98 A 10-year Retrospective Review of Older Adult Admissions at a Regional Burn Center

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S64-S65
Author(s):  
Stephanie Campbell ◽  
Trina Andres
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Retrospective Review ◽  
Tap Water ◽  
Burn Injuries ◽  
Age Group ◽  
Prevention Programming ◽  
Burn Center ◽  
Number Of Patients ◽  
Fire Flame

Abstract Introduction A verified regional burn center conducted a 10-year retrospective review of older adult patients admitted to the burn service. The primary goal of the review was to examine trends in mechanisms of injury, demographics, and outcomes to inform burn prevention programming. Methods Admission data from 2009–2018 was retrieved from burn center databases and combined into a Microsoft Excel spreadsheet. Older adults were defined as age 65 years and older. Patients admitted to the burn service for skin disorders or soft tissue infections were excluded. Patients with cutaneous burn injuries or inhalation only injuries were included. Results The total number of patients included was 697. Nearly a third of the patients were 65 to 69 years old, with incidence declining with each subsequent 5-year age group. Males accounted for 61.3% of admissions. Two thirds of the patients were White (67.6%). The other third consisted of Black (18.4%) and Hispanic (9.8%), Asian (1.9%) and Native American (0.14%) patients. Overall mortality was 14%. Mortality generally increased per 5-year age group: 65–69 (7.8%), 70–74 (10.6%), 75–79 (13.7%), 80–84 (20.6%), 85–89 (29.8%), 90–94 (24.2%), and 95–99 (42.9%). Baux scores ranged from 65 to 180. The highest Baux score that lived to discharge was 119. The average Baux score of the mortality group was 114 and the average of the lived group was 82. No patients with a Total Body Surface Area (TBSA) above 43% lived. Fire/flame burns accounted for 72.7%. Scald burns made up 19.9%, contact burns 3%, chemical burns 2.3% and electrical burns < 1%. Nearly a quarter (24.6%) of fire/flame burns were related to smoking on home oxygen therapy (HOT), which was also the overall most common mechanism at 17.8%. Other fire/flame mechanisms included housefires (21.2%), clothing catching on fire (16.9%), and gasoline-related injuries (11.7%). More than 70% of scald burns came from the three mechanisms: hot tap water, boiling water, and hot grease. For the mortality group, a third of patients had been injured in housefires (32.7%), followed by clothing catching on fire (17.4%) and HOT burns (12.2%). Conclusions Incidence rates decline with increasing age but mortality rates climb. Burn injuries with a TBSA greater than 40% are generally fatal in the older adult. Flame burns account for the majority of injuries with HOT and house fire injuries as the leading mechanisms. Scald burns were most often caused by hot tap water or boiling water. White older adults accounted for more than double the number of patients identified in all other races combined. Applicability of Research to Practice The demographics and mechanism of injury insight gained from this review can be utilized to inform prevention programming design in this region. Trends in mortality can help emphasize the seriousness of preventing older adult burn injuries and anticipate the mortality risk for older adults admitted to the burn center.

scholarly journals 94 Association between Dual-Task Timed “UP and GO” Test and Occurrence of Falls According to Age Group (Young-Older or Old-Older Adults): A Longitudinal Observation Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Tsuyoshi Asai ◽  
Kensuke Oshima ◽  
Yoshihiro Fukumoto ◽  
Shogo Misu
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Dual Task ◽  
Community Dwelling ◽  
Age Group ◽  
Adult Group ◽  
Observation Study ◽  
Timed Up And Go ◽  
Community Dwelling Older Adults

Abstract Aim To elucidate the association between the occurrence of falls and timed “up and go” (TUG) test score in a dual-task condition among community-dwelling older adults by age group. Methods This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG test (single-TUG) and a TUG test while counting aloud backward from 100 (dual-TUG) were conducted at baseline. The dual-task cost (DTC) value was computed from these results. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. At follow-up, 322 participants had dropped out and six participants had missing data for falls. The final analysis included 658 individuals (follow-up rate: 658/987, 67%) divided into a young-older adult group (aged 60–74 years) and an old-older adult group (aged 75 years or older). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models. Results For old-older adults, there were significant associations between the occurrence of falls and DTC value (odds ratio [OR] 0.981, 95% confidence interval [CI]: 0.963–0.999, p = 0.040) and single-TUG score (OR 1.129, 95% CI: 1.006–1.268, p = 0.039). However, no significant associations were observed for young-older adults. Conclusions Slower single-TUG test score and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual task assessment is useful for predicting falls in TUG fall assessment for old-older adults.

