Burn Injury, In-Hospital Mortality
Conditions
Keywords
ABSI, Revised Baux score, Modified Ryan score, Burn mortality, In-hospital mortality, Prognostic score, Retrospective cohort, Total body surface area burned, Inhalation injury, ROC analysis
Brief summary
This retrospective observational cohort study evaluates hospitalized burn admissions treated at the Burn Center of Gaziantep City Hospital between October 2023 and February 2026. The study aims to compare the ability of three burn severity scoring systems, the Abbreviated Burn Severity Index (ABSI), Revised Baux score, and modified Ryan score, to predict in-hospital mortality. Electronic medical records were reviewed for demographic characteristics, burn-related variables, inhalation injury, burn depth, intensive care admission, mechanical ventilation, sepsis, surgical procedures, length of hospital stay, and survival status at hospital discharge. The primary outcome is in-hospital mortality. The predictive performance of the scoring systems will be evaluated using receiver operating characteristic analysis and logistic regression.
Detailed description
Burn injuries are associated with substantial morbidity, mortality, intensive care use, prolonged hospitalization, and surgical burden. Early identification of patients at high risk of death may support clinical triage, intensive care planning, resource allocation, and communication with patients' families. This study is a single-center, retrospective, observational cohort study conducted at the Burn Center of Gaziantep City Hospital, a tertiary referral burn center serving southern Türkiye and cross-border regions. The study includes hospitalized burn admissions treated between October 2023 and February 2026. A total of 1315 burn admission records were screened. Admissions transferred to another facility before final clinical outcome assessment and admissions in which treatment was refused were excluded. After applying eligibility criteria, 1082 hospitalized burn admissions were included in the primary analysis cohort. The study evaluates the prognostic performance of the Abbreviated Burn Severity Index (ABSI), Revised Baux score, and modified Ryan score for predicting in-hospital mortality. ABSI is calculated using age, sex, total body surface area burned, inhalation injury, and full-thickness burn status. Revised Baux score is calculated using age, total body surface area burned, and the presence of inhalation injury. The modified Ryan score is calculated using age category, total body surface area burned category, inhalation injury, and third-degree burn status. The primary outcome is in-hospital mortality, defined as death occurring during the index hospitalization. Secondary evaluations include associations between mortality and selected clinical variables, including inhalation injury, sepsis, intensive care admission, mechanical ventilation, number of surgical procedures, and length of hospital stay. The discriminative performance of prognostic scores will be assessed using receiver operating characteristic analysis. Area under the curve, confidence intervals, optimal cut-off values, sensitivity, and specificity will be reported. Associations between score increments and mortality will be examined using univariable logistic regression.
Interventions
OTHERRetrospective Prognostic Score Assessment
ABSI, Revised Baux score, and modified Ryan score were retrospectively calculated using routinely collected electronic medical record data from hospitalized burn admissions. These scores were evaluated for their ability to predict in-hospital mortality. No drug, device, procedure, or treatment intervention was assigned by the study protocol.
Sponsors
Gaziantep City Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
Hospitalized burn admissions treated at the Burn Center of Gaziantep City Hospital between October 2023 and February 2026. Admissions with a documented in-hospital outcome of discharge alive or death. Admissions with available electronic medical records for age, sex, total body surface area burned, burn depth, inhalation injury, and core clinical variables.
Exclusion criteria
Admissions transferred to another facility before final clinical outcome assessment. Admissions in which treatment was refused. Admissions without sufficient electronic medical record data for calculation of the prognostic scores or assessment of the primary outcome.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| In-Hospital Mortality | From hospital admission to hospital discharge or in-hospital death, assessed up to 240 days. | In-hospital mortality was defined as death occurring during the index hospitalization for burn injury. Mortality status was determined from electronic hospital records and was used as the primary outcome for evaluating the prognostic performance of burn severity scoring systems. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Area Under the Receiver Operating Characteristic Curve for the Abbreviated Burn Severity Index | Score variables were obtained from admission and early hospitalization records; in-hospital mortality was assessed from hospital admission to discharge or in-hospital death, up to 240 days. | The Abbreviated Burn Severity Index was calculated using age, sex, total body surface area burned, inhalation injury, and full-thickness burn status recorded in electronic hospital records. Higher scores indicate greater burn severity and higher predicted mortality risk. Predictive discrimination for in-hospital mortality was evaluated using the area under the receiver operating characteristic curve. The area under the curve ranges from 0.0 to 1.0, with higher values indicating better discriminative performance. |
| Area Under the Receiver Operating Characteristic Curve for the Revised Baux Score | Score variables were obtained from admission and early hospitalization records; in-hospital mortality was assessed from hospital admission to discharge or in-hospital death, up to 240 days. | The Revised Baux score was calculated using age, total body surface area burned, and the presence of inhalation injury. Higher scores indicate greater burn severity and higher predicted mortality risk. Predictive discrimination for in-hospital mortality was evaluated using the area under the receiver operating characteristic curve. The area under the curve ranges from 0.0 to 1.0, with higher values indicating better discriminative performance. |
| Predictive Performance of the Modified Ryan Score | Score variables were obtained from admission and early hospitalization records; in-hospital mortality was assessed from hospital admission to discharge or in-hospital death, up to 240 days. | The predictive performance of the modified Ryan score for in-hospital mortality was evaluated using receiver operating characteristic analysis. Area under the curve, 95% confidence interval, optimal cut-off value, sensitivity, and specificity were calculated. |
| Association of Selected Clinical Factors With In-Hospital Mortality | Clinical factors and mortality status were assessed from hospital admission to hospital discharge or in-hospital death, up to 240 days. | The association of selected clinical factors, including inhalation injury, sepsis, intensive care admission, mechanical ventilation, number of surgical procedures, and length of hospital stay, with in-hospital mortality was evaluated using appropriate statistical analyses. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORBekir Suat Kurkcuoglu
Gaziantep City Hospital
Outcome results
None listed