A 10-year mono-center study on patients with burns ≥70% TBSA: prediction model construction and multi-center validation: retrospective cohort

• Published in: International journal of surgery (London, England)
• Main Authors: Huang, Runzhi, Yao, Yuntao, Li, Linhui, Tong, Xirui, Liu, Yifan, Li, Junqiang, Xu, Dayuan, Wu, Minjuan, Chang, Zhengyan, Xu, Long, Xian, Shuyuan, Xie, Sujie, Zhang, Wei, Lu, Jianyu, Lu, Yuwei, Lu, Bingnan, Wang, Siqiao, Qian, Weijin, Sun, Hanlin, Jin, Minghao, Huang, Jie, Yang, Yiting, Zhu, Yushu, Li, Yuanan, Guo, Xinya, Gu, Minyi, Jiang, Luofeng, Luo, Pengfei, Xiao, Shichu, Ji, Shizhao
• Format: Journal Article
• Language: English
• Published: United States 04.07.2024
• ISSN: 1743-9159; 1743-9159
• DOI: 10.1097/JS9.0000000000001880

Burn injuries with ≥70% total body surface area (TBSA) are especially acute and life-threatening, leading to severe complications and terrible prognosis, while a powerful model for prediction of overall survival (OS) is lacked. The objective of this study is to identify prognostic factors for the OS of patients with burn injury ≥70% TBSA, construct and validate a feasible predictive model. Patients diagnosed with burns ≥70% TBSA admitted and treated between 2010 and 2020 in our hospital were included. A cohort of the patients from the Kunshan explosion were assigned as the validation set. The Chi-square test and K-M survival analysis were conducted to identify potential predictors for OS. Then, multi-variate Cox regression analysis was performed to identify the independent factors. Afterwards, we constructed a nomogram to predict OS probability. Finally, the Kunshan cohort was applied as an external validation set. Gender, the percentage of third- and fourth-degree burn as well as organ dysfunction were identified as significant independent factors. A nomogram only based on the factors of the individuals was built and evidenced to have promising predictive accuracy, accordance, and discrimination by both internal and external validation. This study recognized significant influencing factors for the OS of patients with burns ≥70% TBSA. Furthermore, our nomogram proved to be an effective tool for doctors to quickly evaluate patients' outcomes and make appropriate clinical decisions at an early stage of treatment.