scholarly journals Epidemiology of burn injury in older adults: An Australian and New Zealand perspective

2020 ◽  
Vol 6 ◽  
pp. 205951312095233
Author(s):  
Lincoln M Tracy ◽  
Yvonne Singer ◽  
Rebecca Schrale ◽  
Jennifer Gong ◽  
Anne Darton ◽  
...  
Keyword(s):  
Older Adults ◽  
New Zealand ◽  
Older Adult ◽  
Surgical Management ◽  
Surgical Procedure ◽  
Burn Injury ◽  
Burn Injuries ◽  
Younger Patients ◽  
Care Community ◽  
Burn Care

Introduction: The ageing global population presents a novel set of challenges for trauma systems. Less research has focused on the older adult population with burns and how they differ compared to younger patients. This study aimed to describe, and compare with younger peers, the number, causes and surgical management of older adults with burn injuries in Australia and New Zealand. Methods: The Burns Registry of Australia and New Zealand was used to identify patients with burn injuries between 1 July 2009 and 31 December 2018. Temporal trends in incidence rates were evaluated and categorised by age at injury. Patient demographics, injury severity and event characteristics, surgical intervention and in-hospital outcomes were investigated. Results: There were 2394 burn-injured older adults admitted during the study period, accounting for 13.4% of adult admissions. Scalds were the most common cause of burn injury in older adults. The incidence of older adult burns increased by 2.96% each year (incidence rate ratio = 1.030, 95% confidence interval = 1.013–1.046, P < 0.001). Compared to their younger peers, a smaller proportion of older adult patients were taken to theatre for a surgical procedure, though a larger proportion of older adults received a skin graft. Discussion: Differences in patient and injury characteristics, surgical management and in-hospital outcomes were observed for older adults. These findings provide the Australian and New Zealand burn care community with a greater understanding of burn injury and their treatments in a unique group of patients who are at risk of poorer outcomes than younger people. Lay Summary The number and proportion of older persons in every country of the world is growing. This may create challenges for healthcare systems. While burn injuries are a unique subset of trauma that affect individuals of all ages, less is known about burns in older adults and how they differ from younger patients. We wanted to look at the number, type, management, and outcomes of burns in older adults in Australia and New Zealand. To do this, we used data from the Burns Registry of Australia and New Zealand, or BRANZ. The BRANZ is a database that collects information on patients that present to Australian and New Zealand hospitals that have a specialist burns unit. Our research found that one in eight adult burns patients was over the age of 65, and that the rate of burn injuries in older adults has increased over the last decade. Older adult burns patients were most commonly affected by scalds after coming in contact with wet heat such as boiling liquids or steam. Fewer older adults went to theatre for an operation or surgical procedure compared to their younger counterparts. However, a larger proportion of older adults that went to theatre had a skin graft (where skin is removed from an uninjured part of the body and placed over the injured part). This research provides important information about a unique and growing group of patients to the local burn care community. It also highlights potential avenues for injury prevention initiatives.

Most prominent factors contributing to burn injury-related amputations: an analysis of a referral Burn Center

2021 ◽  
Author(s):  
Kayhan Gurbuz ◽  
Mete Demir ◽  
Abdulkadir Basaran ◽  
Koray Das
Keyword(s):  
Burn Injury ◽  
Total Body Surface Area ◽  
Health And Safety ◽  
Multivariate Logistic Regression Analysis ◽  
Past Research ◽  
Risk Groups ◽  
Burn Injuries ◽  
Burn Center ◽  
Severe Burns ◽  
Fire Flame

