Dexter G, et al. - This retrospective analysis was performed to examine outcomes following burns in patients >70 years over a period of 17 years. Among burn patients, patients >70 years constituted small (8.6%) but a significant number. In this group of the population, the overall intensive care unit (ICU) admissions, number of days on ventilator, ICU stay, in-hospital mortality and overall mortality was higher, even for low percent total body surface area (% TBSA) burns. Mortality was increased by the presence of smoke inhalation.

• The authors examined data on 6512 patients admitted to a Level I Burn Center between 1995 and 2011.
• They abstracted age, gender, ethnicity, TBSA, burn etiology, hospital and burn intensive care unit (ICU) length of stay (LOS) and status at discharge.
• They created three broad categories based on presence or absence of smoke inhalation, No smoke inhalation (Group A), smoke inhalation only (Group B) and smoke inhalation with burn injury (Group C).
• Using the student’s t-test for continuous variables and Chi-Square test for categorical variables, differences were analyze.

• 564 patients formed the study group, 72.3% in group A, 4.8% in group B and 22.9% in group C formed the study population.
• With female patients being more common (58%), the mean age of the patients studied was 80.4 ± 6.7.
• In group C, the number of Caucasians (72.9%) was highest compared to other racial groups (p = 0.047).
• In the group B (59.3%), majority of patients were admitted directly compared to other two groups (group A = 24.0%, group B = 34.9%, p < 0.001).
• While % TBSA second degree burns were common in group B (p < 0.05), overall % TBSA and % TBSA third degree burns were higher in group C.
• In group C patients (p < 0.001), the number of ICU admissions, the mean length of ICU stay, mean duration of ventilator support and mean length of hospitalization were all highest.
• In group A, the number of discharges to home without home health aide were higher, while the number of discharges to nursing home/rehabilitation/extended care facility was higher in group B (p < 0.001).
• In group C, the in-hospital mortality (58.1%, p < 0.001) and overall burn-related mortality (62.8%, p < 0.001) were highest.
• No significant difference was found between the groups for the number of patients converted to hospice care (p = 0.21).
• ICU admission (Odds Ratio [OR] = 3.7, 95% Confidence Interval [95% CI] = 2.1-6.5), ventilator support (OR = 7.1, 95% CI = 4.1-12.0), and %TBSA >10% (OR = 3.1, 95% CI = 1.9-5.0) significantly increased mortality in multivariate analysis.
• Group C had a significantly higher incidence of pneumonia (18.6%, p < 0.001), respiratory failure (17.1%, p = 0.001), and sepsis (7.8%, p = 0.003) in terms of complications.