Infection in Elderly Burn Patients: What Do We Know?

Abstract

Background: Infection is the greatest cause of mortality in burn patients. As our population ages, the need to care for elderly burn patients will increase, and with it our understanding of how infection affects older patients with burn injuries. This article presents a review of the available literature on the effect of aging on the physiologic response to burns, of the known effects of infection in the elder population, and of the contribution of underlying medical comorbidities to the outcomes for the elderly burn patient. The potential for more serious outcomes from multi-drug resistance in the elder population is also discussed. Methods: This article is a review of the available literature on infection in elderly burn patients. A literature search was performed for key words: elderly; geriatric; burn; infection; comorbidity; multi-drug resistance; central line; urinary tract infection; and burn sepsis. Relevant findings were included in each section. Results: Pre-existing conditions are common in the elderly and contribute to a higher rate of development of pneumonia, cellulitis, urinary tract infection, central line infections, and burn wound infections. Specific data pertaining to infections in the elderly burn population are scarce or confined to single-center reports. Conclusions: Because of the inherent susceptibility of the elder population to infection because of pre-existing medical conditions, immunosenescence, and potential exposure via frequent interaction with the medical system, vigilance must be maintained for preventing and treating infection in elderly burn patients. More research is needed to define the risks and extent of this increasingly important issue.

Keywords: burn care; elderly; infection; multi-drug resistant organism.