30 years later-Does the ABSI need revision?
30 years later-Does the ABSI need revision?
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DOI：
10.1016/j.burns.2011.03.009
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发表时间：
2011-09-01
期刊：
影响因子：
2.7
通讯作者：
Guggenheim, Merlin
中科院分区：
文献类型：
--
作者：
Forster, Natasha A.;Zingg, Matthias;Guggenheim, Merlin
鉴于患者人口统计学的变化和烧伤护理的不断发展，1982年首次提出的简化烧伤严重程度指数(ABSI)在估计当今烧伤患者死亡率方面的预测准确性可能会受到质疑。我们回顾了1968年1月至2008年12月在我所重症监护病房治疗的2813名烧伤患者的记录，目的是识别基于每个ABSI变量和总烧伤评分估计和计算结果之间的新出现的差异。每个定义的ABSI变量的预测值被证实具有非常显著的意义。单变量和多变量分析显示，60岁以上和烧伤面积超过30%的患者死亡率的优势比(OR)呈指数级增加，OR值是其他重要变量(如吸入性损伤)的10倍以上。尽管如此，我们整个患者群体中用于估计死亡率的ABSI是非常准确的，并且不能通过调整点数分布来优化以适应OR的增加。我们的数据表明，尽管过去30年来患者人口统计和医学进步发生了重大变化，ABSI评分系统仍然是预测烧伤患者死亡率的准确和有价值的工具。(C)2011年爱思唯尔有限公司和ISBI。版权所有。
In light of changes in patient demographics together with constant developments in burn care, the predictive accuracy of the Abbreviated Burns Severity Index (ABSI) - first described in 1982 - for estimating the mortality of present day burns patients, may be questionable.We reviewed the records of 2813 burns patients treated between January 1968 and December 2008 in the intensive care unit at our institution, aiming to identify emerging discrepancies between the estimated and calculated outcome, based on each of the ABSI variables and the total burn score.The predictive value of each of the defined ABSI variables was confirmed to be highly significant. Univariable and multivariable analysis revealed an exponential increase in odds ratio (OR) for mortality for patients older than 60 years and more than 30% TBSA burned and showed OR values over 10 times higher than other significant variables like inhalation injury. Nevertheless, the ABSI for the estimation of mortality in our entire patient collective was highly accurate and could not be optimised by adapting the point distribution to the increase in OR.Our data indicates that despite significant changes in patient demographics and medical advances over the past 30 years, the ABSI scoring system is still an accurate and valuable tool in the prediction of burn patient mortality. (C) 2011 Elsevier Ltd and ISBI. All rights reserved.