title: Social issues prolong elderly burn patient hospitalization.
abstract: A retrospective audit of length of hospital inpatient stay of all patients admitted to the Royal Adelaide Hospital Burns Unit over a 5-year period was performed. Data gathered from the Burns Unit database and records allowed patient division into two comparison groups: those younger than 70 years and those aged 70 years or older. Further comparison based on discharge destination was made in the ≥70 years group. Outcomes included length of stay, burn size, and discharge destination. A total of 1641 patients were included. The median length of stay was 5.0 days for patients younger than 70 years and 10.0 days for those aged 70 years or older (P < .0001). The mean percentage of TBSA burned was similar. A greater proportion of those aged 70 years or older were discharged to supported care facilities, such as nursing homes, and a greater proportion needed assessment for placement (P < .001) when compared with those younger than 70 years. The median length of stay of those aged 70 years or older who did not need assessment for placement was 9.0 days compared with 38.0 days for those who needed assessment (P < .0001). Elderly patients have, generally, nearly twice the length of stay of younger patients; when further subdivided according to discharge destination, the effect of placement delay (a social issue) becomes apparent and disturbing. This has significant implications, given the limited capacity and high cost of burn unit admission. A geriatrician will be appointed to the Burn Service over the next 12 months to assess whether earlier geriatric assessment can decrease the length of inpatient admission by facilitating a more efficient placement process.
authors.affiliation: Adult Burn Centre, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Solanki
authors.forename: John E
authors.initials: JE
authors.lastname: Greenwood
authors.forename: Ian P
authors.initials: IP
authors.lastname: Mackie
authors.forename: Sheila
authors.initials: S
authors.lastname: Kavanagh
authors.forename: Robert
authors.initials: R
authors.lastname: Penhall
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D003266:Continuity of Patient Care / Q000191:economics / Q000639:trends*; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008485:Medical Audit; D020380:Needs Assessment; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013021:South Australia; D018709:Statistics, Nonparametric; D016019:Survival Analysis