Epidemiological Investigation of Elderly Patients with Severe Burns at a Major Burn Center in Southwest China

Abstract

BACKGROUND The treatment of elderly patients with severe burns is difficult and the mortality rate is high. The aim of this study was to investigate the epidemiological features of elderly patients with severe burns. MATERIAL AND METHODS Data from 109 elderly patients with severe burns between January 2009 and December 2018 were retrospectively analyzed. Demographic data, clinical characteristics, treatments, and outcomes were statistically analyzed. RESULTS Among the 109 elderly patients with severe burns, the male-to-female ratio was 1.73: 1.0. The median age of the elderly patients was 67 years, and the median total body surface area (TBSA) burned was 42%. Notably, 67.9% of burns occurred at home and most frequently occurred in summer (38.5%) and winter (28.4%); flame and flash burns predominated (83.4%). The incidence of inhalation injury was 35.8%, and pre-existing comorbidities were observed in approximately 51.4% of the patients. The median length of stay in the hospital per TBSA burned was 0.4 days. The mortality rate in the elderly patients was 24.8%, and the mortality rates in the ≥70% TBSA group, inhalation injury group, and patients with 3 or more pre-existing comorbidities were significantly higher than in the other groups. The risk of death increased with an increase in the number of pre-existing comorbidities (odds ratio: 2.222; 95% confidence interval: 1.174-4.205). CONCLUSIONS At a major burn center in Southwest China, the incidence and mortality of elderly patients with severe burns displayed no downward trend. There are etiological characteristics of these age groups that should be considered for prevention. Meanwhile, multidisciplinary treatment in a hospital and an increase in the social support for the elderly population might improve outcomes.

Figure 1

The proportions of elderly patients with severe burns among patients with severe burns (A) and elderly patients with burns (B) in different years. Distribution of elderly patients with severe burns in different age groups (C). The proportion of elderly patients with severe burns among all patients with severe burns and all elderly patients with burns in the 2009–2013 and 2014–2018 cohorts (D). * P<0.05 compared with the 2009–2013 cohort.

Figure 2

Distribution of the location (A), etiology (B), seasons (C), and time to hospitalization (D) in elderly patients with severe burns from 2009 to 2018. * Scald, electricity, and contact burns.

Figure 3

Monthly distribution of elderly patients with severe burns.

Figure 4

The most common pre-existing comorbidities. HTN – hypertension; DM – diabetes mellitus; IHD – ischemic heart disease; COPD – chronic obstructive pulmonary disease.

Figure 5

Mortality rates of elderly patients with severe burns presenting with and without inhalation injury (A). Mortality rates of elderly patients with severe burns stratified according to the number of pre-existing comorbidities (B). Distribution of the time of death after burns in elderly patients with severe burns (C). * P<0.05 compared with patients without inhalation injury and ** P<0.05 compared patients with 0 and 1–2 comorbidities.