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2013, Number 1

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Cir Plast 2013; 23 (1)

ABSI index, evaluation of cases that do not correspond to the prognosis of the score and considerations for its modification

Cuenca-Pardo J, Álvarez-Díaz CJ

Language: Spanish
References: 37
Page: 14-23
PDF size: 273.76 Kb.


ABSTRACT

We studied 2,562 patients who were treated in the Burn Unit of the «Dr. Victorio de la Fuente Narvaez» Traumatology Hospital of the Mexican Institute of Social Security. We calculated the Abbreviate Burn Severity Index index, and found a predictive power R = 0. 6659 (p = 0.006), with many residual cases that do not conform to the prognosis; some cases with low scores that died and others with high scores that survived. In patients with moderate and low scores, mortality was related to inhalation injury, obesity, two or more diseases and burns caused by fire. The risk increased significantly, when fire burns were associated with other factors. In patients with high scores, survival was linked to prompt attention, the absence of two or more diseases, not having had fire burns or inhalation injury or perianal burns. There was no significant difference in mortality or survival related to sex, deep burns, aging, pre-existing illness, and other mechanisms of injury. Age and the extent of the burns had a moderate impact. Higher impact factors were inhalation injury (OR 13.38), obesity (OR 8.3), perianal burns (OR 34.58) and the presence of two or more diseases (OR 10.91). By changing the Abbreviate Burn Severity Index index, not taking into account patient’s sex, increasing inhalation injury by one point, giving one point in cases of obesity, a point for perianal burns and a point for the presence of two or more diseases; we achieved an increase in the predictive power R = 0. 860 (p ‹ 0.001), a decrease in residual cases, obtaining a more consistent predictive constant and maintaining the simplicity of the score.


REFERENCES

  1. Tobiasen J, Hieben JM, Edlich RF. The abbreviate burn severity index. Ann Emerg Med. 1982; 11: 260-272.

  2. Forster NA, Zingg M, Haile SR, Künzi W, Giovanoli P, Guggenheim M. 30 years later--does the ABSI need revision? Burns. 2011; 37(6): 958-963.

  3. Lionelli GT, Pickus EJ, Beckum OK, Decoursey RL, Korentager RA. A three decade analysis of factors affecting burn mortality in the elderly. Burns. 2005; 31(8): 958-963. Epub 2005 Nov 2.

  4. Hemington-Gorse SJ, Clover AJ, Macdonald C, Harriott J, Richardson P, Philp B et al. Comfort care in burns: the Burn Modified Liverpool Care Pathway Burns. 2011.

  5. Nguyen TT, Gilpin DA, Meyer NA, Herndon DN. Current treatment burned severely patients. Ann Surg. 1996; 225: 14-25.

  6. Jeng JC. Patrimonie de Docteur Baux-Baux Scores. J Burn Care Res. 2007; 28: 380-381.

  7. Wibbenmeyer LA, Amelon MJ, Morgan LJ, Robinson BK, Chang PX, Lewis R 2nd et al. Predicting survival in an elderly burn patient population. Burns. 2001; 27(6): 583-590.

  8. Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the baux score. J Trauma. 2010; 68(3): 690-697.

  9. Rao K, Ali SN, Moiemen NS. Aetiology and outcome of burns in the elderly. Burns. 2006; 32(7): 802-805. Epub 2006 Sep 25.

  10. Colohan SM. Predicting prognosis in thermal burns with associated inhalational injury: a systematic review of prognostic factors in adult burn victims. J Burn Care Res. 2010; 31: 529-539.

  11. Coste J, Wasserman D, Venot A. Predicting mortality in adult burn patients: methodological aspect of the construction and validation of composite ratio scale. J Clin Epidemiol. 1996; 49(10): 1125-1131.

  12. Moreau AR, Westfall PH, Cancio LC, Mason AD Jr. Development and validation of an age-risk score for mortality predication after thermal injury. J Trauma. 2005; 58(5): 967-972.

  13. Knaus WA, Wagner DP, Draper EA, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985; 13: 818-829.

  14. Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG et al. The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest. 1991; 100: 1619-1636.

