Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar;42(2):276-81.
doi: 10.1016/j.burns.2015.12.008. Epub 2016 Jan 21.

Threshold age and burn size associated with poor outcomes in the elderly after burn injury

Marc G Jeschke  1 , Ruxandra Pinto  2 , Sheila R Costford  2 , Saeid Amini-Nik  2
Affiliations

Threshold age and burn size associated with poor outcomes in the elderly after burn injury

Marc G Jeschke et al. Burns. 2016 Mar.

Abstract

Elderly burn care represents a vast challenge. The elderly are one of the most susceptible populations to burn injuries, but also one of the fastest growing demographics, indicating a substantial increase in patient numbers in the near future. Despite the need and importance of elderly burn care, survival of elderly burn patients is poor. Additionally, little is known about the responses of elderly patients after burn. One central question that has not been answered is what age defines an elderly patient. The current study was conducted to determine whether there is a cut-off age for elderly burn patients that is correlated with an increased risk for mortality and to determine the burn size in modern burn care that is associated with increased mortality. To answer these questions, we applied appropriate statistical analyses to the Ross Tilley Burn Centre and the Inflammatory and Host Response to Injury databases. We could not find a clear cut-off age that differentiates or predicts between survival and death. Risk of death increased linearly with increasing age. Additionally, we found that the LD50 decreases from 45% total body surface area (TBSA) to 25% TBSA from the age of 55 years to the age of 70 years, indicating that even small burns lead to poor outcome in the elderly. We therefore concluded that age is not an ideal to predictor of burn outcome, but we strongly suggest that burn care providers be aware that if an elderly patient sustains even a 25% TBSA burn, the risk of mortality is 50% despite the implementation of modern protocolized burn care.

Keywords: Age; Burn; Elderly; Mortality.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest:

There is no conflict of interest.

Figures

Figure 1
Figure 1. Mortality plotted against age
(A) Mortality versus age binned in 5 equal groups. (B): c-statistic adjusted for % TBSA, inhalation injury and gender for age dichotomized at every year. (C): c-statistic with 95% confidence using adjusted bootstrap confidence intervals.
Figure 1
Figure 1. Mortality plotted against age
(A) Mortality versus age binned in 5 equal groups. (B): c-statistic adjusted for % TBSA, inhalation injury and gender for age dichotomized at every year. (C): c-statistic with 95% confidence using adjusted bootstrap confidence intervals.
Figure 2
Figure 2
The probit curves for age vs LD50 burn size are depicted for different age groups.
See this image and copyright information in PMC

References

    1. Jeschke MG, et al. Pathophysiologic response to severe burn injury. Ann Surg. 2008;248(3):387–401. - PMC - PubMed
    1. Jeschke MG, et al. Long-term persistance of the pathophysiologic response to severe burn injury. PLoS One. 2011;6(7):e21245. - PMC - PubMed
    1. Wearn C, et al. Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre. Burns. 2015;41(6):1161–1168. - PubMed
    1. Pereira CT, et al. Age-dependent differences in survival after severe burns: a unicentric review of 1,674 patients and 179 autopsies over 15 years. J Am Coll Surg. 2006;202(3):536–548. - PubMed
    1. Kraft R, et al. Burn size and survival probability in paediatric patients in modern burn care: a prospective observational cohort study. Lancet. 2012;379(9820):1013–1021. - PMC - PubMed

Publication types