Abbreviated Burn Severity Index in a reference Burn Care Unit – a 3-year experience

Silva E., Lima G., Ferreira C., Rego S., Marques M., Martins M.
Coimbra Hospital and Universitary Center, Dept of Anesthesiology
Coimbra, Portugal

Background and Goal of Study:
Since its first description in 1982, the Abbreviated Burn Severity Index (ABSI) has gained wide acceptance as an useful tool for predicting the mortality of burned patients. The main predictor variables which determine mortality (%) related to burn are: age (years), total body surface area burned (TBSA burned, %), and inhalation injury. The ABSI uses the above parameters with the additional predictor variables of full thickness burn and gender. The goal of this study is to re-evaluate these parameters as prognosis factors in burn patients.

Materials and methods: 
Retrospective data analysis of all patients admitted in Coimbra University and Hospital Center Burns Critical Care Unit, from January 2013 to December 2015, excluding patients with necrotizing fasciitis and Steven-Johnson syndrome/ toxic epidermal necrolysis/ Lyell syndrome (22 patients). Statistical analysis was made with SPSS 22.0®.

Results and discussion: 
From a total of 474 patients, 22 were excluded and 31 died. The presence of inhalation injury (survivors (S)= 51 vs non-survivors (NS)=11; OR 4; p<0,001) and of full thickness burn (S=229 vs NS=26; OR 4,4; p<0,001) were both independently associated with mortality. Age (ẋ(S)= 57.6 vs ẋ(NS)= 72.3; p<0.001), TBSA burned (ẋ(S)= 10.4 vs ẋ(NS)= 29.3; p<0.001) and ABSI (ẋ(S)= 6.0 vs ẋ(NS)= 9.4; p<0.001) were also independently associated with mortality. In this population, gender was not independently associated with mortality (p>0.05). 

Conclusion(s):
The mortality rate was 4 times higher in patients with inhalation injury and 4.4 times higher in patients with full thickness burn. The mortality rate was also higher in older patients, in those with higher TBSA burned and in those with higher ABSI. In our population, each of the ABSI variables, beside gender, as well as ABSI itself, was found to be a predictor of mortality.
Keywords: Burns, Intensive Care, Risk.

References:
Forster NA, Zingg M, Haile SR, Künzi W, Giovanoli P, Guggenheim M. 30 years later – Does the ABSI need revision? Burns. 2011 Sep;37(6):958-63. doi: 10.1016/j.burns.2011.03.009. Epub 2011 Apr 13

Williams DJ, Walker JD. A normogram for calculation of the Revised Baux Score. Burns. 2015 Feb;41(1):85-90. doi: 10.1016/j.burns.2014.05.001. Epub 2014 Jun 14

Abbreviated Burn Severity Index in a reference burn care unit – a 3 year experience