Article Sidebar
Views Full article: 92
Treatment outcomes and risk factors for death of burn in elderly patients
Main Article Content
Abstract
Aims: Describe treatment outcomes and identify risk factors for mortality in the elderly with burns.
Object and method: This is a retrospective study, performed on 586 elderly patients (≥ 60 years old) with burns, they were treated at the National Burn Hospital from January 1, 2017, to December 31, 2019.
The research targets include: Treatment outcomes; data on age, gender, residence, the causative agent with burns, total burn body area and deep burn area, combined severe chronic illness, combined injuries, complications were collected and analyzed individually variables and multi-variable. They were conducted to determine the factors affecting mortality in the elderly with burns.
Result: The mortality rate in the burns elderly is 9.6%. The time of mortality within the first 3 days after burns accounted for the highest rate (35.7%), followed by the second week after burns (28.6%). The mortality rate in men (12.7%) is higher than that of women (5.5%); the group of patients living in the countryside (10.5%) is higher than in the city area (8.1%). The age group from 70 to 79 years old has the highest mortality rate (11.8%), followed by the age group from 60 to 69 (9.3%) and ≥ 80 years old (7.0%).
By causative agent with burns: Fire burns have the highest mortality rate (19.7%).
By burn situation: Highest rate of injury-related mortality (50%). The mortality rate increased proportionally with the total burn area and deep burn (p < 0.05) when there were complications of burn shock, multi-organ failure, renal failure, and septic shock (p < 0.01); in which the increase is very high in the group of patients with the total burn area >= 40% of the total body surface area (64.4%), deep burns area > 20% of the total body surface area (> 50%) if deep burns area >= 40% of the total body surface area (TBSA) then mortality rate is up to 94.1%.
The mortality rate was very high in the group of patients with inhalation injuries burns (95.8%). Multi-variate analysis showed that inhalation injuries burns and complications of multi-organ failure were independent factors for mortality in the elderly with burns (p < 0.05).
Conclusion: Although there have been advances in treatment, the mortality rate in elderly patients with burns is still high, especially in the group of inhalation injuries burns patients, patients have total burn area ≥ 40% of TBSA, patients have a deep burn area ≥ 40% of TBSA; when there are complications.
Article Details
Keywords
Elderly, burn injury, risk factor, mortality rate
References
2. Học viện Quân y (2018), Giáo trình Bỏng dùng cho đào tạo trình độ sau đại học, Nhà xuất bản Quân đội Nhân dân, Hà Nội.
3. C. Smolle, J. Cambiaso-Daniel, A. A. Forbes. et al (2017), Recent trends in burn epidemiology worldwide: A systematic review. Burns, 43 (2), 249-257.
4. J. Hwee, C. Song, K. C. Tan. et al (2016), The trends of burns epidemiology in a tropical regional burns centre. Burns, 42 (3), 682-686.
5. Y. Zheng, G. Lin, R. Zhan. et al (2019), Epidemiological analysis of 9,779 burn patients in China: An eight‑year retrospective study at a major burn center in southwest China. Experimental and Therapeutic Medicine, 17 (4), 2847-2854.
6. W. Cheng, S. Wang, C. Shen. et al (2018), Epidemiology of hospitalized burn patients in China: A systematic review. Burns Open, 2 (1), 8-16.
7. Đoàn Chí Thanh và CS (2020), Tình hình thu dung và điều trị bệnh nhân bỏng nội trú tại bệnh viện Bỏng Quốc gia Lê Hữu Trác năm 2019, Tạp chí y học Thảm họa và Bỏng, 3, tr. 1-7.
8. T. Iqbal, M. Saaiq and Z. Ali (2013), Epidemiology and outcome of burns: early experience at the country's first national burns centre. Burns, 39 (2), 358-362.
9. S. Dissanaike and M. Rahimi (2009), Epidemiology of burn injuries: highlighting cultural and socio-demographic aspects. International review of psychiatry, 21 (6), 505-511.
10. D. C. Santos, F. Barros, N. Gomes. et al (2017), The effect of comorbidities and complications on the mortality of burned patients. Annals of burns and fire disasters, 30 (2), 103.
11. S.A. Emami, S. A. Motevalian, M. Momeni. et al (2016), The epidemiology of geriatric burns in Iran: A national burn registry-based study. Burns, 42 (5), 1128-32.
12. Nguyễn Tiến Dũng, Nguyễn Như Lâm (2012), Nghiên cứu các yếu tố tiên lượng tử vong ở bệnh nhân bỏng do tai nạn lao động. Tạp chí y học Thảm họa và Bỏng, 1-2012,
13. Nguyễn Như Lâm (2014), Nghiên cứu một số yếu tố ảnh hưởng đến kết quả điều trị bỏng nặng ở trẻ em tuổi trước học đường Tạp chí y học Thảm họa và Bỏng, 1-2014, 32-36.
14. Nguyễn Viết Lượng (2014), Một số đặc điểm của bệnh nhân bỏng nặng và các biến chứng thường gặp ở các bệnh nhân bỏng nặng điều trị tại Khoa Hồi sức cấp cứu Viện bỏng Quốc gia. Tạp chí y học Thảm họa và Bỏng, 1-2014, 25-31.
15. H. T. C. Lip, J. H. Tan, M. Thomas. et al (2019), Survival analysis and mortality predictors of hospitalized severe burn victims in a Malaysian burn intensive care unit. Burns & Trauma, 7 (1), 3.
16. H. Li, Z. Yao, J. Tan. et al (2017), Epidemiology and outcome analysis of 6325 burn patients: a five-year retrospective study in a major burn center in Southwest China. Scientific reports, 7, 46066.