Skunca Agata, Mesic Ana, Zagorac Dorotea, Dobric Mirela, Lokosek Vedran, Banic Morana, Munjiza Aleksandra, Muratovic Aisa
Department of Anesthesiology, Intensive Care and Pain Medicine, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia.
Department of Traumatology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia.
Eur Burn J. 2024 Nov 15;5(4):410-417. doi: 10.3390/ebj5040036.
The primary aim of this study was to evaluate the performance of four burn prognostic scores-Abbreviated Burn Severity Index (ABSI), Ryan, Belgium Outcome Burn Injury (BOBI), and revised Baux score (rBaux) in a Croatian burn center. A secondary aim was to compare patient outcomes before and after the organizational and protocol changes.
A retrospective study and comparison of four prediction scores was conducted over a nine-year period in burn patients with ≥20% total body surface area (TBSA) burned. Additionally, outcomes before and after organizational changes were compared.
A total of 149 patients were included, with the mean patient age of 54.62 ± 19.38 years, the mean of TBSA of 42.98 ± 19.90, and an overall mortality rate of 48.99%. The area under the ROC curve (AUROC) was 0.79 for the rBaux and ABSI score, 0.77 for the BOBI score, and 0.76 for the Ryan score. The duration of mechanical ventilation and length of stay (LOS) in burn intensive care units (BICU) decreased after the organizational changes, though survival rates remained similar.
Prognostic scores are good predictors of mortality but with moderate predictive accuracy. Continuity of care in intensive care could be important for better outcomes.
本研究的主要目的是评估四种烧伤预后评分——简化烧伤严重程度指数（ABSI）、瑞安评分、比利时烧伤结局评分（BOBI）和修订版博克斯评分（rBaux）在克罗地亚一家烧伤中心的表现。次要目的是比较组织和方案变更前后的患者结局。
对九年期间烧伤总面积（TBSA）≥20%的烧伤患者进行了一项回顾性研究，并对四种预测评分进行了比较。此外，还比较了组织变更前后的结局。
共纳入149例患者，患者平均年龄为54.62±19.38岁，TBSA平均为42.98±19.90，总死亡率为48.99%。rBaux和ABSI评分的ROC曲线下面积（AUROC）为0.79，BOBI评分为0.77，瑞安评分为0.76。组织变更后，机械通气时间和烧伤重症监护病房（BICU）的住院时间缩短，尽管生存率保持相似。
预后评分是死亡率的良好预测指标，但预测准确性中等。重症监护中的连续性护理对于改善结局可能很重要。
