Original Article

Comparison of ABSI and Full-Thickness Burns Indexes in the Prediction of Hospital Mortality in Burn Patients

Abstract

The aim of this study was to evaluate the abbreviated burn severity index (ABSI) score and the percentage of full-thickness burn in the prediction of hospital mortality in burn patients admitted to Sina Hospital in Tabriz. A total of 250 burn patients admitted to burn, and ICU wards during December 2016-Sep 2018 entered the present cross-sectional descriptive study. The collected data included age, gender, burn percentage, anatomical location of the burn, cause of the burn, severity of the burn, mucosal or inhalation injury, underlying disease, length of stay (day), and the hospital outcome of the patient. There was a significant difference between the two genders in terms of the cause of burns (P<0.0001). The most common cause of burn-in women and men was hot liquids and fire, respectively. 40% TBSA with 92% sensitivity and 94% specificity and 20% full-thickness burns with 98% sensitivity and 88% specificity was obtained in predicting mortality of patients. ABSI score of 9 with 85% sensitivity and 95% specificity was obtained in predicting mortality in patients. By increasing one unit in the ABSI score, the odds ratio increases by 17.5 times in terms of mortality probability. The present study showed a significant difference between the two genders in terms of the cause of the burn, and it is evidently affected by the culture and lifestyle of our country. On the other hand, an investigation of the cause of death in patients with ABSI>9 and taking appropriate measures to reduce their mortality is recommended. Also, it is recommended to use more simple criteria such as burn percentage or full-thickness burns to predict mortality rate in case of burning injury patients.  

1. DeKoning EP. Thermal Burns. In: Tintinalli JE, ed. Tintinalli’s Emergency Medicine A Comprehensive Study Guide. 8 ed. United States: McGraw-Hill; 2016:1398-405.
2. Forjuoh SN. Burns in low- and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention. Burns 2006;32:529-37.
3. Abazarloo A, Rahmani F. Evaluation of Deceased Pediatric Patients with Burning Injury Admitted to Sina Hospital, Tabriz, 2011-2016. J Compr Ped 2017;8:e58197.
4. Groohi B, Alaghehbandan R, Lari AR. Analysis of 1089 burn patients in the province of Kurdistan, Iran. Burns 2002;28:569-74.
5. Maghsoudi H, Pourzand A, Azarmir G. Etiology and outcome of burns in Tabriz, Iran. An analysis of 2963 cases. Scand J Surg 2005;94:77-81.
6. Nguema PN, Matsiegui PB, Nsafu DN. [Severely burned patients: epidemiology and treatment (a study of 104 Gabonese cases)]. Sante 2000;10:37-42.
7. DeSanti L. Pathophysiology and current management of burn injury. Adv Skin Wound Care 2005;18:323-32.
8. Halgas B, Bay C, Foster K. A comparison of injury scoring systems in predicting burn mortality. Ann Burns Fire Disasters 2018;31:89-93.
9. Ala A, Ebrahimi Bakhtavar H, Shams Vahdati S, Rahmani F, Azargoun M, Ebrahimi Bakhtavar H. Effects of Silver Sulfadiazine and Adibderm® Herbal Ointments in Treatment of Patients with Second Degree Burns: A Randomized Clinical Trial. Trauma Mon 2018;23:e13396.
10. Heng JS, Clancy O, Atkins J, Leon-Villapalos J, Williams AJ, Keays R, et al. Revised Baux Score and updated Charlson comorbidity index are independently associated with mortality in burns intensive care patients. Burns 2015;41:1420-7.
11. Motamed Al-shariati SM, Rezaei E, Beiraghi-Toosi A. Comparison between acute physiology and chronic health evaluation system and abreviated burn severity index (ABSI) in prediction of burn patient’s mortality. Zahedan J Res Med Sci 2012;13:e93712.
12. Salehi SH, As'adi K, Abbaszadeh-Kasbi A, Isfeedvajani MS, Khodaei N. Comparison of six outcome prediction models in an adult burn population in a developing country. Ann Burns Fire Disasters 2017;30:13-7.
13. Tahir S, Memon AR, Kumar M, Ali SA. Prediction of mortality after major burn: physiological versus biochemical measures. Wounds 2009;21:177-82.
14. Tobiasen J, Hiebert JM, Edlich RF. The abbreviated burn severity index. Ann Emerg Med 1982;11:260-2.
15. Dahal P, Ghimire S, Maharjan NK, Rai SM. Baux’s and Abbreviated Burn Severity Score for the Prediction of Mortality in Patients with Acute Burn Injury. J Coll Med Sci-Nepal 2015;11:24-7.
16. 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;38:151-7.
17. Lionelli GT, Pickus EJ, Beckum OK, Decoursey RL, Korentager RA. A three decade analysis of factors affecting burn mortality in the elderly. Burns 2005;31:958-63.
18. 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. Crit Care 2010;14:R188.
19. Kallinen O, Maisniemi K, Bohling T, Tukiainen E, Koljonen V. Multiple organ failure as a cause of death in patients with severe burns. J Burn Care Res 2012;33:206-11.
20. 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;34:965-74.
21. Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clin Microbiol Rev 2006;19:403-34.
22. Legrand M, Depret F, Mallet V. Management of Burns. N Engl J Med 2019;381:1188-9.
23. Mason SA, Nathens AB, Byrne JP, Gonzalez A, Fowler R, Karanicolas PJ, et al. Trends in the epidemiology of major burn injury among hospitalized patients: A population-based analysis. J Trauma Acute Care Surg 2017;83:867-74.
24. Nitzschke S, Offodile AC, Cauley RP, Frankel JE, Beam A, Elias KM, et al. Long term mortality in critically ill burn survivors. Burns 2017;43:1155-62.
25. Toft-Petersen AP, Ferrando-Vivas P, Harrison DA, Dunn K, Rowan KM. The organisation of critical care for burn patients in the UK: epidemiology and comparison of mortality prediction models. Anaesthesia. 2018;73:1131-40.
26. Mirmohammadi SJ, Mehrparvar AH, Jalilmanesh M, Kazemeini K, Delbari N, Mostaghaci M. An Epidemiologic Survey on Burns in Yazd from 2008 till 2009. Acta Med Iran 2012;50:70-5.
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IssueVol 59, No 1 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/acta.v59i1.5401
Keywords
Burns Mortality Outcome

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How to Cite
1.
Rahmani F, Jamali F, Moallemzadeh Vayghan B, Ebrahimi Bakhtavar H. Comparison of ABSI and Full-Thickness Burns Indexes in the Prediction of Hospital Mortality in Burn Patients. Acta Med Iran. 2021;59(1):37-43.