title: Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre.
abstract: Outcomes after burn have continued to improve over the last 70 years in all age groups including the elderly. However, concerns have been raised that survival gains have not been to the same magnitude in elderly patients compared to younger age groups. The aims of this study were to analyze the recent outcomes of elderly burn injured patients admitted to the Birmingham Burn Centre, compare data with a historical cohort and published data from other burn centres worldwide. A retrospective review was conducted of all patients ≥65 years of age, admitted to our centre with cutaneous burns, between 2004 and 2012. Data was compared to a previously published historical cohort (1999-2003). 228 patients were included. The observed mortality for the study group was 14.9%. The median age of the study group was 79 years, the male to female ratio was 1:1 and median Total Body Surface Area (TBSA) burned was 5%. The incidence of inhalation injury was 13%. Median length of stay per TBSA burned for survivors was 2.4 days/% TBSA. Mortality has improved in all burn size groups, but differences were highly statistically significant in the medium burn size group (10-20% TBSA, p≤0.001). Burn outcomes in the elderly have improved over the last decade. This reduction has been impacted by a reduction in overall injury severity but is also likely due to general improvements in burn care, improved infrastructure, implementation of clinical guidelines and increased multi-disciplinary support, including Geriatric physicians.
authors.affiliation: Healing Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Wearn
authors.affiliation: Healing Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: j.hardwicke@bham.ac.uk.
authors.forename: Joseph
authors.initials: J
authors.lastname: Hardwicke
authors.affiliation: University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kitsios
authors.affiliation: University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Siddons
authors.affiliation: Wellcome Trust Clinical Research Facility Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Nightingale
authors.affiliation: Healing Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Naiem
authors.initials: N
authors.lastname: Moiemen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001830:Body Surface Area; D002053:Burn Units; D002056:Burns / Q000453:epidemiology / Q000401:mortality*; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D057187:Independent Living / Q000706:statistics & numerical data*; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015208:Smoke Inhalation Injury / Q000453:epidemiology / Q000401:mortality; D015599:Trauma Severity Indices; D006113:United Kingdom / Q000453:epidemiology
keywords: Burn; Elderly; LA(50); Mortality; Outcomes