Abstract Amputations are un-common surgical procedures in patients with severe burn injuries. However, these patients often face extreme physical and psychological challenges that result in social stigmatization and inadequate rehabilitation facilities. A retrospective cohort study was designed for the patients admitted to the Burn Center of Adana City Training and Research Hospital (ACTRH). During the study period, a total of 2007 patients aged 0.5 to 92 years were hospitalized and treated at the burn center from January 2016 to June 2020. The incidence of amputation observed among inpatient burn injuries regardless of the etiology was 1.9%, and 87.2% were male. The univariate and multivariate logistic regression analysis was performed to detect the most prominent factors contributing to burn injury-related amputations. The cause of burns appears to be one of the main factors in the past research, and in this context, the electrical burns stand out, likewise, the fire-flame-related burns, full-thickness burns, the existence of infection, male gender, patients aged within the 18 to 64 age group, and the burn extent within the total body surface area (TBSA) range of 10 to &lt;50% were found to be the most leading factors of amputations among patients having severe burns. Although they are rare, amputations related to burns commonly cause a decrease in quality of life. Therefore, besides increasing occupational health and safety methods for these risk groups, especially for adults of working age; also, it is essential to increase the importance and awareness of the precautions to be taken in daily life.

601 Burn Injuries Associated with At-home Hair Braiding

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S152-S153
Author(s):  
Afaaf Shakir ◽  
Megan Teele ◽  
Annemarie O’Connor ◽  
Lawrence J Gottlieb ◽  
Sebastian Q Vrouwe
Keyword(s):  
African American ◽  
Total Body Surface Area ◽  
Hot Water ◽  
Burn Injuries ◽  
Wound Management ◽  
Patient Demographics ◽  
Burn Center ◽  
Number Of Patients ◽  
The Mean ◽  
At Home

Abstract Introduction Hair braiding that incorporates synthetic extensions has increased in popularity across all age groups. During the styling process, the ends of the braid are commonly dipped in hot water. As a result of this practice, an increasing number of patients have presented to our Burn Center after containers of recently boiled water are accidentally tipped over and spilled onto patients. Here, we report on patient demographics, outcomes, and our experience managing this injury pattern. Methods A retrospective chart review was performed of all patients who sustained burn injuries associated with at-home hair braiding presenting to an ABA-verified Burn Center between January 1, 2006 and July 31, 2020. Data on patient demographics, injury characteristics, wound management and, burn outcomes was collected. Results A total of 41 patients presented over the study period with burn injuries related to at-home hair braiding. The frequency of this type of burn increased over time, with 54% of injuries occurring in the last three years (2018–2020). The mean patient age was 7.5 years (range 0.7 – 32 years). Demographically, the vast majority of patients were under 18 years of age (90%), female (95%), and African American (98%). Seventy-three percent of injuries occurred at the patient’s home and 88% of incidents involved another person in the hair braiding process. The mean total body surface area of burn was 5% (range 1–20%). The most commonly involved areas were the back (54%), thigh/leg (37%), neck (24%), shoulder (24%), and arm/forearm (22%). Ninety percent were entirely partial thickness injuries with 10% of patients suffering some degree of full thickness injury. Ninety percent of patients required inpatient admission, and 36% of patients required at least one operative procedure. For those managed as inpatients, the average length of stay was 5.4 days (range 1–30 days). Three patients were reported to experience complications with one developing respiratory failure and two with delayed wound healing. Conclusions Hair braiding, with the use of scalding water to seal and set the ends of braids, can lead to significant accidental burn injuries. At our institution, these injuries occur predominantly in young African-American females. These burns can result in acute hospitalization and the need for surgical intervention. This is the largest series of this injury type to date with trends towards increasing frequency in the most recent time period.

scholarly journals 600 ESCALATION DECISIONS DURING THE COVID-19 PANDEMIC AMONGST OLDER ADULTS

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
L Bishop ◽  
D Tiwari
Keyword(s):  
Older Adults ◽  
Critical Care ◽  
Retrospective Review ◽  
Decision Aid ◽  
Age Group ◽  
Younger Age ◽  
Nice Guidance ◽  
Treatment Escalation ◽  
Second Wave ◽  
Care Decision

