Ranking the impact of co-morbidities on mortality in burn injuries: A global perspective across adult, older adult, and elderly populations

Published Date: 12th May 2026

Publication Authors: Shokrollahi. K, Tridente. A, Cappuyns. L

Background
Although comorbidities in patients with major burns are recognised as important modifiers of outcomes, existing literature often generalises their impact. Using an international dataset of major burn injuries, this study investigated the significance and the relative importance of specific comorbidities to mortality and explored how their importance may change across age-specific cohorts.

Methods
We performed a sub-analysis of the RE-ENERGIZE clinical trial dataset, which included 1200 patients worldwide with 2nd and/or 3rd degree burns expected to require skin grafting. We categorised patients into < 50 years (young adults), 50–79 years (older adults), and 80 + years (elderly). Multivariable logistic regression and dominance analysis identified comorbidities independently associated with mortality and ranked them in terms of their contribution to outcome.

Results
Distinct age-specific patterns emerged. In patients < 50 years, neurological comorbidities and malignancy were significantly associated with mortality. In the 50–79 group, vascular disease, particularly hypertension, alongside diabetes and neurological illness were most important. In the elderly, pulmonary disease conferred highest risk; in this cohort pulmonary disease was almost entirely represented by COPD.

Conclusions
Our unique approach underscores the heterogeneous impact of comorbidities on burn outcomes and highlights the importance of age-specific risk stratification. Recognition of these patterns can guide resource allocation and improve survivorship in vulnerable burn populations.

Dempsey, N.C.; Shokrollahi, K.; Tridente, A.; Cappuyns, L. et al. (2026). Ranking the impact of co-morbidities on mortality in burn injuries: A global perspective across adult, older adult, and elderly populations. Burns. 52(6), p.107986. [Online]. Available at: https://doi.org/10.1016/j.burns.2026.107986 [Accessed 21 May 2026].