External validation of the revised Baux score for the prediction of mortality in patients with acute burn injury

BACKGROUND

Since the original Baux score was outdated and inhalation injury was recognized as an important contributor to mortality, Osler et al. developed a revised Baux score for the prediction of mortality of burn patients in an American population.

The aim of this study was to validate the revised Baux score with data of patients admitted to the Rotterdam Burn Center (RBC) in the Netherlands.

METHODS

Prospectively collected data were analyzed for all patients with acute burn injury admitted to the RBC from 1987 to 2009 (n = 4,389), including sex, age, total body surface area involved, inhalation injury, mortality, and premorbid conditions.

Logistic regression analysis was used to determine the relationship between mortality and possible contributing variables. The discriminative power of the revised Baux score was assessed by receiver operating characteristics curve analysis.

RESULTS

Overall mortality in our center was 6.5%; mortality in patients with intention to treat was 4.4%. Age, total body surface area, inhalation injury, as well as premorbid circulatory and central nervous system conditions were significant independent predictors of in-hospital mortality. Revised Baux score in the RBC population (area under the curve, 0.96; 95% confidence interval, 0.95–0.97) performed less specific and sensitive in a selected group of patients with high Baux scores (area under the curve, 0.81; 95% confidence interval, 0.76–0.84).

CONCLUSION

The revised Baux score is a simple and accurate model for predicting mortality in patients with acute burn injuries in a burn center setting.

LEVEL OF EVIDENCE

Prognostic study, level III.