With the aim of identifying patterns of burn injury, remediable risk f
actors, and policies in the overall surgical and medical management a
retrospective review of 111 octogenarian burn victims admitted between
1983 and 1993 is presented. The mean age was 84 years, with the mean
percentage body surface area burned (%BSAB) being 9.6 per cent (range
0.5-65 per cent). Contrary to expectations, the annual incidence appea
rs to be declining, the possible reasons far which are discussed. Surg
ery was required in 69 patients; in 11 this was performed within 1 wee
k of injury. When compared to the more traditional delayed surgical ap
proach, early surgery conveyed no benefits in either mortality (early
group, 18 per cent; delayed group, 13 per cent) or length of hospital
stay (early group survivors, 38 days; delayed group survivors, 42 days
). Medical and social problems were very common and led to an often di
fficult and frequently prolonged rehabilitation, with the mean length
of hospital stay for all patients being 29 days. The mortality of the
whole group was 26 per cent, the patients on average faring better tha
n their predicted mortalities as derived using either the Baux index,
the Bull fable or the Abbreviated Burn Severity Score.