title: Long-term functional outcomes in the elderly after burn injury.
abstract: Although the elderly represent a substantial proportion of the population, limited information exists on postdischarge long-term outcomes of elderly burn survivors. The purpose of this study was to assess elderly burn patient outcomes 2 to 10 years after discharge. This study was a prospective cross-sectional survey assessment of quality of life and retrospective trauma registry for the American College of Surgeons review of patients ≥ 60 years of age discharged alive after acute burn from 1997 to 2007. In-hospital treatment and burn demographic information were obtained from database and chart review. Surviving patients or their families were contacted, and the Short-Form-12 and Functional Independence Measure (FIM) administered. Of the 344 patients discharged, 232 participated. Mean age was 72.3 (60-85.8) years, TBSA burn was 7.8% (1-79), and length of stay was 11.2 ± 0.9 days (1-51). Most patients were discharged home (71%) or to a skilled nursing facility (SNF; 20%). Mean interval between discharge and survey administration was 46.1 months. In all, 24% of patients sent home died after discharge and prior to interview compared with 58% of patients sent to an SNF. On multivariate analysis, mortality increased with age (confidence interval [CI] 1.04-1.09), and government insurance (CI 0.34-0.94), but decreased with discharge to home (CI 1.68-4.47). There were no differences in FIM or Short-Form-12 scores between groups. Long-term mortality after discharge in elderly burn survivors is substantial. Patients sent to an SNF or with government insurance had increased mortality postdischarge. These data suggest that issues that may influence disposition status of elderly burn patients should be optimized prior to discharge to mitigate adverse outcomes associated with SNF placement.
authors: Department of Surgery, University of California Davis Regional Burn Center, Sacramento, CA, USA.
authors: Tina L
authors: TL
authors: Palmieri
authors: Fred
authors: F
authors: Molitor
authors: Grace
authors: G
authors: Chan
authors: Elizabeth
authors: E
authors: Phelan
authors: Brian J
authors: BJ
authors: Shier
authors: Soman
authors: S
authors: Sen
authors: David G
authors: DG
authors: Greenhalgh
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002053:Burn Units; D002056:Burns / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D002140:California; D003266:Continuity of Patient Care / Q000592:standards / Q000639:trends; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D015601:Injury Severity Score; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D018570:Risk Assessment; D012737:Sex Factors; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D015996:Survival Rate; D017741:Survivors; D013997:Time Factors