Institutional members access full text with Ovid®

Share this article on:

Long-Term Functional Outcomes in the Elderly After Burn Injury

Palmieri, Tina L. MD*†; Molitor, Fred PhD; Chan, Grace RN§; Phelan, Elizabeth LCSW; Shier, Brian J. MA*; Sen, Soman MD*†; Greenhalgh, David G. MD*†

doi: 10.1097/BCR.0b013e31825aeaac
Original Articles

Although the elderly represent a substantial proportion of the population, limited information exists on postdischarge long-term outcomes of elderly burn survivors. The purpose of this study was to assess elderly burn patient outcomes 2 to 10 years after discharge. This study was a prospective cross-sectional survey assessment of quality of life and retrospective trauma registry for the American College of Surgeons review of patients ≥ 60 years of age discharged alive after acute burn from 1997 to 2007. In-hospital treatment and burn demographic information were obtained from database and chart review. Surviving patients or their families were contacted, and the Short-Form-12 and Functional Independence Measure (FIM) administered. Of the 344 patients discharged, 232 participated. Mean age was 72.3 (60–85.8) years, TBSA burn was 7.8% (1–79), and length of stay was 11.2 ± 0.9 days (1–51). Most patients were discharged home (71%) or to a skilled nursing facility (SNF; 20%). Mean interval between discharge and survey administration was 46.1 months. In all, 24% of patients sent home died after discharge and prior to interview compared with 58% of patients sent to an SNF. On multivariate analysis, mortality increased with age (confidence interval [CI] 1.04–1.09), and government insurance (CI 0.34–0.94), but decreased with discharge to home (CI 1.68–4.47). There were no differences in FIM or Short-Form-12 scores between groups. Long-term mortality after discharge in elderly burn survivors is substantial. Patients sent to an SNF or with government insurance had increased mortality postdischarge. These data suggest that issues that may influence disposition status of elderly burn patients should be optimized prior to discharge to mitigate adverse outcomes associated with SNF placement.

From the Departments of *Surgery, §Nursing and Social Services, University of California Davis Regional Burn Center, Sacramento; Shriners Hospitals for Children, Northern California, Sacramento; and ETR Associates, Sacramento, California.

Presented at the 41st Annual American Burn Association Meeting in San Antonio, TX, March 27, 2009.

Address correspondence to Tina L. Palmieri, MD, FACS, FCCM, 2425 Stockton Blvd, Suite 718, Sacramento, California 95817.

© 2012 The American Burn Association