Models predicting mortality risk of patients with burns to ≥ 50% of the total body surface

Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved..

BACKGROUND: Several models predicting mortality risk of burn patients have been proposed. However, models that consider all such patients may not well predict the mortality of patients with extensive burns.

METHOD: This retrospective multicentre study recruited patients with extensive burns (≥ 50% of the total body surface area [TBSA]) treated in three hospitals of Eastern China from 1 January 2016 to 30 June 2022. The performances of six predictive models were assessed by drawing receiver operating characteristic (ROC) and calibration curves. Potential predictors were sought via "least absolute shrinkage and selection operator" regression. Multivariate logistic regression was employed to construct a predictive model for patients with burns to ≥ 50% of the TBSA. A nomogram was prepared and the performance thereof assessed by reference to the ROC, calibration, and decision curves.

RESULT: A total of 465 eligible patients with burns to ≥ 50% TBSA were included, of whom 139 (29.9%) died. The FLAMES model exhibited the largest area under the ROC curve (AUC) (0.875), followed by the models of Zhou et al. (0.853) and the ABSI model (0.802). The calibration curve of the Zhou et al. model fitted well; those of the other models significantly overestimated the mortality risk. The new nomogram includes four variables: age, the %TBSA burned, the area of full-thickness burns, and blood lactate. The AUCs (training set 0.889; internal validation set 0.934; external validation set 0.890) and calibration curves showed that the nomogram exhibited an excellent discriminative capacity and that the predictions were very accurate.

CONCLUSION: For patients with burns to ≥ 50%of the TBSA, the Zhou et al. and FLAMES models demonstrate relatively high predictive ability for mortality. The new nomogram is sensitive, specific, and accurate, and will aid rapid clinical decision-making.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Burns : journal of the International Society for Burn Injuries - (2024) vom: 04. März

Sprache:

Englisch

Beteiligte Personen:

Wang, Yiran [VerfasserIn]
Cai, Chenghao [VerfasserIn]
Zhu, Zhikang [VerfasserIn]
Duan, Deqing [VerfasserIn]
Xu, Wanting [VerfasserIn]
Shen, Tao [VerfasserIn]
Wang, Xingang [VerfasserIn]
Xu, Qinglian [VerfasserIn]
Zhang, Hongyan [VerfasserIn]
Han, Chunmao [VerfasserIn]

Links:

Volltext

Themen:

Extensive burns
Journal Article
Mortality
Multicentre
Nomogram

Anmerkungen:

Date Revised 15.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1016/j.burns.2024.02.031

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369805119