Kaita Yasuhiko, Tarui Takehiko, Tanaka Yuya, Suzuki Jun, Yoshikawa Kei, Yamaguchi Yoshihiro
Department of Trauma and Critical Care Medicine Kyorin University School of Medicine Tokyo Japan.
Acute Med Surg. 2020 Mar 17;7(1):e499. doi: 10.1002/ams2.499. eCollection 2020 Jan-Dec.
The prognostic burn index (PBI), which consists of half partial-thickness burn surface area plus full-thickness burn surface area and age, has been widely used to predict mortality in Japan. However, the prognostic value of PBI has not been investigated sufficiently. The purpose of the present study is to clinically reevaluate the PBI in severe burn patients.
Data of 69 severe burn patients admitted to the burn center at Kyorin University Hospital (Tokyo, Japan) from January 2008 to December 2017 were analyzed retrospectively. The primary outcome in this study was in-hospital mortality.
The overall in-hospital mortality rate was 34.8%. There were significant differences in age, the presence of inhalation injury, total burned surface area, full-thickness burn area, burn index, and PBI between survivors and non-survivors. In logistic regression analysis, PBI was independently associated with mortality, while the presence of inhalation injury was not. A PBI above the threshold of 105 was significantly associated with in-hospital mortality. The area under the receiver operating characteristic curve for PBI was 0.85 (95% confidence interval, 0.73-0.93).
The PBI could be a good prognostic indicator. A PBI above the threshold of 105 was associated with mortality among severe burn patients treated in burn-care facilities.
预后烧伤指数（PBI）由半侧Ⅱ度烧伤面积加Ⅲ度烧伤面积与年龄组成，在日本已被广泛用于预测死亡率。然而，PBI的预后价值尚未得到充分研究。本研究的目的是对重度烧伤患者的PBI进行临床再评估。
回顾性分析2008年1月至2017年12月入住杏林大学医院（日本东京）烧伤中心的69例重度烧伤患者的数据。本研究的主要结局是住院死亡率。
总体住院死亡率为34.8%。幸存者和非幸存者在年龄、吸入性损伤的存在、总烧伤面积、Ⅲ度烧伤面积、烧伤指数和PBI方面存在显著差异。在逻辑回归分析中，PBI与死亡率独立相关，而吸入性损伤的存在则不然。PBI高于105的阈值与住院死亡率显著相关。PBI的受试者工作特征曲线下面积为0.85（95%置信区间，0.73 - 0.93）。
PBI可能是一个良好的预后指标。PBI高于105的阈值与烧伤护理机构治疗的重度烧伤患者的死亡率相关。
