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PREDICTING MORTALITY AMONG BURN VICTIMS.

A simple and reliable way to predict mortality from burn injuries would be helpful in counseling patients and their families. To derive a predictive formula, researchers reviewed the cases of 1,665 patients admitted to two Boston hospitals with burn injuries between 1990 and 1994.

The overall mortality rate was 4 percent. Multivariate analysis revealed three predictors of death -- age greater than 60, a burn covering more than 40 percent of body surface area, and inhalation injury. The proportions of patients with 0, 1, 2 and 3 risk factors were 79, 13, 7, and 1 percent, respectively. Estimated mortality was 0.3 percent for those with no risk factors, and 3, 33, and 87 percent for those with 1, 2, and 3 risk factors, respectively. The model was evaluated prospectively in 530 cases from 1995 to 1996 and yielded similar results.

Comment: The applicability of this model is limited by several factors; for example, only 22 patients were in the highest-risk group, and a third of patients who died had do-not-resuscitate orders. Nevertheless, it can serve as a rough guideline when discussing the prognosis of burn victims.

— AS Brett

Published in Journal Watch General Medicine February 10, 1998

Citation(s):

Ryan CM et al. Objective estimates of the probability of death from burn injuries. N Engl J Med 1998 Feb 5 338 362-366.

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