Associationbetween hyperoxia and mortality in severely burned patients

Halgas, Barret J.; Bay, Curt; Neagoe, Alexandra; Richey, Karen; Hofmann, Luke J.; Foster, Kevin N

doi:10.1016/j.burns.2019.12.002

Cited by 3 publications

(6 citation statements)

References 19 publications

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“…The reason for the differences in our results when compared with the training population 5 6 7 and other validation populations 9 10 11 12 13 14 15 16 17 18 are explained by the differences in the population characteristics and the healthcare infrastructure of our setup. The patients in our study were more severely burnt and had a high incidence of inhalational injury.…”

Section: Discussionmentioning

confidence: 80%

“…The FLAMES score has not been as extensively validated as ABSI and rBaux. In the studies by Moore et al, 18 Halgas et al, 12 and Kim et al, 13 the AUROC is more than 0.9. The population characteristics in these studies was similar to those of the training population.…”

Section: Discussionmentioning

confidence: 92%

“…The external validation studies performed in the developed countries, such as the United States of America, 9 12 Switzerland, 10 Ireland, 11 Korea, 13 and Japan 8 have found excellent discrimination. These studies consisted of patients with less severe burns and a low incidence of inhalational injury.…”

Section: Discussionmentioning

confidence: 98%

“…The ABSI has been extensively validated in the developed world 8 9 10 11 12 13 and two developing countries, Ghana 14 and Iran. 15 Brusselaers et al studied the performance of ABSI in the Ghanaian population and reported excellent discrimination.…”

Section: Discussionmentioning

confidence: 99%

“…The rBaux score has been extensively validated in the developed countries 8 9 10 11 12 13 16 17 and the Caucasian population and only two studies tested it in developing countries. 14 15 Brussealers et al 14 studied the model in the Ghanaian population and Salehi et al 15 studied the same in the Iranian population.…”

Section: Discussionmentioning

confidence: 99%

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External Validation of Three Burn-Specific Mortality Prediction Models in Adult Burn Patients at a Tertiary Care Hospital in India

Sharma

Tandon

2023

Indian J Plast Surg

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Background Several burn-specific mortality prediction models have been formulated and validated in the developed countries. There is a dearth of studies validating these models in the Indian population. Our objective was to validate three such models in the Indian burn patients. Methods A prospective observational study was performed after ethical clearance on consecutive eligible consenting burn patients. Patient demographics, vitals, and results of hematological workup were collected. Using these. the Abbreviated Burn Severity Index (ABSI), the revised Baux score (rBaux), and the Fatality by Longevity, APACHE II score, Measured extent of burn, and Sex score (FLAMES) were calculated. The discriminative ability of the ABSI, rBaux, and the FLAMES was tested using the receiver operating characteristic (ROC) curve at 30 days and the area under the ROC curve (AUROC) compared. A p-value ≤ 0.05 was considered significant. Probability of death was calculated using these models. Hosmer–Lemeshow goodness of fit test was run. Results The ABSI (AUROC 0.7497, 95% CI 0.67796–0.82141), rBaux (AUROC 0.7456, 95% CI 0.67059–0.82068) and FLAMES (AUROC 0.7119, 95% CI 0.63209–0.79172), had fair discriminative ability. The Hosmer–Lemeshow test reported that ABSI and rBaux were a good fit for the Indian population, while FLAMES was not a good fit. Conclusion The ABSI and rBaux had a fair discriminative ability and were a good fit for the adult patients with 30 to 60% thermal and scald burn patients. FLAMES despite having fair discriminative ability was not a good fit for the study population.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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External Validation of Three Burn-Specific Mortality Prediction Models in Adult Burn Patients at a Tertiary Care Hospital in India

Sharma

Tandon

2023

Indian J Plast Surg

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Survival and analysis of prognostic factors for severe burn patients with inhalation injury: based on the respiratory SOFA score

Tang

et al. 2023

BMC Emerg Med

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Background It is important to determine the severity of inhalation injury in severely burned patients. The oxygenation index PaO2/FiO2(PF) ratio is a key clinical indicator of inhalation injury. Sequential organ failure assessment (SOFA) is developed to assess the acute incidence of critical illness in the population. We hope to provide an assessment of survival or prognostic factor for severely burned patients with inhalation injury based on the respiratory SOFA score. Methods This is a retrospective cohort study of all admissions to Department of Burn and Plastic Surgery at West China Hospital of Sichuan University from July 2010 to March 2021. Data was analyzed using Cox regression models to determine significant predictors of mortality. Survival analysis with time to death event was performed using the Kaplan–Meier survival curve with the log-rank test. All potential risk factors were considered independent variables, while survival was considered the risk dependent variable. Results One hundred eighteen severe burn patients with inhalation injury who met the inclusion and exclusion criteria were admitted, including men accounted for 76.3%. The mean age and length of stay were 45.9 (14.8) years and 44.3 (38.4) days. Flame burns are the main etiology of burn (74.6%). Patients with the respiratory SOFA score greater than 2 have undergone mechanical ventilation. Univariate Kaplan–Meier analysis identified age, total body surface area burned (TBSA), ICU admission and the respiratory SOFA score as significant factors on survival. Cox regression analysis showed that TBSA and the respiratory SOFA score were associated with patient survival (p < 0.001). In some patients with severe burns and inhalation damage, the survival probability drops to less than 10% (TBSA greater than 80%: 8.9% and respiratory SOFA score greater than 2: 5.6%). This study statistically found that the TBSA with the respiratory SOFA score model (AUROC: 0.955) and the rBaux score (AUROC: 0.927) had similar predictive value (p = 0.175). Conclusion The study indicates that a high respiratory system SOFA score was identified as a strong and independent predictor of severely burned patients with inhalation injury during hospitalization. When combined with TBSA, the respiratory SOFA scores can dynamically assess the severity of the patient's lung injury and improve the predictive level.

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Epidemiological Characteristics and Factors Associated with Mortality in Severely Burned Patients – Croatian National Burn Center Report

Škunca

2023

ACC

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SUMMARY The authors conducted a single-center retrospective study during the last 6.5 years. The study aimed to describe demographic data of burn patients in the Croatian Burn Center and investigate factors affecting mortality for the first time after the Center was established. The study included 109 severely burned patients with a total body surface area (TBSA) burned ≥20%, admitted to the burn intensive care unit. The relationship between the fatal outcome and age, sex, comorbidity, mechanism of injury, TBSA burned, and inhalation injury was investigated. The mean patient age was 54.50±20.21 years and the mean TBSA burned was 42.48±18.64%, with the mortality rate of 50%. The results demonstrated that patients with 2 or more comorbidities compared with those with no comorbidities had a higher chance of lethal outcome (p<0.0001). With an increase of TBSA by 1%, the odds of lethal outcome are expected to increase by 7% (p<0.0001). Other variables included in the analysis did not show statistical significance. TBSA percentage is a well-known predictor of mortality and numerous studies indicate an association between comorbidities and mortality but there are conflicting results about other demographic factors and injury characteristics.

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Associationbetween hyperoxia and mortality in severely burned patients

Cited by 3 publications

References 19 publications

External Validation of Three Burn-Specific Mortality Prediction Models in Adult Burn Patients at a Tertiary Care Hospital in India

External Validation of Three Burn-Specific Mortality Prediction Models in Adult Burn Patients at a Tertiary Care Hospital in India

Survival and analysis of prognostic factors for severe burn patients with inhalation injury: based on the respiratory SOFA score

Epidemiological Characteristics and Factors Associated with Mortality in Severely Burned Patients – Croatian National Burn Center Report

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