Mortality prognostication scores do not predict long-term, health-related quality of life after burn: A burn model system national database study
Publications
Model System:
Burn
Reference Type:
Journal article
Accession No.:
J89278
Journal:
Burns
Year, Volume, Issue, Page(s):
, 47, 1, 42-51
Publication Website:
Abstract:
Study investigated whether commonly used mortality prognostication scores (i.e., revised Baux and Ryan scores) predict long-term, health-related quality of life (HRQOL) after burn injury using data obtained from the Burn Model System database (1994-2019). The revised Baux and Ryan scores use patient age, burn size, and presence of inhalation injury to estimate in-hospital mortality. The 12-Item Short Form Health Survey (SF-12) physical and mental component scores reported one year after major burn injury were analyzed for 1,606 survivors. Ninety percent of the observations were randomly assigned to a model development dataset. Multilevel, mixed-effects, linear regression models determined the relationship between revised Baux and Ryan Scores and SF-12 measures. Additionally, the study tested a model with disaggregated independent and other covariates easily obtained around the time of index admission: age, sex, race, burn size, inhalation injury. Residuals from the remaining 10 percent of observations in the validation dataset were examined. The data showed that median burn size was 16 percent of total body surface area and 13 percent of participants sustained inhalation injury. Higher revised Baux and Ryan Scores negatively correlated with long-term physical health, but not mental health, after burn injury. Female sex, black race, burn size, and inhalation injury correlated with lower mental health scores. All models poorly explained the variance in SF-12 scores one year after injury. More accurate models are needed to predict long-term, HRQOL and support shared decision-making during acute burn care.
