Development and validation of a model for prediction of mortality in patients with acute burn injury.

Abstract

The objective was to develop a user-friendly model to predict the probability of death from acute burns soon after injury, based on burned surface area, age and presence of inhalation injury. This population-based cohort study included all burned patients admitted to one of the six Belgian burn centres. Data from 1999 to 2003 (5246 patients) were used to develop a mortality prediction model, and data from 2004 (981 patients) were used for validation. Mortality in the derivation cohort was 4.6 per cent. A mortality score (0-10 points) was devised: 0-4 points according to the percentage of burned surface area (less than 20, 20-39, 40-59, 60-79 or at least 80 per cent), 0-3 points according to age (under 50, 50-64, 65-79 or at least 80 years) and 3 points for the presence of an inhalation injury. Mortality in the validation cohort was 4.3 per cent. The model predicted 40 deaths, and 42 deaths were observed (P = 0.950). Receiver-operator characteristic curve analysis of the model for prediction of mortality demonstrated an area under the curve of 0.94 (95 per cent confidence interval 0.90 to 0.97). An accurate model was developed to predict the probability of death from acute burn injury based on simple and objective clinical criteria.