Objective: Geriatric patients represent a separate group in the treatment of burn injury regarding pathogenesis, pathophysiology and therapeutic procedure. Methods: From 2000 to 2010 on our burn unit 53 patients aged ...Objective: Geriatric patients represent a separate group in the treatment of burn injury regarding pathogenesis, pathophysiology and therapeutic procedure. Methods: From 2000 to 2010 on our burn unit 53 patients aged over 60 years were treated. The mean age of the 27 women and 26 men was 76 years (60 - 102 years), with an average of 33.2% of total burn surface area. 25 patients (47.2%) had severe inhalation injury, 77.4% of the patients suffered full thickness burn injuries. Mean ABSI Score was 12. Relevant additional diseases were coronary heart disease, heart insufficiency, hypertension, COPD, adiposity and chronic alcoholism. Results: 22 patients were treated by early operative intervention (day 0 - 4), 13 of these patients survived further process. In 17 cases first operative procedure could take place only at a later date, 14 patients deceased before operation. 26 patients developed pneumonia. The total morbidity amounted to 26 of 53 patients (49%). A total of 19 injured with a burn index over 80 survived. 9 of them had an index of more than 100. Usual indices as the “Zellweger Index” and the ABSI-Score are not adequate to determine the prognosis of thermal injuries in the elderly. Conclusion: The treatment of elderly with burn trauma is affected by many factors. Compared to younger patients the increased incidence of an inhalation injury is decisive for the prognosis of older patients. The frequency of pre-existing diseases is clearly largely than with younger burn injured patients. These prognostically relevant parameters were not sufficiently considered by established score systems.展开更多
文摘Objective: Geriatric patients represent a separate group in the treatment of burn injury regarding pathogenesis, pathophysiology and therapeutic procedure. Methods: From 2000 to 2010 on our burn unit 53 patients aged over 60 years were treated. The mean age of the 27 women and 26 men was 76 years (60 - 102 years), with an average of 33.2% of total burn surface area. 25 patients (47.2%) had severe inhalation injury, 77.4% of the patients suffered full thickness burn injuries. Mean ABSI Score was 12. Relevant additional diseases were coronary heart disease, heart insufficiency, hypertension, COPD, adiposity and chronic alcoholism. Results: 22 patients were treated by early operative intervention (day 0 - 4), 13 of these patients survived further process. In 17 cases first operative procedure could take place only at a later date, 14 patients deceased before operation. 26 patients developed pneumonia. The total morbidity amounted to 26 of 53 patients (49%). A total of 19 injured with a burn index over 80 survived. 9 of them had an index of more than 100. Usual indices as the “Zellweger Index” and the ABSI-Score are not adequate to determine the prognosis of thermal injuries in the elderly. Conclusion: The treatment of elderly with burn trauma is affected by many factors. Compared to younger patients the increased incidence of an inhalation injury is decisive for the prognosis of older patients. The frequency of pre-existing diseases is clearly largely than with younger burn injured patients. These prognostically relevant parameters were not sufficiently considered by established score systems.
