Background: Majority burn mortality prognostic scores were developed and validated in western populations. The\nprimary objective of this study was to evaluate and identify possible risk factors which may be used to predict\nburns mortality in a local Malaysian burns intensive care unit. The secondary objective was to validate the five well\nknown burn prognostic scores (Baux score, Abbreviated Burn Severity Index (ABSI) score, Ryan score, Belgium\nOutcome Burn Injury (BOBI) score and revised Baux score) to predict burn mortality prediction.\nMethods: Patients that were treated at the Hospital Sultan Ismailâ??s Burns Intensive Care (BICU) unit for acute burn\ninjuries between 1 January 2010 to 31 December 2017 were included. Risk factors to predict in-patient burn\nmortality were gender, age, mechanism of injury, total body surface area burn (TBSA), inhalational injury,\nmechanical ventilation, presence of tracheotomy, time from of burn injury to BICU admission and initial centre of\nfirst emergency treatment was administered. These variables were analysed using univariate and multivariate\nanalysis for the outcomes of death. All patients were scored retrospectively using the five-burn mortality prognostic\nscores. Predictive ability for burn mortality was analysed using the area under receiver operating curve (AUROC).\nResults: A total of 525 patients (372 males and 153 females) with mean age of 34.5 ± 14.6 years were included.\nThere were 463 survivors and 62 deaths (11.8% mortality rate). The outcome of the primary objective showed that\namongst the burn mortality risk factors that remained after multivariate analysis were older age (p = 0.004), wider\nTBSA burn (p < 0.001) and presence of mechanical ventilation (p < 0.001). Outcome of secondary objective showed\ngood AUROC value for the prediction of burn death for all five burn prediction scores (Baux score; AUROC:0.9, ABSI\nscore; AUROC:0.92, Ryan score; AUROC:0.87, BOBI score; AUROC:0.91 and revised Baux score; AUROC:0.94). The\nrevised Baux score had the best AUROC value of 0.94 to predict burns mortality.\nConclusion: Current study evaluated and identified older age, total body surface area burns, and mechanical\nventilation as significant predictors of burn mortality. In addition, the revised Baux score was the most accurate\nburn mortality risk score to predict mortality in a Malaysian burnâ??s population.
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