Development and validation of a model for prediction of mortality in patients with acute burn injury

Background: The objective was to develop a user-friendly model to predict the probability of death from acute burns soon after injury, based on burned surface area, age and presence of inhalation injury. Methods: This population-based cohort study included all burned patients admitted to one of the six Belgian burn centres. Data from 1999 to 2003 (5246 patients) were used to develop a mortality prediction model, and data from 2004 (981 patients) were used for validation. Results: Mortality in the derivation cohort was 4.6 per cent. A mortality score (0-10 points) was devised: 0-4 points according to the percentage of burned surface area less than 20, 20-39, 40-59, 60-79 or at least 80 per cent), 0-3 points according to age (under 50, 50-64, 65-79 or at least 80 years) and 3 points for the presence of an inhalation injury. Mortality in the validation cohort was 4.3 per cent. The model predicted 40 deaths, and 42 deaths were observed (P = 0.950). Receiver-operator characteristic curve analysis of the model for prediction of mortality demonstrated an area under the curve of 0.94 (95 per cent confidence interval 0.90 to 0.97). Conclusion: An accurate model was developed to predict the probability of death from acute burn injury based on simple and objective clinical criteria.