi:10.1016/S0196-0644(82)80096-6
[3] W. S. Ho, S. Y. Ying and H. A. Chan, “A Study of Burn Injuries in the Elderly in A Regional Burn Centre,” Burns, Vol. 27, No. 4, 2001, pp. 382-385. doi:10.1016/S0305-4179(00)00146-7
[4] P. Q. Bessey, R. R. Arons, C. J. Dimaggio and R. W. Yurt, “The Vulnerabilities of Age: Burns in Children and Older Adults,” Surgery, Vol. 140, No. 4, 2006, pp. 705-715.
[5] A. R. Ehrlich, “Preventing Burns in Older Patients,” American Family Physician, Vol. 74, No. 10, 2006, pp. 1688-1693.
[6] V. McGill, A. Kowal-Vern and R. L. Gamelli, “Outcome for Older Burn Patients,” Archives of Surgery, Vol. 135, No. 3, 2000, pp. 320-325. doi:10.1001/archsurg.135.3.320
[7] W. L. Straus, J. F. Plouffe, T. M. File, H. B. Lipman, B. H. Hackman, S. J. Salstrom, R. F. Benson and R. F. Breiman, “Risk Factors for Domestic Acquisition of Legionnaires Disease. Ohio legionnaires Disease Group,” Archives of Internal Medicine, Vol. 156, No. 15, 1996, pp. 1685-1692. doi:10.1001/archinte.1996.00440140115011
[8] B. McCampbell, N. Wasif, A. Rabbitts, L. Staiano-Coico, R. W. Yurt and S. Schwartz, “Diabetes and Burns: Retrospective Cohort Study,” Journal of Burn Care & Rehabilitation, Vol. 23, No. 3, 2002, pp. 157-166. doi:10.1097/00004630-200205000-00004
[9] D. L. Smith, B. A. Cairns, F. Ramadan, J. S. Dalston, S. M. Fakhry, R. Rutledge, A. A. Meyer and H. D. Peterson, “Effect of Inhalation Injury, Burn Size, and Age on Mortality: A Study of 1447 Consecutive Burn Patients,” Journal of Trauma and Acute Care Surgery, Vol. 37, No. 4, 1994, pp. 655-659. doi:10.1097/00005373-199410000-00021
[10] A. Seekamp, M. van Griensven, F. Hildebrandt, T. Wahlers and H. Tscherne, “Adenosine-Triphosphate in Trauma-Related and Elective Hypothermia,” Journal of Trauma, Vol. 47, No. 4, 1999, pp. 673-683.
[11] F. Horbrand, C. Schrank, G. Henckel-Donnersmarck and W. Muhlbauer, “Integration of Preexisting Diseases and Risk Factors in the Abbreviated Burn Severity Index (ABSI),” Anasthesiol Intensivmed Notfallmed Schmerzther, Vol. 38, No. 3, 2003, pp. 151-157.
[12] N. E. Alden, A. Rabbitts and R. W. Yurt, “Burn Injury in Patients with Dementia: An Impetus for Prevention,” Journal of Burn Care & Rehabilitation, Vol. 26, No. 3, 2005, pp. 267-271.
[13] O. Oncul, F. Yuksel, H. Altunay, C. Acikel, B. Celikoz and S. Cavuslu, “The Evaluation of Nosocomial Infection During 1-Year-Period in the Burn Unit of a Training Hospital in Istanbul, Turkey,” Burns, Vol. 28, No. 8, 2002, pp. 738-744. doi:10.1016/S0305-4179(02)00106-7
[14] H. K. Estahbanati, P. P. Kashani and F. Ghanaatpisheh, “Frequency of Pseudomonas Aeruginosa Serotypes in Burn Wound Infections and Their Resistance to Antibiotics,” Burns, Vol. 28, No. 4, 2002, pp. 340-348. doi:10.1016/S0305-4179(02)00024-4
[15] J. A. Griswold, “White Blood Cell Response to Burn Injury,” Seminars in Nephrology, Vol. 13, No. 4, 1993, pp. 409-415.
[16] G. Uhlenbruck, J. Solter, E. Janssen and H. Haupt, “Two new, Additional ‘Combining Sites’ of C-Reactive Protein: Lectin Specificity of the Anti-Galactan Type and AntiHaemocyanin Reactivity,” Hoppe Seylers’ Journal of Physiological Chemistry, Vol. 362, No. 8, 1981, pp. 1167-1169.

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