External validation of the revised Baux score for the prediction of mortality in patients with acute burn injury

Abstract

Prognostic study, level III.

The organisation of critical care for burn patients in the UK: epidemiology and comparison of mortality prediction models

“…The casemix, activity and outcome in general and specialist burn intensive care units were compared and the fit of two burn-specific risk prediction models (revised Baux and Belgian Outcome in Burn Injury models) and one generic model (Intensive Care National Audit and Research Centre model) were compared. Patients in burn intensive care units had more extensive injuries compared with patients in general intensive care units (median (IQR [range]) burn surface area 16 (7-32 [0-98])% vs. 8 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) [0-100])%, respectively) but in-hospital mortality was similar (22.8% vs. 19.0%, respectively). The discrimination and calibration of the generic Intensive Care National Audit and Research Centre model was superior to the revised Baux and Belgian Outcome in Burn Injury burn-specific models for patients managed on both specialist burn and general intensive care units.…”

Revised Baux Score and updated Charlson comorbidity index are independently associated with mortality in burns intensive care patients

“…Although the Revised Baux Score does not have a strictly linear relation with the probability of mortality, a normogram has now been developed which could facilitate its use in a clinical setting [41]. A major criticism of the burn injury-specific scoring systems mentioned above is not accounting for patients' comorbidities in the prediction of outcomes [12,17], which is counter-intuitive as poorer outcomes would be expected in patients with more comorbidities. It has been argued that the impact of comorbidities may be too small to sway the prediction model [15].…”

“…The Revised Baux Score [14], the Belgian Outcome in Burn Injury (BOBI) Score [15], and the Abbreviated Burn Severity Index [16], are notable examples of such scores that have been externally validated [17][18][19]. The original Baux Score [20] is equivalent to the summation of the patient's age and the percentage of total body surface area (%TBSA) burned, and this is often quoted as the estimated percentage risk of death [12].…”

The effect of smoking status on burn inhalation injury mortality

“…[2,4] To better prognosticate burn outcomes, the Baux score was created, [6,7] however, to account for the weighted contribution of inhalational injury to burn mortality, it was later revised to include this predictor variable (Age + Percent Burn + 17 * (Inhalation Injury, 1 = yes, 0 = no). [8,9] More recently, with the recognition of increased longevity of the US population and its health related sequelae, it is paramount that future burn mortality prediction models account for pre-existing comorbidities in the prognostication of injury outcomes. Specifically the role of pre-existing respiratory disease markers such as smoking in the subset of burn patients with inhalational injury.…”