TY - JOUR
T1 - Short-term and long-term increased mortality in elderly patients with burn injury
T2 - a national longitudinal cohort study
AU - FRAIL group
AU - Dutch Burn Repository group
AU - Cords, Charlotte I.
AU - van Baar, Margriet E.
AU - Pijpe, Anouk
AU - Nieuwenhuis, Marianne K.
AU - Bosma, Eelke
AU - Verhofstad, Michael H.J.
AU - van der Vlies, Cornelis H.
AU - Roukema, G.
AU - Lucas, Y.
AU - Gardien, K.
AU - Middelkoop, E.
AU - Polinder, S.
AU - Scholten, S. M.H.J.
AU - Damen, J.
AU - Boudestein, K.
AU - van Zuijlen, P. P.M.
AU - Mattace-Raso, F. U.S.
AU - Boekelaar, A.
AU - Roodbergen, D.
AU - Stoop, M. M.
AU - van Zuijlen, P. P.M.
AU - Lucas, Y.
AU - van Es, A.
AU - Eshuis, H.
AU - Hiddingh, J.
AU - Scholten-Jaegers, S. M.H.J.
AU - Middelkoop, E.
AU - Novin, A.
N1 - Funding Information:
This study was supported by The Dutch Burn Foundation (grant number: 18.101). The funding source had no role in any part of the study.
Funding Information:
The authors would like to thank H Eshuis, RN, J Hiddingh, MSc, J Meijer RN, M. Stoop RN and M. Cuijpers, MSc, for their assistance with data collection and dedication to this study; M Kuijper, MD, PhD, for his help with the statistical analysis, the Dutch Burn Repository Group, for their contribution to the Dutch Burn Repository and Dutch Burns Foundation Beverwijk; Red Cross Hospital Beverwijk, Martini Hospital Groningen, and Maasstad Hospital Rotterdam, for their support to the Dutch Burn Repository. CONSORTIUM NAME FRAIL group G Roukema3, MD, PhD, Y Lucas3, MD, K Gardien10, MD, E Middelkoop4,5,10, PhD, S Polinder2, PhD, SMHJ Scholten6, MD, PhD, J Damen10, MD, K Boudestein11, MD, A Pijpe4,5, PhD, PPM van Zuijlen5,12,13, MD, PhD F.U.S. Mattace-Raso14, MD, PhD, E Bosma15, MD, PhD MHJ Verhofstad9MD, PhD, 3. Department of Trauma and Burn Surgery, Maasstad Hospital, Rotterdam, the Netherlands 4. Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, the Netherlands 5. Department of Plastic Reconstructive and Hand Surgery, Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands 6. Association of Dutch Burn Centres, Martini Hospital, Groningen, the Netherlands 7. Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands 8. University of Groningen, University Medical Centre Groningen, Department of Human Movement Sciences, Groningen, the Netherlands 9. Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands 10. Burn Center, Red Cross Hospital, Beverwijk, the Netherlands 11. Department of Geriatric Medicine, Maasstad Hospital, Rotterdam, the Netherlands. 12. Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands 13. Pediatric Surgical Centre, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands 14. Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. 15. Burn center, martini hospital, Groningen, the Netherlands Dutch Burn Repository group: Burn Centre Beverwijk: A Boekelaar, RN, A Pijpe, PhD, D Roodbergen, MD, MM Stoop, RN, PPM van Zuijlen, MD, PhD Burn Centre Rotterdam: Y Lucas, MD, A van Es, MSc, CH van der Vlies, MD, PhD. Burn Centre Groningen: E Bosma, MD, PhD, H Eshuis, RN, J Hiddingh, MsC, SMHJ Scholten-Jaegers, MD, PhD Association of Dutch Burn centres: ME van Baar, PhD, E Middelkoop, PhD, MK Nieuwenhuis, PhD, A Novin, MSc
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/1/17
Y1 - 2023/1/17
N2 - 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.
AB - 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.
KW - Burn injury
KW - Elderly
KW - Five-year mortality
KW - Long-term outcome
U2 - 10.1186/s12877-022-03669-1
DO - 10.1186/s12877-022-03669-1
M3 - Article
C2 - 36650431
AN - SCOPUS:85146403623
SN - 1471-2318
VL - 23
JO - BMC Geriatrics
JF - BMC Geriatrics
IS - 1
M1 - 30
ER -