The impact of dementia on burn survival

D Barnes1, A Tan2, P Caine3, P Dziewulski4

1 St Andrews Centre for Plastic and Burn Surgery, Court Road, CM1 7TH, UK, David.barnes@meht.nhs.uk
2 St Andrews Centre for Plastic and Burn Surgery, Court Road, CM1 7TH, UK, alethea.tan@doctors.org.uk
3 St Andrews Centre for Plastic and Burn Surgery, Court Road, CM1 7TH, UK, paul.caine@doctors.org.uk
4 St Andrews Centre for Plastic and Burn Surgery, Court Road, CM1 7TH, UK, Peter.Dziewulski@meht.nhs.uk

Introduction

The impact of dementia on risk of burns and survival outcomes has been a relatively unexplored territory. With an ageing population, the implications of dementia will undoubtedly form an integral part in managing elderly burns. This study reviews the proportion of dementia in burn intensive care (BICU) admission, demographics and to identify its impact on mortality in resuscitation burns.

Methodology

A 5-year retrospective review was conducted. Data was collated using case notes and intensive care database. Fisher’s test with a two-tailed p value was used to determine any relationship between survival and presence of dementia.

Results

162 patients were admitted. 4 were diagnosed with dementia pre-admission. Median age was 75.9 years (range 70 – 81 years). Median Modified Baux score was 97.5. Mode of injury included flame and scald. Injuries occurred at patients’ own home in majority of cases. Mean TBSA burn 26.75 (range 15% to 50%). Mean full thickness/total TBSA ratio = 0.875. Fisher’s test showed no significant relationship between survival and presence of dementia (p=0.08). This could be attributable to the small sample size of patients. When compared to non-dementia patients, the odds ratio of death was noted to be 7-fold.

Discussion

Our review has shown that these patients suffer a higher percentage of full thickness injuries and an overall increased mortality rate compared to non- dementia group. Challenges in identifying exact risk contribution of dementia to survival is compounded by the heterogeneous nature of burn injuries and the presence of other co-morbidities. Further research is still required.

Key Words

Dementia; Burns; Mortality

Biography

I am a consultant burn and reconstructive plastic surgeon at St Andrew Centre for Plastics and Burns, Chelmsford. Previously, I trained in North East England and did a specialist burn fellowship at Middlemore Hospital at Auckland which I thoroughly enjoyed. I have completed a  MSc in  Health Science and a degree in Biomedical Engineering. I play an active role in research and innovation in burns. Currently, I also hold the role of an educational tutor for the hospital and I am the current deputy of London South East Burn Network

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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