From the Rotterdam Burn Center (J.D., J.M., I.M.M.H.O., C.H.V.D.V., H.B.), Department of Surgery, Maasstad Hospital; and Association of Dutch Burn Centers (M.E.V.B.), the Netherlands.
J Trauma Acute Care Surg. 2014 Mar;76(3):840-5. doi: 10.1097/TA.0000000000000124.
Since the original Baux score was outdated and inhalation injury was recognized as an important contributor to mortality, Osler et al. developed a revised Baux score for the prediction of mortality of burn patients in an American population.The aim of this study was to validate the revised Baux score with data of patients admitted to the Rotterdam Burn Center (RBC) in the Netherlands.
Prospectively collected data were analyzed for all patients with acute burn injury admitted to the RBC from 1987 to 2009 (n = 4,389), including sex, age, total body surface area involved, inhalation injury, mortality, and premorbid conditions.Logistic regression analysis was used to determine the relationship between mortality and possible contributing variables. The discriminative power of the revised Baux score was assessed by receiver operating characteristics curve analysis.
Overall mortality in our center was 6.5%; mortality in patients with intention to treat was 4.4%. Age, total body surface area, inhalation injury, as well as premorbid circulatory and central nervous system conditions were significant independent predictors of in-hospital mortality. Revised Baux score in the RBC population (area under the curve, 0.96; 95% confidence interval, 0.95-0.97) performed less specific and sensitive in a selected group of patients with high Baux scores (area under the curve, 0.81; 95% confidence interval, 0.76-0.84).
The revised Baux score is a simple and accurate model for predicting mortality in patients with acute burn injuries in a burn center setting.
Prognostic study, level III.
由于原始的 Baux 评分已经过时，吸入性损伤被认为是导致死亡率的重要因素，因此 Osler 等人针对美国人群开发了修订后的 Baux 评分来预测烧伤患者的死亡率。本研究的目的是用荷兰鹿特丹烧伤中心（RBC）的数据来验证修订后的 Baux 评分。
对 1987 年至 2009 年期间收治于 RBC 的所有急性烧伤患者的前瞻性数据进行分析，包括性别、年龄、总体表烧伤面积、吸入性损伤、死亡率和潜在疾病状况。使用逻辑回归分析来确定死亡率与可能的影响因素之间的关系。使用受试者工作特征曲线分析评估修订后的 Baux 评分的判别能力。
本中心的总体死亡率为 6.5%；意向治疗患者的死亡率为 4.4%。年龄、总体表烧伤面积、吸入性损伤以及潜在的循环和中枢神经系统疾病是院内死亡率的独立预测因素。在 RBC 人群中，修订后的 Baux 评分（曲线下面积为 0.96；95%置信区间为 0.95-0.97）在选择 Baux 评分较高的患者组中特异性和敏感性较差（曲线下面积为 0.81；95%置信区间为 0.76-0.84）。
修订后的 Baux 评分是预测烧伤中心急性烧伤患者死亡率的一种简单而准确的模型。
预后研究，III 级。
