Development and validation of a model for prediction of mortality in patients with acute burn injury
Development and validation of a model for prediction of mortality in patients with acute burn injury
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DOI：
10.1002/bjs.6329
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发表时间：
2009-01-01
影响因子：
9.6
通讯作者：
Hoste, E.
中科院分区：
文献类型：
--
作者：
Blot, S.;Brusselaers, N.;Hoste, E.
背景：目的是开发一种用户友好的模型，根据烧伤表面积、年龄和吸入性损伤的存在来预测受伤后不久因急性烧伤死亡的可能性。方法：这项基于人群的队列研究包括比利时六个烧伤中心之一收治的所有烧伤患者。 1999 年至 2003 年（5246 名患者）的数据用于开发死亡率预测模型，2004 年（981 名患者）的数据用于验证。结果：推导队列中的死亡率为 4.6%。设计死亡率评分（0-10分）：0-4分根据烧伤面积百分比小于20%、20-39%、40-59%、60-79%或至少80%），0-3分根据年龄（50岁以下、50-64岁、65-79岁或至少80岁），3分根据吸入性损伤的存在。验证队列的死亡率为 4.3%。该模型预测有 40 人死亡，实际观察到 42 人死亡 (P = 0.950)。死亡率预测模型的接受者-操作者特征曲线分析显示曲线下面积为 0.94（95% 置信区间为 0.90 至 0.97）。结论：基于简单客观的临床标准，开发了一个准确的模型来预测急性烧伤死亡的概率。
Background: The objective was to develop a user-friendly model to predict the probability of death from acute burns soon after injury, based on burned surface area, age and presence of inhalation injury.Methods: This population-based cohort study included all burned patients admitted to one of the six Belgian burn centres. Data from 1999 to 2003 (5246 patients) were used to develop a mortality prediction model, and data from 2004 (981 patients) were used for validation.Results: Mortality in the derivation cohort was 4.6 per cent. A mortality score (0-10 points) was devised: 0-4 points according to the percentage of burned surface area less than 20, 20-39, 40-59, 60-79 or at least 80 per cent), 0-3 points according to age (under 50, 50-64, 65-79 or at least 80 years) and 3 points for the presence of an inhalation injury. Mortality in the validation cohort was 4.3 per cent. The model predicted 40 deaths, and 42 deaths were observed (P = 0.950). Receiver-operator characteristic curve analysis of the model for prediction of mortality demonstrated an area under the curve of 0.94 (95 per cent confidence interval 0.90 to 0.97).Conclusion: An accurate model was developed to predict the probability of death from acute burn injury based on simple and objective clinical criteria.