Abstract Introduction NICE guidance recommends that during the COVID-19 pandemic all adults are assessed for frailty, suitability for resuscitation and escalation to critical care on admission to hospital. Risks, benefits and likely outcomes should be discussed with patients/relatives. Aim To investigate impact of intervention on treatment escalation plan (TEP) use during the first wave (W1) and second wave (W2) of pandemic. Intervention W1: An ethically approved TEP and a Critical Care Decision Aid (CCDA) was added to the admission booklet. W2: The TEP update included a ‘confirm discussed with patient/relatives’ section. Method W1: We conducted retrospective review of 62 case-notes of patients admitted through COVID-19 pathway and grouped into &gt;80 and ≤ 80 years old. Resuscitation, TEP, CCDA and communication with patient/relatives were collected. W2: 60 further case-notes of patients with COVID-19 admitted in January 2021 were analysed. Results W1: 100% patients had resuscitation decisions and 95% had TEPs in both groups. Significantly higher proportions of Frailty scores were calculated in &gt;80s (58% vs 35% p = 0.04). On average resuscitation and TEPs were made within 13.8 hours of admission (range 1–72 hours). 53.2% of resuscitation decisions and 30% TEPs were discussed with patients of whom higher proportions were discussed in younger age group, majority were discussed at the time of deterioration. W2: 98.3% patients had resuscitation decisions made and 96.7% had TEPs across both groups. On average resuscitation decisions were made within 14.9 hours of admission. In the &gt;80s, 86.7% of resuscitation decisions were discussed and 63.3% of the TEPs were discussed with patient/relatives. In the &lt;80s, 82.8% of resuscitation decisions were discussed and 71.4% of TEPs were discussed with the patient/relatives. Conclusion We significantly improved Treatment Escalation planning during W1 and W2 of pandemic by introducing the TEP in W1 and adding prompt to improve communication with patients/relatives in W2 (p = 0.02).

Rhinoplasty in the Older Adult

2021 ◽  
Author(s):  
Sumun Khetpal ◽  
Arvind U Gowda ◽  
Yassmin Parsaei ◽  
Mohammad Ali Mozaffari ◽  
Jacob Dinis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Soft Tissue ◽  
Older Adult ◽  
Retrospective Review ◽  
Surgical Indications ◽  
Institutional Review ◽  
Age Related ◽  
Primary Indication ◽  
Post Traumatic

Abstract Background Rhinoplasty in older adults requires unique consideration of the ageing nose. The purpose of this study was to systematically review the literature pertaining to rhinoplasty in this population, review the senior author’s experience, and describe techniques aimed at addressing such features. Objectives We hypothesized consistent age-related nasal dysmorphology is described in the literature and standard rhinoplasty techniques may effectively address these changes. Furthermore, we hypothesized rhinoplasty is more commonly performed for post traumatic and functional indications than for aesthetic reasons. Methods A literature review including publications describing rhinoplasty in patients over 55 years old was conducted. Additionally, a retrospective review of the senior author’s cases was performed. Pre- and postoperative photographs were used to compare anthropometric changes. Demographic factors, surgical indications and operative details were collected. Results Nine articles met study criteria. Manifestations of the ageing nose included soft tissue atrophy, bony fragility and resorption, tip ptosis, internal and external valve collapse, and worsening dorsal hump. 27 patients were included in our institutional review. Primary indication for rhinoplasty was post-traumatic deformity in 17 (63%) patients and nasal obstructive symptoms in 10 (37%) patients. Tip refinement and ptosis were addressed through tip grafts (70%), columellar struts (26%), and caudal septal extension grafts (67%). Nasal obstruction was relieved through septoplasty (96%), turbinate ablation (85%), and spreader grafts (70%). Conclusions This study presents a systematic review of rhinoplasty in the older adult as well as a retrospective review of the senior author’s patients. Unique considerations specific to this population should be integrated into treatment planning.

scholarly journals ANALYSIS OF INCIDENCE, ETIOLOGY AND RISK FACTORS ASSOCIATED IN ACUTE BURN INJURY IN ADULTS AT ANMMCH, GAYA, BIHAR

2020 ◽  
pp. 1-3
Author(s):  
Kishore Kumar Sinha ◽  
Abhai Kumar Jha Suman ◽  
Alok Kumar ◽  
Debarshi Jana
Keyword(s):  
Burn Injury ◽  
Point Of View ◽  
Burn Injuries ◽  
Unknown Etiology ◽  
High Morbidity ◽  
Burn Patients ◽  
Age Group ◽  
Major Health Problem ◽  
Number Of Patients ◽  
Study Results

