title: The impact of caregiver support on mortality following burn injury in the elderly.
abstract: Advances in burn care have decreased mortality in the past 20 years, but affecting elderly mortality rates (>65 years) remain challenging. This study evaluates the impact of home caregiver support on elderly burn patients' mortality. The authors retrospectively reviewed patients aged 65 and older admitted to their burn center from July 1995 to October 2004. Patient demographics, Injury Severity Score, TBSA, and patients' primary caregiver were collected. The outcomes were mortality, disposition, and length of stay and these were evaluated using univariate and subsequently multivariate regression. Significance was calculated at P ≤ .05. A total of 112 patients were included in the analysis. The mean age was 76±8. Male patients constituted 47%, whereas 53% were female patients, and mean TBSA was 21±16%. Thirty patients' primary caregiver was a spouse, for 38 it was a child, and 44 had no caregiver. Fifty-eight patients survived (51.7%), and 54 patients died (48.3%). Only 21% of the survivors had a child as their primary caregiver; however, 48% of the nonsurvivors had a child as the primary caregiver (P ≤ 0.05). On multivariate analysis, age, TBSA, and child as primary caregiver were all independent predictors of mortality. Having a child as a caregiver provided the largest impact, with an odds ratio of 4.4 (95% confidence interval, 1.2-15.62; P = .02).
authors.affiliation: Division of Burns, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Florida, USA.
authors.forename: Salman K
authors.initials: SK
authors.lastname: Alsafran
authors.forename: James S
authors.initials: JS
authors.lastname: Davis
authors.forename: Susan
authors.initials: S
authors.lastname: Tankel
authors.forename: Robin
authors.initials: R
authors.lastname: Varas
authors.forename: Olga
authors.initials: O
authors.lastname: Quintana
authors.forename: Ron
authors.initials: R
authors.lastname: Manning
authors.forename: Candace
authors.initials: C
authors.lastname: Glenn
authors.forename: Louis R
authors.initials: LR
authors.lastname: Pizano
authors.forename: Nicholas
authors.initials: N
authors.lastname: Namias
authors.forename: Carl I
authors.initials: CI
authors.lastname: Schulman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002053:Burn Units; D002056:Burns / Q000401:mortality* / Q000451:nursing*; D017028:Caregivers; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies