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Publications (4)5.29 Total impact

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    ABSTRACT: IntroductionThe elderly are the fastest growing population segment, and particularly susceptible to burns. Predicting outcomes for these patients remains difficult. Our objective was to identify early predictors of mortality in elderly burn patients.Methods Our Burn Center's prospective database was reviewed for burn patients 60+ treated in the past 10 years. Predictor variables were identified by correlative analysis and subsequently entered into a multivariate logistic regression analysis examining survival to discharge.Results203 patients of 1343 (15%) were eligible for analysis. The average age was 72 ± 10 (range 60–102) and the average total body surface area (TBSA) burned was 23 ± 18% (range 1–95). Age, TBSA, base deficit, pO2, respiratory rate, Glasgow Coma Score (GCS), and Revised Trauma Score (RTS, based on systolic blood pressure, respiratory rate, and GCS) all correlated with mortality (p ≤ 0.05). Using multiple logistic regression analysis, a model with age, TBSA and RTS was calculated, demonstrating:increased risk of mortality=β0+1.12 (age)+1.094 (TBSA)+0.718 (RTS)increased risk of mortality=β0+1.12 (age)+1.094 (TBSA)+0.718 (RTS)In this model, β0 is a constant that equals −8.32.Conclusions Predicting outcomes in elderly burn patients is difficult. A model using age, TBSA, and RTS can, immediately upon patient arrival, help identify patients with decreased chances of survival, further guiding end-of-life decisions.
    Burns: journal of the International Society for Burn Injuries 12/2012; 38(8):1114–1118. · 1.95 Impact Factor
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    ABSTRACT: The American Burn Association publishes a list of defined criteria for patients who require admission or transfer to a burn center. This study examines the extent to which those criteria are observed within a regional burn network. Hospital discharge data for 2008 were obtained for all hospitals within the South Florida regional burn network. Patients with International Classification of Diseases, 9th revision discharge diagnoses for burns were reviewed, and their triage destination was compared with the burn triage referral criteria to determine whether patients were inappropriately triaged. Descriptive statistics were used to analyze the data. Four hundred ninety-eight burn admissions were documented to non-burn center center hospitals, 269 (54%) of which were deemed inappropriate by burn triage referral criteria. Burn center patients had greater length of stay when compared with non-burn center patients (14 vs 7 days), but a greater percentage were discharged home for self-care (88 vs 57%). Thirty-three percent of the inappropriate admissions were in a neighboring county, whereas 27% were in the same county where the burn center is located. Inappropriate burn patient triage may be occurring to more than half of the burn patients within our regional burn network despite better functional outcomes at the burn center. This may be because of a lack of knowledge regarding triage criteria, patient insurance status, or other factors. Further studies are necessary to fully characterize the problem and implement education or incentives to encourage appropriate burn patient triage.
    Journal of burn care & research: official publication of the American Burn Association 08/2012; · 1.54 Impact Factor
  • Journal of Burn Care & Research - J BURN CARE RES. 01/2006; 27.
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    ABSTRACT: A technique is described for the intra-operative positioning of the burn patient, which allows circumferential access without the need for specialized equipment or extra personnel. The equipment is available in any standard operating room and table without the need for redesign or new construction. In addition, it allows full 360 degrees access and eliminates the need for extra personnel to hold proper positioning. This allows for more efficient operating and should minimize the unwanted sequelae of hypothermia and blood loss. Operating time may be decreased and the patient may require less operative procedures. The same or more work can be done by less personnel, in less time, with no added cost.
    Burns 09/2005; 31(5):647-9. · 1.80 Impact Factor