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Scripta Scientifica Medica

Possibilities for more accurate prediction of thermal injury severity and determination of its impact on the body using the Abbreviated Burn Severity Index

Emiliya Mihaylova Kaisheva, Dobrinka Radoynova, Yolanda Zayakova

Abstract

INTRODUCTION: During the last decades, the chances of survival in burn patients have been progressively increasing, but the issue of prognosis of death after such injuries is still of great ethical, social, medical, and forensic interest.

AIM: The purpose of our study was to examine and confirm the accuracy of the ABSI (Abbreviated Burn Severity Index) system in predicting the risk of death in thermal trauma by comparing its values with the actual risk reported.

MATERIALS AND METHODS: In order to achieve this purpose, the medical records of burn patients admitted to the Clinic of Thermal Trauma, Plastic, Reconstructive and Aesthetic Surgery at the Naval Hospital of Varna for a five-year period (2011-2015) were studied and the death cases were analyzed. The mortality rate predicted by ABSI was compared to the actual death rate reported in the medical records.

RESULTS: There was a significant difference in the mean values of ABSI in survivors and deceased: 4.65 and 11, respectively. All with an ABSI value less than 3 survived. For ABSI values up to 10, a slightly lower mortality was reported than the predicted. For the values ≥11 they matched. Despite these discrepancies, we believe that ABSI is suitable for calculating the risk of death in thermal trauma, especially in more severe burns, where the threat to life is higher.

CONCLUSION: Three groups were differentiated with a sharp increase in the percentage of actually reported mortality. Their respective ABSI values can be taken as a reference for forensic medical practitioners in the classification of bodily injuries due to burns.


Keywords

thermal injury; scoring systems; ABSI; trauma assessment; bodily injury

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References

Tahir SM, Memon AR, Kumar M, Ali SA. Prediction of mortality after major burn: Physiological versus biochemical measures. Wounds. 2009; 21(7):177-82.

Latenser BA. Critical care of the burn patient: the first 48 hours. Crit Care Med. 2009;37(10): 2819-26.doi: 10.1097/CCM.0b013e3181b3a08f.

Alvarado R, Chung KK, Cancio LC, Wolf SE. Burn resuscitation. Burns. 2009; 35(1): 4-14. doi: 10.1016/j.burns.2008.03.008.10.

Benito-Ruiz J, Navarro-Monzonis A, Baena-Montilla P, Mirabet-Ippolito V. An analysis of burn mortality. A report from a Spanish regional burn centre. Burns. 1991;27(3):201-4.

Brusselaers N, Monstrey S, Vogelaers D, Hoste E, Blot S. Severe burn injury in Europe: a systematic review of the incidence, etiology, morbidity, and mortality. Critical Care. 2010;14(5): 188. doi: 10.1186/cc9300.

Karimi H, Motevalian SA, Rabbani A, Motabar AR, Vasigh M, Sabzeparvar M. et al. Prediction of mortality in pediatric burn injuries: R-Baux score to be applied in children (pediatrics-baux score). Iran J Pediatr. 2013;23(2):165-70.

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):958-63. doi: 10.1016/j.burns.2005.06.006.

Rose JK, Herndon DN. Advances in the treatment of burn patients. Burns. 1997;23(1):19-26.

Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med. 1998;338(6):362-6. doi: 10.1056/NEJM199802053380604.

Berndtson AE, Sen S, Greenhalgh DG, Palmieri TL. Estimating severity of burn in children: Pediatric Risk of Mortality (PRISM) score versus Abbreviated Burn Severity Index (ABSI). Burns. 2013;39(6): 1048-53. doi: 10.1016/j.burns.2013.05.00.

Andel D, Kamolz LP, Niedermayr M, Hoerauf K, Schramm W, Andel H. Which of the abbreviated burn severity index variables are having impact on the hospital length of stay? J Burn Care Res. 2007;28(1):163-6. doi: 10.1097/BCR.0B013E31802C9E8F.

George RL, McGwin G Jr, Schwacha MG, Metzger J, Cross JM, Chaudry IHet al. The association between sex and mortality among burn patients as modified by age. J Burn Care Rehabil. 2005;26(5):416-21.

Klein MB, Lezotte DC, Heltshe S, Fauerbach J, Holavanahalli RK, Riara FP et al. Functional and psychosocial outcomes of older adults after burn injury: results from a multicenter database of severe burn injury. J Burn Care Res. 2011;32(1):66-78. doi: 10.1097/BCR.0b013e318203336a.

