Creation of a decision aid for goal setting after geriatric burns: a study from the prognostic assessment of life and limitations after trauma in the elderly [PALLIATE] consortium

The Journal of Trauma and Acute Care Surgery
Erica I HodgmanHerb A Phelan

Abstract

We hypothesized that a decision-support aid to predict index admission mortality and discharge disposition for geriatric burns could be constructed using the well-accepted Baux score (age +total body surface area burned) in a geriatric-specific cohort. National Burn Repository version 8.0 (2002-2011) was queried for all subjects aged 65 years or older. Baux scores were calculated and patients grouped into deciles. Three discharge outcomes (death,home, discharge to nonhome setting) were measured per decile. A receiver operating characteristic analysis was used to determine optimal Baux score cutpoints based on the Youden Index. The odds of mortality at various Baux score cutoffs were estimated using logistic regression. The sample was composed of 8,001 subjects. Withdrawal of care was documented in 264 deaths; median time to withdrawal was three days. As Baux score increased, three peaks in disposition were seen. Less than 50% of patients with a Baux score of 80 or greater were discharged home. Patients with a moderate Baux score (80-130) had an increased likelihood of discharge to a nonhome setting. Baux scores of 130 or greater were nearly uniformly fatal (mortality, 94-100%). Baux score of 86.15 or less was predictive of disc...Continue Reading

References

Mar 18, 2000·Archives of Surgery·V McGillR L Gamelli
Mar 17, 2001·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·L P FriedUNKNOWN Cardiovascular Health Study Collaborative Research Group
Aug 30, 2001·Burns : Journal of the International Society for Burn Injuries·L A WibbenmeyerG P Kealey
Sep 1, 2005·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Kenneth RockwoodArnold Mitnitski
Aug 8, 2007·Annals of Internal Medicine·Christine T CigolleCaroline S Blaum
Dec 9, 2008·Journal of Burn Care & Research : Official Publication of the American Burn Association·Tam N PhamMatthew B Klein
Jan 24, 2009·Journal of Burn Care & Research : Official Publication of the American Burn Association·Rachel S LundgrenMatthew B Klein
Jun 1, 2010·Journal of the American College of Surgeons·Martin A MakaryLinda P Fried
Jun 22, 2010·Critical Care Medicine·Judith E NelsonUNKNOWN Improve Palliative Care in the Intensive Care Unit Project
Dec 3, 2010·Journal of Burn Care & Research : Official Publication of the American Burn Association·Matthew B KleinLoren Engrav
Feb 9, 2012·The Journal of Trauma and Acute Care Surgery·Geoffrey RobertsPeter Dziewulski
Jan 8, 2013·Journal of Burn Care & Research : Official Publication of the American Burn Association·Samuel P MandellMatthew B Klein
Mar 26, 2013·Burns : Journal of the International Society for Burn Injuries·Daan den Hollander
Feb 21, 2014·The Journal of Trauma and Acute Care Surgery·Jan DokterHan Boxma
Dec 11, 2014·Journal of Palliative Medicine·David B DuvallHerb A Phelan
Jul 7, 2015·Journal of Burn Care & Research : Official Publication of the American Burn Association·Erica I HodgmanSteven E Wolf

❮ Previous
Next ❯

Citations

Sep 8, 2016·Critical Care Clinics·Elisha G BrownsonKevin K Chung
Sep 15, 2016·Journal of Palliative Medicine·Natalia S PartainHerb A Phelan
Nov 3, 2020·ANZ Journal of Surgery·Kristian StefaniJohn E Greenwood
Jun 12, 2021·The Journal of Surgical Research·Rachel S MorrisChristopher J Tignanelli

❮ Previous
Next ❯

Related Concepts

Related Feeds

Epidemiology of Aging

This feed focuses on epidemiology of aging and aging-related conditions, including Alzheimer’s disease, dementia, and age-associated cognitive impairment. Here is the latest research.