Department of Pediatric Surgery, Burn Unit, Plastic and Reconstructive Surgery, Altona Children's Hospital, Bleickenallee 38, 22763 Hamburg, Germany.
Department of Plastic and Aesthetic Surgery, Helios Hospital Berlin Buch, Schwanenbecker Chaussee 50, 13125 Berlin, Germany; German Society for Burn Treatment (DGV), Committee of the German Burn Registry, Luisenstrasse 58-59, 10117 Berlin, Germany; Department for Plastic and Reconstriuctive Surgery, Burn Care Center, Cologne Merheim Medical Center, University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109 Cologne, Germany.
Burns. 2020 Sep;46(6):1272-1279. doi: 10.1016/j.burns.2020.05.003. Epub 2020 May 19.
The Abbreviated Burn Severity Index (ABSI) is a widely used and simple score to predict mortality after burn injuries. On the one hand, significant improvements in intensive care management and surgical treatment result in an increased survival rate. On the other hand, the aging population might lead to an increased injury-related mortality rate. Therefore, the question arises whether the ABSI still accurately predicts survival.
Data of 14,984 patients from the German Burn Registry from 2015 to 2018 were analyzed to re-evaluate the variables included in the ABSI, identify discrepancies between the predicted age-related probability of survival and the actual survival rate. Descriptive statistics, univariate analysis and binary logistic regression were used to test the variable impact and to establish a modified score.
The original ABSI does not accurately predict the survival in the present cohort. In particular, univariate analysis identified age, total body surface area burned, full thickness burn and inhalation injury as significant impactors on survival. Moreover, sex could not be confirmed as significant and was, therefore, excluded from the modified score. The assumption of a linear relation between age and mortality was not correct. We developed a new age scale representing the actual existing relationship. The resulting modified score was significantly more accurate in predicting the probability of survival for all burn score categories.
The ABSI does not accurately predict probability of survival. Mortality is overestimated in severely burned patients. A modified version was developed that was significantly more accurate in predicting the probability of survival in this cohort.
简化烧伤严重度指数（ABSI）是一种广泛使用的简单评分方法，可用于预测烧伤后的死亡率。一方面，重症监护管理和外科治疗的显著改善导致存活率提高。另一方面，人口老龄化可能导致与损伤相关的死亡率增加。因此，出现了一个问题，即 ABSI 是否仍然能准确预测生存率。
对 2015 年至 2018 年德国烧伤登记处的 14984 名患者的数据进行分析，重新评估 ABSI 中包含的变量，确定预测年龄相关生存率与实际生存率之间的差异。使用描述性统计、单变量分析和二项逻辑回归来检验变量的影响，并建立改良评分。
原始的 ABSI 并不能准确预测本队列的生存率。特别是，单变量分析确定年龄、全身烧伤面积、全层烧伤和吸入性损伤是对生存率有显著影响的因素。此外，性别不能被确认为显著因素，因此被排除在改良评分之外。年龄与死亡率之间的线性关系假设不正确。我们开发了一种新的年龄量表，代表了实际存在的关系。由此产生的改良评分在预测所有烧伤评分类别的生存率方面明显更准确。
ABSI 不能准确预测生存率。死亡率在严重烧伤患者中被高估。开发了一种改良版本，在本队列中预测生存率的准确性显著提高。
