Document Detail


Epidemiology and outcomes of older adults with burn injury: an analysis of the National Burn Repository.
MedLine Citation:
PMID:  19060727     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Improvements in outcomes for older adults sustaining burn injuries have lagged far behind those of younger patients. As this segment of the population grows, there has been an increasing interest in better understanding the epidemiology and outcomes of injury in older adults. The National Burn Repository (NBR) provides a unique opportunity to examine burn injuries on a national level. We aimed to characterize specific injury and outcome trends in older adult with burns through analysis of the NBR. We examined the records of all patients in the NBR aged 55 and older. To characterize age effects on injury and outcomes, patients were stratified into three age categories: 55 to 64 years, 65 to 74 years, and 75 years and older. Baseline characteristics, details of hospital treatment, mortality, and disposition were compared among these three age groups using chi or analysis of variance. Logistic regression analysis was performed to assess the impact of age on burn mortality. A total of 180,401 patient records were available from 1991 to 2005, of which 23,180 (14%) met age inclusion criteria. Mean burn size (9.6% TBSA) and percent with inhalation injury (11.3%) did not markedly differ by age. Men predominated overall (ratio 1.4:1), although women (4290) outnumbered men (3439) in the oldest age category. Length of stay per TBSA and median hospital charges increased with increasing age category, suggesting higher resource consumption with aging. Mean number of operations per patient, however, decreased with age. Mortality rates and discharge to nonindependent status increased with age. By logistic regression, the adjusted odds ratio for mortality was 2.3 (95% CI 2.1-2.7) in the 65 to 74 age group, and 5.4 (95% CI 4.8-6.1) in the oldest group when compared with the 55 to 64 age group. Mortality rates decreased significantly after 2001 across all age groups. This analysis demonstrates age-dependent differences in resource utilization and mortality risk within the older burn population and highlights the need for a national research agenda focused on management practices and outcomes in older adult with burns.
Authors:
Tam N Pham; C Bradley Kramer; Jin Wang; Frederick P Rivara; David M Heimbach; Nicole S Gibran; Matthew B Klein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of burn care & research : official publication of the American Burn Association     Volume:  30     ISSN:  1559-047X     ISO Abbreviation:  J Burn Care Res     Publication Date:    2009 Jan-Feb
Date Detail:
Created Date:  2009-01-12     Completed Date:  2009-03-06     Revised Date:  2011-07-25    
Medline Journal Info:
Nlm Unique ID:  101262774     Medline TA:  J Burn Care Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  30-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Washington, Seattle, Washington, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Analysis of Variance
Burns / epidemiology*,  mortality,  therapy
Chi-Square Distribution
Female
Humans
Length of Stay / statistics & numerical data
Logistic Models
Male
Middle Aged
Outcome Assessment (Health Care)*
Registries
Risk Factors
United States / epidemiology
Grant Support
ID/Acronym/Agency:
KL2 RR025015-02/RR/NCRR NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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