The predictive probability of mortality in the presence of full-thickness burns


Prognostication of burn injury mortality is challenging. Recent mortality prognostication
tools have incorporated the percent of full-thickness surface area (FTSA). We hypothesize
that the presence of full-thickness burn injury independently increases in-hospital


We performed a retrospective review of the National Trauma Data Bank (NTDB) from 2007
to 2019 of adults (≥16 years old) with burn injuries. Variables evaluated included
basic demographics, presence of inhalation injury, percent TBSA, and percent FTSA
burned. The primary outcome was in-hospital mortality. We performed modified Poisson
regression modeling adjusting for significant variables to estimate the relative mortality


75,816 patients met inclusion criteria. When controlling for TBSA, the presence of
a full-thickness burn had a relative risk of in-hospital mortality of 1.42 (95% CI
1.09–1.85, p = 0.008). The predicted probability of mortality was 100% at 50% FTSA.


The presence of full-thickness burns and the proportion of full-thickness burns independently
and significantly increased in-hospital mortality. Therefore, clinicians should utilize
prognostication models incorporating percent full-thickness burn area to predict mortality
more accurately.

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