Baraka Samuel Mandro, Kiswezi Ahmed, Olasinde Anthony Ayotunde, Edyedu Isaac, Molen Selamo Fabrice, Muhumuza Joshua, Zawadi Gift Vulwaghe, Okedi Francis Xaviour
Faculty of Clinical Medicine and Dentistry, Department of Surgery.
Faculty of Clinical Medicine and Dentistry, Department of Pediatrics and Child Health, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda.
Ann Med Surg (Lond). 2024 Jan 30;86(8):4364-4367. doi: 10.1097/MS9.0000000000001774. eCollection 2024 Aug.
Burn injury is a major cause of mortality. Majority of the burns occur in low and middle-income countries like Uganda. Uganda has a limited number of burn centres and medical resources, making a predictor of mortality necessary in allocation of the limited resources. Although the revised Baux (r-Baux) score has been validated and used in many high income countries, no study has assessed its role in an African low-income country; the reason this study was done.
This was a prospective multicentre cohort that enroled 101 burn patients with moderate and severe burns admitted in three tertiary hospitals in western Uganda. Follow-up was done until discharge, documenting mortality. A receiver operator characteristic curve was used to determine the role of r-Baux score in predicting mortality.
This study included 101 patients, with a mean age of 21.3 (SD=16.8) years. The majority of the participants were male (69.3%). The area under the curved for r-Baux score's prediction of mortality was 0.943 (<0.001). The most appropriate cut-off was determined to be 74.5. At this cut-off, r-Baux score predicted mortality with a sensitivity of 100% and specificity of 83.5%. After controlling for burn severity using Poisson regression, a patient with r-Baux score greater than 74.5 was 1.358 times more likely to die (adjusted risk ratio=1.358, 95% CI=1.195-1.543, <0.001).
The r-Baux score was found to be excellent at predicting mortality among burn patients in Uganda and therefore should be done for all patients at admission, in order to predict mortality and do proper planning.
烧伤是导致死亡的主要原因。大多数烧伤发生在乌干达等低收入和中等收入国家。乌干达的烧伤中心和医疗资源有限，因此在分配有限资源时需要一个死亡率预测指标。尽管修订后的博克斯（r - Baux）评分已在许多高收入国家得到验证和应用，但尚无研究评估其在非洲低收入国家的作用，这就是开展本研究的原因。
这是一项前瞻性多中心队列研究，纳入了乌干达西部三家三级医院收治的101例中重度烧伤患者。随访至出院，记录死亡率。采用受试者工作特征曲线来确定r - Baux评分在预测死亡率方面的作用。
本研究纳入101例患者，平均年龄21.3（标准差 = 16.8）岁。大多数参与者为男性（69.3%）。r - Baux评分预测死亡率的曲线下面积为0.943（<0.001）。确定最合适的临界值为74.5。在此临界值下，r - Baux评分预测死亡率的灵敏度为100%，特异度为83.5%。在使用泊松回归控制烧伤严重程度后，r - Baux评分大于74.5的患者死亡可能性高1.358倍（调整风险比 = 1.358，95%置信区间 = 1.195 - 1.543，<0.001）。
发现r - Baux评分在预测乌干达烧伤患者死亡率方面表现出色，因此应对所有入院患者进行该评分，以预测死亡率并进行合理规划。
