Dysphagia in older persons following severe burns: Burn location is irrelevant to risk of dysphagia and its complications in patients over 75 years

Abstract

BackgroundManagement of burns in older persons is complex with evidence indicating advanced age is associated with elevated risk for morbidity and mortality. Dysphagia and its sequelae may further increase this risk. Aims(1) Determine the prevalence, and (2) identify risk factors for dysphagia in patients admitted with severe burn injury over 75 years. MethodsAll patients >75 years admitted to Concord Repatriation General Hospital with severe burn injury over a 4-year period (2013–2017) were assessed for dysphagia on presentation and continually monitored throughout their admission. Burn injury, demographic and nutritional data were captured and analysed for association with and predictive value for dysphagia. ResultsSixty-six patients (35 male; 31 female) aged 75–96 years (median 82 years) were recruited. Dysphagia was identified in 46.97% during their hospital admission. Dysphagia was significantly associated with burn size, pre-existing cognitive impairment, mechanical ventilation, duration of enteral feeding, hospital length of stay, in-hospital complications and mortality. No association was identified between burn location, burn mechanism, surgery and dysphagia. Burn size and Malnutrition Screening Tool score were found to be independent predictors for dysphagia. ConclusionsDysphagia prevalence is high in older persons with burns and is associated with increased morbidity and mortality, regardless of burn location.