Introduction: Burn injuries have major health problem because of its high, morbidity, disability andmortality in young and middle-aged people. Burn injuries also have social problems associated with it. It may be associated with accidental, suicidal or homicidal causes. Despite of such importance of burn injuries from clinical and social point of view, there is scarcity of research on burn injuries in India. Thus we tried to highlight our observations in this study which had been undertaken to find out the causes of burn and it's clinical profile and treatment outcome of burn patients in the our Institute. Material methods: This observational study was conducted from August 2016 to March 2020 in patients ofburn injury who were admitted in surgery wardsand burn ICU of Anugrah Narayan Magadh Medical College & Hospital, Gaya, Bihar. We have studied 226 burn patients who admitted in our general surgical units and burn icu of our Institute. Burns patients who are above 18 years and both sexes were including in the study. Results: A total of 226 patients had burns injuries. 162 were male and 64 female in the ratio of M: F-2.53:1.Males were mostly affected (71.68%) in comparison to females. Most of the burn patients were in the age group of 21-30 years in this studied.i.e.42.02%. Lesser patients were seen in age group 50 -75 . As regard the causes,duringthe house hold activities has maximum number of patients as shown and electricity is causing second highest cases (26.99%), less number of patients are suicidal (3.53) and unknown etiology is seen in seven cases. Conclusion: Burn injury prevention is very difficult task, but to avoid the significant morbidity andmortality following the burn injury. We have to take every measures to control its incidence. A coordinated and dedicated approach by social workers, medical and paramedical personnel and administrators can only minimize the incidence of burn injury in India.

700 A Comparison of Pediatric Burn Injuries Based on Cultural Environment

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S180-S181
Author(s):  
Nicole Bennie ◽  
Heather Belacic ◽  
David Bruckman ◽  
Mary A Mondozzi ◽  
John Crow
Keyword(s):  
Injury Severity ◽  
Burn Injury ◽  
Cultural Beliefs ◽  
Median Number ◽  
Burn Injuries ◽  
Surgical Interventions ◽  
Burn Center ◽  
Fire Flame ◽  
Need For Rehabilitation ◽  
Flame Burn

Abstract Introduction The Amish maintain cultural customs that preserve their identity minimizing assimilation into American culture and selectively use technology. Cultural beliefs and environmental situations can predispose the Amish, especially children to burn injuries. As a burn center it is important to examine demographics, incidence and causes of burn injury to bring awareness for prevention efforts. The purpose of this study was to determine if burns in Amish children are associated with greater severity when compared to non-Amish children. Methods A retrospective analysis of the burn registry at a verified burn center collected data on inpatient children &lt; 14 years with an acute burn injury from 2012 through 2018. Children with frostbite and non-accidental burn trauma were excluded. Results Of the 273 children, 16 (5.9%) Amish children were similar to the 257 (94.1%) non-Amish children in age (mean age 4.8y, SD=3.8 vs. 4.0y, SD=3.7), male gender (63% vs. 59%) and percent needing surgery (44% vs. 26%, p=0.14). However, Amish children had a greater median injury severity score (ISS) (9.0, IQR [1, 25] vs. 1.0, [1, 4], p&lt; 0.0001), median TBSA (19.5% [5.2, 52] vs. 4.0 [1.7, 7], p&lt; 0.0001), median length of stay (LOS) (10.5 days [4, 50] vs. 2.0 days [1, 8], p&lt; 0.0001), and median number of surgeries (0.5 [0, 6.5] vs. 0 [0, 1], p&lt; 0.0074). Complications of ARDS (25%), sepsis (25%), compartment syndrome (18.8%), acute renal injury/failure (12.5%) and amputation (18.8%) were more prevalent among Amish children (all p&lt; 0.0033) and non-existent in the non-Amish group. Amish children had a higher incidence of fire/flame burn (43.8% vs. 19.5%) and need for rehabilitation (37.5% vs. 0.8%). Conclusions In this study, Amish children had greater burn area, severity, longer LOS, more surgical interventions and complications than non-Amish children. Applicability of Research to Practice Culturally appropriate prevention efforts and education are needed to enhance existing care and burn or fire awareness with the Amish population.

Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Gait Speed ◽  
Well Being ◽  
Self Report ◽  
Subjective Report ◽  
Healthy Older Adults ◽  
Relative Value ◽  
Cognitive Speed ◽  
Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

Prescription of Exercise in Older Adults, Physiotherapeutic Approach

2017 ◽  
Vol 2 (5) ◽  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Exercise Prescription

• Identify the changes related to aging that must be taken into account for the prescription of the exercise • Define the appropriate functional assessmentsforthe prescription of the exercise in the older adult • Recognize the factors that influence the adherence to exercise by older adults • Describe according to the objectives the correct exercise prescription for older adults.

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