  15. Moore EC, Pilcher DV, Bailey MJ, Cleland H, McNamee J. A simple tool for mortality prediction in burns patients: APACHE III score and FTSA. Burns. 2010; 36(7): 1086-1091.

  16. Gomez M, Wong DT, Stewart TE, Redelmeier DA, Fish JS. The FLAMES score accurately predicts mortality risk in burn patients. J Trauma. 2008; 65 (3): 636-645.

  17. Demirdjian G. Adjusting a prognostic score for burned children with logistic regression. J Burn Care Rehabil. 1997; 18(4): 313-316.

  18. Hörbrand F, Schrank C, Henckel-Donnersmarck G, Mühlbauer W. Integration of preexisting diseases and risk factors in the Abbreviated Burn Severity Index (ABSI). Anasthesiol Intensivmed Notfallmed Schmerzther. 2003; 38(3): 151-157.

  19. Lumenta DB, Hautier A, Desouches C, Gouvernet J, Giorgi R, Manelli JC et al. Mortality and morbidity among elderly people with burns-evaluation of data on admission. Burns. 2008; 34(7): 965-974.

  20. Germann G, Barthold U, Lefering R, Raff T, Hartmann B. The impact of risk factors and pre-existing conditions on the mortality of burn patients and the precision of predictive admission-scoring systems. Burns. 1997; 23(3): 195-203.

  21. Kraft R, Herndon DN, Williams FN, Al-Mousawi AM, Finnerty CC, Jeschke MG. The effect of obesity on adverse outcomes and metabolism in pediatric burn patients. Int J Obes (Lond). 2012; 36(4): 485-490.

  22. Roi L, Flora JD, Davis TM, Wolfe RA. Two new burn severity indices. J Trauma Inj Infect Crit Care. 1983; 23(12): 1023-1029.

  23. Bray GA. Contemporary diagnosis in management of obesity. New-Town Pa. Handbook in Health Care, 1998.

  24. Pi-Sunyer FX. Proc obesity: criteria and classification. Nutr Soc. 2000; 59(4): 505-509.

  25. Rosenbaum M, Leibel RL, Hirsch J. Obesity. N Engl J Med. 1997; 337: 396-407.

  26. Bray GA. Etiology and pathogenesis of obesity; clinical cornerstone. Excerpta Med. 1999; 2(3): 1-15.

  27. Darryl YS. Obesity and pulmonary function: more or less? Chest. 1997; 111(4): 844-845.

  28. Susan ZY. Overweigth, obesity, and health risk. Arch Intern Med. 2000; 160(7): 898-904.

  29. Clark JM, Brancati FL. The challenge of obesity-related chronic diseases. J Gen lntern Med. 2000; 15(11): 828-829.

  30. Expert panel on overweight and obesity in adults. Arch Int Med. 1998; 158(17): 1855.

  31. Neville AL et al. Obesity is an independent risk factor of mortality in severely injured blunt trauma patients. Arch Surg. 2004; 139(9): 983-987.

  32. Cuenca-Pardo J, Luján-Olivar F, Castañeda-Rodríguez H. Quemaduras en pacientes obesos. Estudio comparativo. Cir Plast. 2008; 18 (1): 6-12.

  33. Patil BM, Joshi RC, Toshniwal D, Biradar S. A new approach: role of data mining in prediction of survival of burn patients. J Med Syst. 2011; 35: 1531-1542.

  34. Kraft R, Herndon DN, Al-Mousawi AM, Williams FN, Finnerty CC, Jeschke MG. Burn size and survival probability in paediatric patients in modern burn care: a prospective observational cohort study. Lancet. 2012; 379: 1013-1021.

  35. el Danaf A. King Abdulaziz-MOH-Hospital, Jeddah, Saudi Arabia. Burn variables influencing survival: a study of 144 patients. Burns. 1995; 21: 517-520.

  36. Curreri PW, Luterman A, Braun DW Jr, Shires GT. Burn injury. Analysis of survival and hospitalization time for 937 patients. Ann Surg. 1980; 192: 472-478.

  37. Kallinen O, Partanen TA, Maisniemi K, Böhling T, Tukiainen E, Koljonen V. Comparison of pre mortem clinical diagnosis and autopsy findings in patients with burns. Burns. 2008.




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