Dr Jason Diab1, Ms Rebecca Lebler1, Dr Andrea Issler-Fisher1 , Ms Christine Parker1, Prof Peter Kennedy1, Prof Peter Haertsch1, Dr Justine O’Hara1, Professor Peter Maitz1
1Concord Hospital, Concord, Australia
Burns in the elderly pose challenges to management where they are not only at risk of physiological changes associated with ageing, but the additional comorbidities predispose them to multi organ failure. These factors are often associated with a trauma and indirectly a thermal injury that lead to higher morbidity and mortality. Although this represents a small percentage of burns admissions, their length of stay and mortality are often complicated by other factors and require holistic care.
A retrospective audit was conducted at Concord Burns Unit from June 2016 to June 2019 at the Concord Repatriation General Hospital. The study group included all adult patients over the age of 65 years whom were admitted to the unit. The aim of this study is to provide an understanding of the clinical characteristics of elderly patients whom presented with burns. The secondary objective is to provide educational awareness about holistic care for nursing, medical and patient education to this cohort. Demographic and clinical data extracted included age, gender, ethnicity, total body surface area (TBSA), burn etiology, status at discharge, hospital admission duration, and burn intensive care unit length of stay (LOS). Differences were analysed using the student’s t-test for continuous variables and Chi-Square test for categorical variables.
There were 143 patients aged over 65 years whom were admitted to the concord burns unit with 60.8% men. The average age was 76.5 years (+/- 8.52 years)with a median TBSA of 3.00% [0.25 – 45%]. The most common season affected was winter (36.4%). The most common mechanism of injury was scald (52.4%), followed by flame (31.5%) with the lower limbs being most affected (37.8%). Overall, there was inadequate first aid amongst all patients (54.5%). There is a mean statistical difference amongst men and women for mechanism of injury (t=-2.721, p=0.007), age (t=-2.949, p=0.004), seasons (t=2.701, p=0.008), and discharge destination (t=-2.261, p=0.025).
Although trauma is one of the leading causes of death in the elderly, thermal injury is one of the principal mechanisms of injury. Education regarding prevention strategies and first aid treatment should be implemented to decrease morbidity and mortality.
Jason is a SRMO at Concord Burns Unit with an interest in public health epidemiology of burns and reconstructive surgery.