Department of Traumatology and Critical Care Medicine, National Defense Medical College, Saitama, Japan; Department of Emergency and Acute Medicine, Saitama Medical University International Medical Center, Saitama, Japan.
Department of Traumatology and Critical Care Medicine, National Defense Medical College, Saitama, Japan; Division of Traumatology, Research Institute, National Defense Medical College, Saitama, Japan.
Burns. 2020 Dec;46(8):1746-1755. doi: 10.1016/j.burns.2020.10.008. Epub 2020 Oct 17.
Prognostic burn index (PBI) is a unique model utilized to predict mortality of burn patients in Japan. In contrast, other prediction models are rarely used in Japan, and their accuracy and predictive value are unknown. The present study aimed to compare commonly used burn prediction models and determine the appropriate model for mortality prediction in Japanese burn patients.
Japanese burn patients registered in the nationwide burn registry of Japanese Society for Burn Injury between April 1, 2011 and March 31, 2019 were reviewed retrospectively. The prognostic performance of PBI was compared with Baux score, revised Baux score, abbreviated burn severity index (ABSI), Ryan score and Belgian outcome in burn injury score (BOBI). The primary outcome was in-hospital mortality.
The study included 7911 acute burn patients. The overall mortality rate was 10.7%, the median age was 52 (interquartile range, 26-72) years, and the median % total body surface area was 7% (interquartile range, 3%-17%). The areas under the receiver operating characteristic curve for PBI, Baux score, ABSI, revised Baux score, Ryan score, and BOBI were 0.940 (95% confidence interval [CI]: 0.931-0.948), 0.943 (95% CI: 0.934-0.951; p=0.002), 0.945 (95% CI: 0.937-0.953; p=0.058), 0.946 (95% CI: 0.937-0.953; p=0.002), 0.859 (95% CI: 0.846-0.870; p<0.001), and 0.896 (95% CI: 0.885-0.905; p<0.001), respectively.
Although the performance of PBI was good, it was not superior to the Baux score, revised Baux score, and ABSI. These three scores have a high prognostic accuracy. Hence, they are considered as alternative burn prognostic scores in Japan. The Baux score was an optimal prognostic model for patients with burns in Japan.
预后烧伤指数（PBI）是一种用于预测日本烧伤患者死亡率的独特模型。相比之下，日本很少使用其他预测模型，其准确性和预测价值尚不清楚。本研究旨在比较常用的烧伤预测模型，并确定适合日本烧伤患者死亡率预测的模型。
回顾性分析 2011 年 4 月 1 日至 2019 年 3 月 31 日期间在日本烧伤学会全国烧伤登记处登记的日本烧伤患者。比较 PBI 与 Baux 评分、改良 Baux 评分、简化烧伤严重程度指数（ABSI）、Ryan 评分和比利时烧伤结局评分（BOBI）的预后性能。主要结局是院内死亡率。
本研究纳入 7911 例急性烧伤患者。总死亡率为 10.7%，中位年龄为 52 岁（四分位距 26-72 岁），中位%总体表面积为 7%（四分位距 3%-17%）。PBI、Baux 评分、ABSI、改良 Baux 评分、Ryan 评分和 BOBI 的受试者工作特征曲线下面积分别为 0.940（95%置信区间：0.931-0.948）、0.943（95%置信区间：0.934-0.951；p=0.002）、0.945（95%置信区间：0.937-0.953；p=0.058）、0.946（95%置信区间：0.937-0.953；p=0.002）、0.859（95%置信区间：0.846-0.870；p<0.001）和 0.896（95%置信区间：0.885-0.905；p<0.001）。
尽管 PBI 表现良好，但并不优于 Baux 评分、改良 Baux 评分和 ABSI。这三个评分具有较高的预后准确性。因此，它们被认为是日本替代烧伤预后评分。Baux 评分是日本烧伤患者的最佳预后模型。
