Rahimpour Armein, Fox Nathan, Anderson Jamie, Arcand Christina M, Balakrishnan Pranav, Denning David, Amiri Farzad, Harrison Curtis W, Bown Paul, Barry Rahman
General Surgery, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Plastic and Reconstructive Surgery, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Cureus. 2024 Dec 23;16(12):e76253. doi: 10.7759/cureus.76253. eCollection 2024 Dec.
Burn injuries are associated with high mortality and morbidity, especially in the elderly population. Although burns are preventable, they account for the fourth most common cause of trauma worldwide. The majority of the mortality associated with burn victims is also seen in the elderly age group. Most mortality predictor scores focus on age and total body surface area (TBSA) burned. However, data focusing specifically on elderly populations with respect to TBSA, particularly within the Appalachian region, remain limited. This rough terrain is accompanied by multiple challenges and health care disparities with limited burn care access. The population was a significant portion of the elderly who have multiple comorbidities; the majority of the population are economically struggling, living in rural communities, and the state of West Virginia (WV) is considered to have the highest drug use/addiction in the country. It is not shocking that they have the worst health outcomes in the nation.
This study aims to evaluate the impact of TBSA burn on clinical outcomes and comorbidities in elderly burn patients within Appalachia.
Cabell Huntington Hospital, the only burn intensive care unit (BICU) in WV, was investigated in this retrospective study. This cohort study analyzed data from 198 patients aged 65 and older admitted to the BICU between January 2017 and January 2023. Data included demographic variables, TBSA burned, comorbidities, and outcomes. Statistical analyses assessed relationships between TBSA and age, gender, length of hospital stay, discharge status, chronic obstructive pulmonary disease (COPD), smoking history, diabetes mellitus (DM), BMI, and inhalation injury. Different statistical analyses were used to analyze the relationship between TBSA and the variables of interest.
Our result section indicated that the majority of the elderly patients with burns were males (65%); however, there was no statistical difference between genders and TBSA (p=0.86). The group with higher TBSA was more likely to have COPD (p<0.0001), use home oxygen (p<0.0001), and have inhalation injury on presentation (p=0.002). Older age was associated with higher TBSA burn (p=0.003), with each one-year increase in age, TBSA burned in our population increased by 0.46% (p=0.002). The group with higher TBSA had higher mortality with a significance (p<0.0001). The annual mortality rate for burn victims above the age of 65 in the Appalachia sole BICU is 14 patients per 100. Our study was not able to find any significance for hospital duration, source of burn, presence of DM, or BMI with TBSA burned.
This study in a unique population base will allow clinicians to understand the elderly burn victim in this underserved area of Appalachia, resource-limited and comorbidity-burdened population. This will allow for targeted interventions to improve outcomes in this vulnerable demographic.
烧伤与高死亡率和高发病率相关，尤其是在老年人群中。尽管烧伤是可预防的，但它是全球第四大常见创伤原因。与烧伤受害者相关的大多数死亡也出现在老年人群体中。大多数死亡率预测评分侧重于年龄和烧伤的体表面积（TBSA）。然而，关于TBSA，特别是阿巴拉契亚地区老年人群体的具体数据仍然有限。这片地形崎岖的地区伴随着多重挑战和医疗保健差异，烧伤护理服务有限。该人群中有很大一部分是患有多种合并症的老年人；大多数人经济困难，生活在农村社区，西弗吉尼亚州（WV）被认为是美国药物使用/成瘾率最高的州。他们在全国健康状况最差也就不足为奇了。
本研究旨在评估TBSA烧伤对阿巴拉契亚地区老年烧伤患者临床结局和合并症的影响。
本回顾性研究对WV唯一的烧伤重症监护病房（BICU）——卡贝尔·亨廷顿医院进行了调查。这项队列研究分析了2017年1月至2023年1月期间入住BICU的198例65岁及以上患者的数据。数据包括人口统计学变量、烧伤的TBSA、合并症和结局。统计分析评估了TBSA与年龄、性别、住院时间、出院状态、慢性阻塞性肺疾病（COPD）、吸烟史、糖尿病（DM）、体重指数（BMI）和吸入性损伤之间的关系。采用不同的统计分析方法来分析TBSA与感兴趣变量之间的关系。
我们的结果部分表明，大多数老年烧伤患者为男性（65%）；然而，性别与TBSA之间无统计学差异（p = 0.86）。TBSA较高的组更有可能患有COPD（p < 0.0001）、使用家庭氧气（p < 0.0001），且入院时存在吸入性损伤（p = 0.002）。年龄较大与较高的TBSA烧伤相关（p = 0.003），年龄每增加一岁，我们研究人群中烧伤的TBSA增加0.
