Burns in older people. Epidemiology, surgical management and outcome in a university hospital referral burn unit, 1994–2004

BackgroundBurn injuries in older people are becoming more frequent as the population ages. Burn management in older people remains controversial.ObjectivesThe aim of this retrospective study was to describe the epidemiologic profile of older people in our university hospital burn unit, to report their surgical management, and to identify factors associated with the risk of death.MethodsWe included all patients aged 70 years and over who were admitted between January 1994 and December 2004.ResultsThere were 84 men (43%) and 111 women (57%), with a median age of 79.0 (IQR 75.0–85.0) and a median total body surface area (TBSA)% of 12.3% (IQR 5.0–23.5). Most injuries occurred at home (85.1%). Most patients had pre-existing co-morbidities (78.5%). Conservative treatment was performed in 74 (37.9%) patients, while 121 (62.1%) patients underwent surgery. Early excision was performed in 17 (14.0%) patients, who were both significantly younger (P = 0.02) and more severely burned (P = 0.004). Forty-seven (24.1%) patients died in hospital. Factors associated with death were TBSA% (P < 10−4), full-thickness TBSA% (P = 0.0016), inhalation injury (P = 0.02) and conservative treatment (P < 10−4). The overall median length of hospital stay was 29.0 days (IQR 11.0–54.0, range 0.0–375.0). One-third of the 148 discharged patients were able to return home alone.ConclusionBurn prevention in older people, by adapting their daily living environment, is a major public health issue. Treatment modalities, i.e. conservative versus surgical, must be evaluated and planned specifically for each patient, depending on overall health status, which should ideally be assessed in collaboration with a geriatrician.