Prediction of mortality from catastrophic burns in children

Marcus Spies, David N. Herndon, Judah I. Rosenblatt, Arthur P. Sanford, Steven E. Wolf

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

Background: We previously developed a model to predict survival in massive paediatric burns (>80% total body surface area [TBSA]). This model included not only demographic variables, but also variables obtained throughout the hospital course. We aimed to prospectively validate our model for accuracy of outcome prediction. Methods: We admitted 33 paediatric burn patients with burns greater than 80% TBSA. We recorded age, burn size, inhalation injury, resuscitation, packed-cell volume at admission, base deficit, serum osmolarity, sepsis, inotropic support, platelet count, creatinine, and ventilator dependency. We entered these data into our previous models. Results: 20 male and 13 female children with mean age 7.6 (SD 1) years with TBSA burns of 88% (SD 1; full thickness 86% [SD 1]) were admitted. Mortality was 39.4% (13 of 30). When all variables were integrated into our final model, we predicted outcome with 97% accuracy. When we used a model based only on demographic characteristics of age, burn size, and presence of inhalation injury, outcome was correctly predicted in only 51% of patients. Conclusions: We show prospectively that mortality in severely burned children can be reliably estimated at a burn centre, and that outcome cannot be reliably predicted on the basis of demographic and injury characteristics alone. These data suggest that all severely burned children should be given a course of treatment before consideration of treatment futility.

Original languageEnglish (US)
Pages (from-to)989-994
Number of pages6
JournalLancet
Volume361
Issue number9362
DOIs
StatePublished - Mar 22 2003

ASJC Scopus subject areas

  • Medicine(all)

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    Spies, M., Herndon, D. N., Rosenblatt, J. I., Sanford, A. P., & Wolf, S. E. (2003). Prediction of mortality from catastrophic burns in children. Lancet, 361(9362), 989-994. https://doi.org/10.1016/S0140-6736(03)12824-3