State of the Science Burn Research: Burns in the Elderly
Marc G. Jeschke, Herb A. Phelan, Steven Wolf, Kathleen S Romanowski, Sarah Rehou, Alisa Saetamal, Joan Weber, John Schulz, Crystal New, Arek J Wiktor, Charles Foster, Lyndsay Deeter, Kelly Tuohy
Abstract
Advances in burn care have led to significant improvements in the outcomes of burn patients except in the elderly: burn patients 65 years of age. 1,2 This is reflected in the LD50 for elderly burn patients, which has not significantly changed over the last three decades and is around 30 to 35% TBSA burn. 4,8 The lack of improvements is even more impactful when considering that elderly represent the fastest growing population, indicating the expected substantial increase in elderly burn patients over the next decades. Additionally, the amount of burn patients in elderly will not only grow due to the growing population of elderly but also have much higher incidence as elderly are at an increased risk for burn injuries due to thinning skin, decreased sensation, mental alterations, pre-existing comorbidities, and numerous other contributing factors. [1] ][3][4][5][6] The high risk of suffering from burns in the elderly population with the rapid growth of this population will require change to the burn treatment paradigm but, at this time, burn care providers lack treatment guidelines or protocols tailored to the special needs of the elderly burn patient. Complicating elderly burn care is the lack of knowledge about maintaining quality of life, independence, and acceptable long-term outcomes. 9,10 As aforementioned, despite the recognition of burn care providers regarding poor outcomes of elderly burn patients, reasons for these detrimental outcomes have yet to be determined. Unfortunately, until 2016, there were no concerted or directed research efforts to improve outcomes. In 2016, past President of the American Burn Association (ABA) Dr. Tredget held the State of Science meeting in Washington, DC, with elderly burn care being one of the main areas of interest and priorities. Subsequently a white paper was published in the Journal of Burn Care & Research (JBCR) that briefly delineated the perceived needs of elderly burn patients and areas ripe for investigations in order to improve outcomes. 11 In addition, ABA past Presidents Dr. Peck and Dr. Tredget initiated an ad hoc Committee on Elderly Burn Care, which changed to a standing committee in 2018.