The analysis and accuracy of mortality prediction scores in burn patients admitted to the intensive care burn unit (ICBU)

BACKGROUND: To date, multiple scoring systems have been utilised in predicting outcomes in burn patients. The aim of this study is to determine the accuracy of three established scoring systems used for burn patients admitted to the intensive care unit and to determine the risk factors associated with poor outcomes. METHODS: A total of 211 patients who were admitted to the ICBU in a tertiary care centre in Kuwait from January 2017 to December 2019 were analysed retrospectively. Data were collected using patient medical records. The FLAMES, BOBI and revised Baux scores were calculated, and the survivor and non-survivor scores of patients were analysed to determine the sensitivity, specificity and Area Under the Receiver Operating Characteristics (AUROC) of the different scoring modalities. RESULTS: The majority of the analysed population were male patients (165/211) and the most common mechanism of burns was flame burns (166/211). Most of the patients admitted to the ICBU survived (188/211). Female gender was associated with a higher mortality rate, whilst inhalational injury and co-morbidities were not associated with a higher mortality rate. The revised Baux score had a sensitivity value of 96% and 90% specificity. The BOBI score had a sensitivity of 91% and 76% specificity. The FLAMES score had a sensitivity of 96% and the highest specificity of 99%. All 3 scores had AUC values exceeding 90%. CONCLUSION: Statistically, FLAMES score had the highest accuracy of predicting outcomes in burn patients, however all three scores demonstrated acceptable predictive rates when it comes to practical application, permitting the use of either one of the studied scores with satisfactory prognostic outcomes.