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Repeat hospitalization and mortality in older adult burn patients.
MedLine Citation:
PMID:  23292594     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The aim of this study was to examine 2-year postdischarge outcomes-including hospital readmissions, complications, and mortality-for a cohort of older adults with burn injury. In a statewide hospital discharge database, we identified all patients ≥ 45 years of age admitted for acute burn injury from 1996 to 2005 and followed each patient for any hospital admissions 2 years following discharge. We then linked the state database to the National Death Index to identify patients who died within the 2-year period. Kaplan-Meier survival functions estimated proportion of patients who died or were readmitted. Logistic regression was used to estimate mortality risk at 2 years for each age group. A total of 2573 patients were admitted with burn injuries, and 2388 (93%) survived to discharge. Of all index patients, 1077 (45%) had at least one rehospitalization, with those in the older age groups having more rehospitalizations. Of patients rehospitalized within 30 days, 25% were admitted for wound coverage or burn infection, 14% for rehabilitation, 10% for sepsis, and 9% for psychiatric reasons. Compared to those discharged home, more patients discharged to nursing facilities had ≥1 rehospitalization (71.5 vs 31.5%, P < .001). Survival progressively decreased by age category throughout the follow-up period. Compared with patients aged 45 to 54 years, the older age groups had increased mortality risk at 2 years: odds ratio (OR) 1.53 (95% confidence interval, 1.22-1.88) for the 55 to 64 years group, OR 2.51 (95% confidence interval, 2.03-3.09) for the 65 to 74 years group, and OR 2.90 (95% confidence interval, 2.36-3.55) for the ≥75 years group. This population-based study indicates that older patients have a high likelihood of rehospitalization and increased long-term mortality.
Authors:
Samuel P Mandell; Tam Pham; 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:  34     ISSN:  1559-0488     ISO Abbreviation:  J Burn Care Res     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101262774     Medline TA:  J Burn Care Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e36-41     Citation Subset:  IM    
Affiliation:
From the University of Washington Burn Center, Harborview Medical Center, Seattle.
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