6645Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, CA, USA.
Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, 8788University of California Irvine, Orange, CA, USA.
Am Surg. 2022 Dec;88(12):2907-2912. doi: 10.1177/00031348211011122. Epub 2021 Apr 16.
Geriatric burn trauma patients (age ≥65 years) have a 5-fold higher mortality rate than younger adults. With the population of the US aging, the number of elderly burn and trauma patients is expected to increase. A past study using the National Burn Repository revealed a linear increase in mortality for those >65 years old. We hypothesized that octogenarians with burn and trauma injuries would have a higher rate of in-hospital complications and mortality, than patients aged 65-79 years old.
The Trauma Quality Improvement Program (2010-2016) was queried for burn trauma patients. To detect mortality risk a multivariable logistic regression model was used.
From 282 patients, there were 73 (25.9%) octogenarians and 209 (74.1%) aged 65-79 years old. The two cohorts had similar median injury severity scores (16 vs. 15 in octogenarians, = .81), total body surface area burned ( = .30), and comorbidities apart from an increased smoking (12.9% vs. 4.1%, = .04) and decreased hypertension (52.2% vs. 65.8%, = .04) in the younger cohort. Octogenarians had similar complications, including acute respiratory distress syndrome, pulmonary embolism, deep vein thrombosis ( > .05), and mortality (15.1% vs. 10.5%, = .30), compared to the younger cohort. Octogenarians were not associated with an increased mortality risk (odds ratio 1.51, confidence interval 0.24-9.56, = .67).
Among burn trauma patients ≥65 years, age should not be a sole predictor for mortality risk. Continued research is necessary in order to determine more accurate approaches to prognosticate mortality in geriatric burn trauma patients, such as the validation and refinement of a burn-trauma-related frailty index.
老年烧伤创伤患者（年龄≥65 岁）的死亡率比年轻成年人高 5 倍。随着美国人口老龄化，老年烧伤和创伤患者的数量预计将增加。过去的一项研究使用国家烧伤资料库显示，65 岁以上患者的死亡率呈线性上升。我们假设，与 65-79 岁的患者相比，80 岁以上的烧伤和创伤患者的院内并发症和死亡率更高。
使用创伤质量改进计划（2010-2016 年）查询烧伤创伤患者。为了检测死亡风险，使用多变量逻辑回归模型。
从 282 名患者中，有 73 名（25.9%）是 80 岁以上的老年人，209 名（74.1%）是 65-79 岁的老年人。这两个队列的损伤严重程度评分中位数相似（80 岁以上老年人为 16，65-79 岁老年人为 15， =.81），全身烧伤面积（ =.30），以及除吸烟率较高（12.9%对 4.1%， =.04）和高血压较低（52.2%对 65.8%， =.04）以外的合并症。与年轻队列相比，80 岁以上老年人的并发症相似，包括急性呼吸窘迫综合征、肺栓塞、深静脉血栓形成（ >.05）和死亡率（15.1%对 10.5%， =.30）。与年轻队列相比，80 岁以上老年人的死亡率无增加风险（比值比 1.51，置信区间 0.24-9.56， =.67）。
在 65 岁以上的烧伤创伤患者中，年龄不应是死亡率风险的唯一预测因素。为了确定更准确的方法来预测老年烧伤创伤患者的死亡率，如烧伤-创伤相关虚弱指数的验证和细化，需要进一步研究。
