Reevaluation for prognostic value of prognostic burn index in severe burn patients

Acute Med Surg. 2020 Mar 17;7(1):e499. doi: 10.1002/ams2.499. eCollection 2020 Jan-Dec.

Abstract

Aim: The prognostic burn index (PBI), which consists of half partial-thickness burn surface area plus full-thickness burn surface area and age, has been widely used to predict mortality in Japan. However, the prognostic value of PBI has not been investigated sufficiently. The purpose of the present study is to clinically reevaluate the PBI in severe burn patients.

Methods: Data of 69 severe burn patients admitted to the burn center at Kyorin University Hospital (Tokyo, Japan) from January 2008 to December 2017 were analyzed retrospectively. The primary outcome in this study was in-hospital mortality.

Results: The overall in-hospital mortality rate was 34.8%. There were significant differences in age, the presence of inhalation injury, total burned surface area, full-thickness burn area, burn index, and PBI between survivors and non-survivors. In logistic regression analysis, PBI was independently associated with mortality, while the presence of inhalation injury was not. A PBI above the threshold of 105 was significantly associated with in-hospital mortality. The area under the receiver operating characteristic curve for PBI was 0.85 (95% confidence interval, 0.73-0.93).

Conclusion: The PBI could be a good prognostic indicator. A PBI above the threshold of 105 was associated with mortality among severe burn patients treated in burn-care facilities.

Keywords: Area under curve; burn; inhalation injury; mortality; prognosis.