Multifactorial Probit Analysis of Mortality in Burned Patients

Zawacki, Bruce E.; Azen, Stanley P.; Imbus, Sharon H.; Chang, Yuan-tai C.

doi:10.1097/00000658-197901000-00001

Cited by 129 publications

(47 citation statements)

References 15 publications

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“…Finally, as the objective of the present study was to finetune the model developed by Ryan and colleagues 13 , the database did not include the data necessary for comparison with more complex prediction models developed by other investigators 9,10,14,19 . However, the findings suggested the limited advantage of formulas that are more complex.…”

Section: Discussionmentioning

confidence: 99%

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

Blot

2009

Journal of British Surgery

152

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Section: Discussionmentioning

confidence: 99%

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

Blot

2009

Journal of British Surgery

152

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“…The low mortality in our population could be attributed to several factors: (1) the dominance of young patients; (2) referral of all patients within hours of the accident; (3) treatment of all patients by trained staff in a specialized burn unit rather than in general surgical wards; and (4) a total burn surface area of less than 15% in 66% of all patients (330 of 501). The error inherent in assessing prognosis based on independent examination of variables rather than in combination has been previously emphasized [20,21].…”

Section: Discussionmentioning

confidence: 99%

The Pattern and Outcome of Burn Injuries at a Burn Unit in Saudi Arabia: Retrospective Analysis of Consecutive 501 Patients

Hegazy

Ibrahim

1991

Ann Saudi Med

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We retrospectively reviewed the cases of 501 consecutive patients with burn injuries who were seen between June 1983 and December 1988. The population consisted predominantly of young patients under 20 years of age (53%); 65% were males and 72% were Saudi nationals. Most burn injuries were the result of domestic accidents (75%) and scald burns were the cause in 55% of patients. There was an inhospital mortality of 8% during first hospitalizations. Multivariate analysis identified several independent adverse prognostic factors: increased total burn surface area, inhalation injury, thrombophlebitis, documented septicemia , and deep circumferential burn over the extremities. Using these poor prognostic factors, we were able to stratify patients into three risk categories, each representing a significant difference in the probability of survival. Our analysis yielded data about the pattern of burn injuries, prognostic factors, and outcome at a dedicated burn unit in Saudi Arabia.

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“…Exclusion criteria involved the presence of any preexisting metabolic disorders and artificial ventilation with an inspiratory O 2 concentration of more than 60%. Measurements of REE above this limit are less reliable.The patients were classified according to the mortality index of Zawacki et al, which accounts for factors relevant to the trauma, such as age, BSAB, third degree BSAB, and the patient's pulmonary status (prior pulmonary disease, abnormal PaO 2 , airway edema) [10]. We set random limits to classify the groups:…”

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confidence: 99%

Long‐term Measurements of Energy Expenditure in Severe Burn Injury

Khorram-Sefat

Behrendt

Heiden³

et al. 1999

World j. surg.

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The objective of this study was to evaluate resting energy expenditure (REE) in spontaneously breathing and artificially ventilated burn patients during the entire intensive care period. In 27 patients with 51 +/- 20% body surface area burned (BSAB) the REE was determined via indirect calorimetry. Three groups were formed according to the mortality prognosis index of Zawacki et al. In groups A, B, and C the predicted mortality rates were <20%, 20% to 80%, and >80%, respectively. The frequency of acute respiratory distress syndrome (ARDS), sepsis, renal failure, and mortality increased from group A toward group C. The REE test revealed wide individual variation and was usually overestimated by all tested formulas. The mean REE was comparable in groups A, B, and C during the first 20 days (49 +/- 16% vs. 59 +/- 21% vs. 57 +/- 18% above the REE calculated by the Harris-Benedict equation, or HBEE). The REE of patients in groups A and B declined after this period, whereas the long-term ventilated patients in the prognostically unfavorable group C showed a high REE up to the 45th day, usually accompanied by severe organ dysfunction and major metabolic disorders. During this time a nutritional regimen meeting the actual REE could not be achieved. In the clinical situation when indirect calorimetry is not available, REE can be stated to be 50% to 60% above HBEE in patients with >20% BSAB for at least 20 days. Expecting a stable clinical course in patients with a predicted mortality of <20% (group A), oral nutrition usually seems sufficient after a short period of artificial nutritional support (1 week). Patients with a predicted mortality of more than 20% have a complication-burdened clinical course and a prolonged period of ventilation (groups B and C). These patients need parenteral and enteral nutrition for at least 20 days after trauma to prevent severe malnutrition.

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Multifactorial Probit Analysis of Mortality in Burned Patients

Cited by 129 publications

References 15 publications

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

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

The Pattern and Outcome of Burn Injuries at a Burn Unit in Saudi Arabia: Retrospective Analysis of Consecutive 501 Patients

Long‐term Measurements of Energy Expenditure in Severe Burn Injury

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