Age-Dependent Differences in Survival after Severe Burns: A Unicentric Review of 1,674 Patients and 179 Autopsies over 15 Years

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Abstract
Improvements in quality of life over the past 50 years in developed countries have increased the average life span by nearly 30 years. 1 Thompson J.C. Gifts from surgical research. Contributions to patients and to surgeons. J Am Coll Surg. 2000; 190 : 509-521 Abstract Full Text Full Text PDF PubMed Google Scholar The proportion of the population in the United States older than 65 years of age is expected to increase from 12.4% in 2000 to 19.4% in 2030, with a projected increase from 420 million to 973 million elderly citizens. 2 US Department of Census 65+ in the United States. US Bureau of the Census, Washington, DC 1996 Google Scholar This trend presents a special challenge because the elderly will constitute an ever-growing segment of the average surgeon’s practice and will influence clinical and ethical decisions and health-care costs. The elderly and the very young are most likely to succumb to severe burns. 3 Saffle J.R. Davis B. Williams P. Recent outcomes in the treatment of burn injury in the United States a report from the American Burn Association Patient Registry. J Burn Care Rehabil. 1995; 16 : 219-232 Crossref PubMed Scopus (275) Google Scholar ,  4 Herndon D.N. Gore D. Cole M. et al. Determinants of mortality in pediatric patients with greater than 70% full-thickness total body surface area thermal injury treated by early total excision and grafting. J Trauma. 1987; 27 : 208-212 Crossref PubMed Scopus (99) Google Scholar ,  5 Jeschke M.D. Barrow R.E. Herndon D.N. Recombinant human growth hormone treatment in pediatric burn patients and its role during the hepatic acute phase response. Crit Care Med. 2000; 28 : 1578-1583 Crossref PubMed Scopus (61) Google Scholar ,  6 Colebrook L. Colebrook V. The prevention of burns and scalds. Lancet. 1949; 11 : 181-188 Abstract Scopus (19) Google Scholar It has been reported that nearly 12 deaths per day result from residential fires, with infants, toddlers, and the elderly representing the highest mortality population. 4 Herndon D.N. Gore D. Cole M. et al. Determinants of mortality in pediatric patients with greater than 70% full-thickness total body surface area thermal injury treated by early total excision and grafting. J Trauma. 1987; 27 : 208-212 Crossref PubMed Scopus (99) Google Scholar ,  5 Jeschke M.D. Barrow R.E. Herndon D.N. Recombinant human growth hormone treatment in pediatric burn patients and its role during the hepatic acute phase response. Crit Care Med. 2000; 28 : 1578-1583 Crossref PubMed Scopus (61) Google Scholar Children less than 5 years of age and adults over 65 years of age have a mortality from burns that is 6 times the national average. 6 Colebrook L. Colebrook V. The prevention of burns and scalds. Lancet. 1949; 11 : 181-188 Abstract Scopus (19) Google Scholar