Moore EC, Pilcher DV, Bailey MJ, Stephens H, Cleland H. The Burns Evaluation and Mortality Study (BEAMS): predicting deaths in Australian and New Zealand burn patients admitted to intensive care with burns. J Trauma Acute Care Surg. 2013;75(2):298-303. doi: 10.1097/TA.0b013e318295409d.

Sheppard NN, Hemington-Gorse S, Shelley OP, Philp B, Dziewulski P. Prognostic scoring systems in burns: a review. Burns. 2011;37(8):1288-95. doi: 10.1016/j.burns.2011.07.017.

Zawacki BE, Azen SP, Imbus SH, Chang YT. Multifactorial probit analysis of mortality in burned patients. Ann Surg. 1979;189(1):1-5.

Tompkins RG, Burke JF, Schoenfeld DA, Bondoc CC, Quinby WC Jr, Behringer GC et al. Prompt eschar excision: a treatment system contributing to reduced burn mortality: a statistical evaluation of burn care at the Massachusetts General Hospital (1974-1984). Ann Surg. 1986;204(3):272-81.

Roberts G, Lloyd M, Parker M, Martin R, Philp B, Shelley O et al. The Baux score is dead. Long live the Baux score: a 27-year retrospective cohort study of mortality at a regional burns service. J Trauma Acute Care Surg. 2012;72(1):251-6. doi: 10.1097/TA.0b013e31824052bb.

Thombs BD, Singh VA, Milner SM. Children under 4 years are at greater risk of mortality following acute burn injury: evidence from a national sample of 12,902 pediatric admissions. Shock. 2006;26(4):348-52. doi: 10.1097/01.shk.0000228170.94468.e1.

Lundgren RS, Kramer CB, Rivara FP, Wang J, Heimbach DM, Gibran NS et al. Influence of comorbidities and age on outcome following burn injury in older adults. J Burn Care Res. 2009;30(2):307-14. doi: 10.1097/BCR.0b013e318198a416.

Wibbenmeyer LA, Amelon MJ, Morgan LJ, Robinson BK, Chang PX, Lewis II R, et al. Predicting survival in an elderly burn patient population. Burns. 2001;27(6):583-90.

Tobiasen J, Hiebert JM, Edlich RF. The abbreviated burn severity index. Ann Emerg Med. 1982;11(5):260-2.

Horbrand F, Schrank C, Henckel-Donnersmarck G, Muhlbauer W. Integration of preexisting diseases and risk factors in the Abbreviated Burn Severity Index (ABSI). Anasthesiol Intensivmed Notfallmed Schmerzther. 2003;38(3):151-7.

McGwin G, Jr., George RL, Cross JM, Rue LW. Improving the ability to predict mortality among burn patients. Burns. 2008; 34(3):320-7. doi: 10.1016/j.burns.2007.06.003.

Saffle JR, Davis B, Williams P. Recent outcomes in the treatment of burn injury in the United States: a report from the American burn association patient registry. J Burn Care Rehabil. 1995;16(3): 219-32.

Siemers F, Liodaki E, Mauss KL, Stang FH, von Wild T, Mailaender P. Burn Injuries in Elderly - A Retrospective Analysis of a Ten Year Period. Modern Plastic Surgery.2012;2:13-19. doi: 10.4236/mps.2012.22004.

Brusselaers N, Hoste EA, Monstrey S, Colpaert KE, De Waele JJ, Vandewoude KH, et al. Outcome and changes over time in survival following severe burns from 1985 to 2004. Intensive Care Med. 2005;31(12):1648-53. doi: 10.1007/s00134-005-2819-6.

Andel H, Kamolz LP. Scoring in burned patients our opinion. Burns. 2003;29(4):297-8.

McGill V, Kowal-Vern A, Gamelli RL. Outcome for older burn patients. Arch Surg. 2000; 135(3):320-5.

Masaki F, Isao T, Hiroshi I, Seiji H, Eisuke S. A case of severe smoke inhalation injury without cutaneous burn required massive fluid for resuscitation. Burns. 2007; 33(5): 670-1. doi: 10.1016/j.burns.2006.07.024.




DOI: http://dx.doi.org/10.14748/ssm.v50i3.5136

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About The Authors

Emiliya Mihaylova Kaisheva
Medical University of Varna
Bulgaria

Department of Forensic Medicine and Deontology, Faculty of Medicine

Dobrinka Radoynova
Medical University of Varna
Bulgaria

Department of Forensic Medicine and Deontology, Faculty of Medicine

Yolanda Zayakova
Naval Hospital of Varna, Military Medical Academy of Sofia
Bulgaria

Clinic of Thermal Trauma, Plastic, Reconstructive and Aesthetic Surgery

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