Impact of Surgical Excision Timing on the Survival in Geriatric Burn Patients: A Retrospective Study

Abstract With the aging population, burn injuries in elderly patients are increasing. Early surgical excision is a key component of burn management, yet its benefits in geriatric patients remain unclear. This study evaluates the impact of excision timing on survival in patients aged 75 years and older. This retrospective, single-center study included patients ≥75 years hospitalized in a burn center between 2018 and 2022. Two groups were defined: early excision (within 14 days post-burn) and conservative treatment (excision after 14 days or wound care only). Primary outcomes were one- and six-month mortality. Secondary outcomes included hospital length of stay (LOS), healing time, and the LOS/total burned surface area (TBSA) ratio. Among 170 patients (mean age 82.9 ± 5.4 years, TBSA 5.7% ± 4.2), early excision was performed in 37.6% (n = 64). One-month mortality was 3.12% in the early excision group vs. 7.55% in the conservative group (OR = 0.4; 95% CI 0.081–1.92; p=.32). Six-month mortality was significantly lower in the early excision group (3.12% vs. 16.04%; OR = 0.17; 95% CI 0.0038–0.76; p=.01). LOS was significantly shorter in the early excision group (p.001). No significant differences were observed for LOS/TBSA ratio (p=.06) or healing time (p=.91). Early surgical excision (14 days) may reduce six-month mortality in elderly burn patients. These results support earlier intervention, however larger prospective studies are needed to confirm these findings and reduce retrospective bias.