Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study
Abstract Background The population of elderly patients with burn injuries is growing. Insight into long-term mortality rates of elderly after burn injury and predictors affecting outcome is limited. This study aimed to provide this information. Methods A multicentre observational retrospective cohor...
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-022-03669-1 |
| _version_ | 1797945740418351104 |
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| author | Charlotte I. Cords Margriet E. van Baar Anouk Pijpe Marianne K. Nieuwenhuis Eelke Bosma Michael H. J. Verhofstad Cornelis H. van der Vlies FRAIL group Dutch Burn Repository group |
| author_facet | Charlotte I. Cords Margriet E. van Baar Anouk Pijpe Marianne K. Nieuwenhuis Eelke Bosma Michael H. J. Verhofstad Cornelis H. van der Vlies FRAIL group Dutch Burn Repository group |
| author_sort | Charlotte I. Cords |
| collection | DOAJ |
| description | Abstract Background The population of elderly patients with burn injuries is growing. Insight into long-term mortality rates of elderly after burn injury and predictors affecting outcome is limited. This study aimed to provide this information. Methods A multicentre observational retrospective cohort study was conducted in all three Dutch burn centres. Patients aged ≥65 years, admitted with burn injuries between 2009 and 2018, were included. Data were retrieved from electronic patient records and the Dutch Burn Repository R3. Mortality rates and standardized mortality ratios (SMRs) were calculated. Multivariable logistic regression was used to assess predictors for in-hospital mortality and mortality after discharge at 1 year and five-year. Survival analysis was used to assess predictors of five-year mortality. Results In total, 682/771 admitted patients were discharged. One-year and five-year mortality rates were 8.1 and 23.4%. The SMRs were 1.9(95%CI 1.5–2.5) and 1.4(95%CI 1.2–1.6), respectively. The SMRs were highest in patients aged 75–80 years at 1 year (SMRs 2.7, 95%CI 1.82–3.87) and five-year in patients aged 65–74 years (SMRs 10.1, 95%CI 7.7–13.0). Independent predictors for mortality at 1 year after discharge were higher age (OR 1.1, 95%CI 1.0–1.1), severe comorbidity, (ASA-score ≥ 3) (OR 4.8, 95%CI 2.3–9.7), and a non-home discharge location (OR 2.0, 95%CI 1.1–3.8). The relative risk of dying up to five-year was increased by age (HR 1.1, 95%CI 1.0–1.1), severe comorbidity (HR 2.3, 95%CI 1.6–3.5), and non-home discharge location (HR 2.1, 95%CI 1.4–3.2). Conclusion Long-term mortality until five-year after burn injury was higher than the age and sex-matched general Dutch population, and predicted by higher age, severe comorbidity, and a non-home discharge destination. Next to pre-injury characteristics, potential long-lasting systemic consequences on biological mechanisms following burn injuries probably play a role in increased mortality. Decreased health status makes patients more prone to burn injuries, leading to early death. |
| first_indexed | 2024-04-10T20:59:55Z |
| format | Article |
| id | doaj.art-6f6cb82c3d4c4885a7ec15b53eb46937 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-10T20:59:55Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj.art-6f6cb82c3d4c4885a7ec15b53eb469372023-01-22T12:24:31ZengBMCBMC Geriatrics1471-23182023-01-0123111110.1186/s12877-022-03669-1Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort studyCharlotte I. Cords0Margriet E. van Baar1Anouk Pijpe2Marianne K. Nieuwenhuis3Eelke Bosma4Michael H. J. Verhofstad5Cornelis H. van der Vlies6FRAIL groupDutch Burn Repository groupAssociation of Dutch Burn Centres, Maasstad HospitalAssociation of Dutch Burn Centres, Maasstad HospitalAssociation of Dutch Burn Centres, Red Cross HospitalAssociation of Dutch Burn Centres, Martini HospitalAssociation of Dutch Burn Centres, Martini HospitalTrauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center RotterdamTrauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center RotterdamAbstract Background The population of elderly patients with burn injuries is growing. Insight into long-term mortality rates of elderly after burn injury and predictors affecting outcome is limited. This study aimed to provide this information. Methods A multicentre observational retrospective cohort study was conducted in all three Dutch burn centres. Patients aged ≥65 years, admitted with burn injuries between 2009 and 2018, were included. Data were retrieved from electronic patient records and the Dutch Burn Repository R3. Mortality rates and standardized mortality ratios (SMRs) were calculated. Multivariable logistic regression was used to assess predictors for in-hospital mortality and mortality after discharge at 1 year and five-year. Survival analysis was used to assess predictors of five-year mortality. Results In total, 682/771 admitted patients were discharged. One-year and five-year mortality rates were 8.1 and 23.4%. The SMRs were 1.9(95%CI 1.5–2.5) and 1.4(95%CI 1.2–1.6), respectively. The SMRs were highest in patients aged 75–80 years at 1 year (SMRs 2.7, 95%CI 1.82–3.87) and five-year in patients aged 65–74 years (SMRs 10.1, 95%CI 7.7–13.0). Independent predictors for mortality at 1 year after discharge were higher age (OR 1.1, 95%CI 1.0–1.1), severe comorbidity, (ASA-score ≥ 3) (OR 4.8, 95%CI 2.3–9.7), and a non-home discharge location (OR 2.0, 95%CI 1.1–3.8). The relative risk of dying up to five-year was increased by age (HR 1.1, 95%CI 1.0–1.1), severe comorbidity (HR 2.3, 95%CI 1.6–3.5), and non-home discharge location (HR 2.1, 95%CI 1.4–3.2). Conclusion Long-term mortality until five-year after burn injury was higher than the age and sex-matched general Dutch population, and predicted by higher age, severe comorbidity, and a non-home discharge destination. Next to pre-injury characteristics, potential long-lasting systemic consequences on biological mechanisms following burn injuries probably play a role in increased mortality. Decreased health status makes patients more prone to burn injuries, leading to early death.https://doi.org/10.1186/s12877-022-03669-1Burn injuryFive-year mortalityElderlyLong-term outcome |
| spellingShingle | Charlotte I. Cords Margriet E. van Baar Anouk Pijpe Marianne K. Nieuwenhuis Eelke Bosma Michael H. J. Verhofstad Cornelis H. van der Vlies FRAIL group Dutch Burn Repository group Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study BMC Geriatrics Burn injury Five-year mortality Elderly Long-term outcome |
| title | Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study |
| title_full | Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study |
| title_fullStr | Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study |
| title_full_unstemmed | Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study |
| title_short | Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study |
| title_sort | short term and long term increased mortality in elderly patients with burn injury a national longitudinal cohort study |
| topic | Burn injury Five-year mortality Elderly Long-term outcome |
| url | https://doi.org/10.1186/s12877-022-03669-1 |
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