Department of Surgery, Division of Burn Surgery, University of California, Davis, 2315 Stockton Boulevard, Sacramento 95817, California, USA.
Shriners Children's Northern Children, Division of Burn Surgery, Shriners Children's Northern California, 2425 Stockton Boulevard, Sacramento 95817, California, USA.
J Burn Care Res. 2023 May 2;44(3):517-523. doi: 10.1093/jbcr/irad032.
The purpose of this study was to determine the relationship between frailty and poverty in burn patients ≥50 years old, and their association with patient outcomes. This was a single-center retrospective chart review from 2009 to 2018 of patients ≥50 years old admitted with acute burn injuries. Frailty was assigned using the Canadian Study of Health and Aging Clinical Frailty Scale. Poverty was defined as a patient from a zip code that had >20% of people living in poverty. The relationship between frailty and poverty, as well as each variable independently on mortality, length of stay (LOS), and disposition location, was examined. Of 953 patients, the median age was 61 years, 70.8% were male, and the median total body surface area burn was 6.6%. Upon admission, 26.4% and 35.2% of patients were frail and from impoverished neighborhoods, respectively. The mortality rate was 8.8%. Univariate analysis demonstrated that nonsurvivors had significantly higher chances of living in poverty (P = .02) and were more likely to be frail compared to survivors. There was no significant correlation between poverty and frailty (P = .08). Multivariate logistic regression confirmed the relationship between lack of poverty and mortality (OR .47, 95% CI 0.25-0.89) and frailty and mortality (OR 1.62, 95% CI 1.24-2.12). Neither poverty (P = .26) nor frailty (P = .52) was associated with LOS. Both poverty and frailty were associated with a patient's discharge location (P = .03; P < .0001). Poverty and frailty each independently predict mortality and discharge destination in burn patients ≥50, but they are not associated with LOS nor each other.
本研究旨在确定≥50 岁烧伤患者虚弱与贫困之间的关系,以及它们与患者结局的关系。这是一项 2009 年至 2018 年对≥50 岁因急性烧伤住院患者的单中心回顾性图表研究。使用加拿大健康与老龄化研究临床虚弱量表对虚弱进行评估。贫困定义为来自邮政编码地区的患者,该地区有超过 20%的人生活贫困。研究了虚弱与贫困之间的关系,以及每个变量独立于死亡率、住院时间(LOS)和处置地点的关系。在 953 名患者中,中位年龄为 61 岁,70.8%为男性,中位全身烧伤面积为 6.6%。入院时,26.4%和 35.2%的患者分别为虚弱和贫困社区。死亡率为 8.8%。单因素分析表明,非幸存者更有可能生活在贫困中(P=0.02),且与幸存者相比更有可能虚弱。贫困与虚弱之间无显著相关性(P=0.08)。多变量逻辑回归证实了缺乏贫困与死亡率之间的关系(OR 0.47,95%CI 0.25-0.89)和虚弱与死亡率之间的关系(OR 1.62,95%CI 1.24-2.12)。贫困(P=0.26)和虚弱(P=0.52)均与 LOS 无关。贫困和虚弱都与患者的出院地点有关(P=0.03;P<0.0001)。贫困和虚弱都独立预测≥50 岁烧伤患者的死亡率和出院目的地,但它们与 LOS 无关,彼此之间也无关。