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


Introduction

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
mortality.

Methods

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
risk.

Results

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.

Conclusion

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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