DOI: http://dx.doi.org/10.18203/2349-2902.isj20160241

Predicting mortality in burns: a new scoring system

Ajay Lunawat, Rishi Kant Vashistha, Vishad Patel, Ravindra Chhabra, Venkatesh Kolla

Abstract


Background: An analysis of various prognostic factors in burn patients was done which included age, sex, TBSA, onset of SIRS, septicemia, TLC, platelet count and grade of inhalational injury which could help in estimating the prognosis and probability of death of patients. On basis of these parameters a scoring system is designed, values of which will help in early assessment of prognosis and mortality.

Methods: This is cross sectional retrospective study and was carried out on 60 patients. Two groups were made one of survivors and other of non survivors with 30 patients in each group. Comparison of above mentioned parameters was done between two groups and a scoring system was designed on basis of six most significant parameters which are age, TLC, platelet count, grade of inhalational injury, TBSA and presence or absence of SIRS. Each parameter is scored according to its weightage. Scoring system has a maximum score of 420 and minimum of 60. Higher score corresponds to higher mortality.

Results: There was a significant difference in mean age of survivors and non-survivor. TBSA >45% showed high mortality. SIRS and sepsis was present in all non survivors. In 72% of non survivors blood culture was positive, inhalational injury was present 33.3% survivors and 53.3% non survivors and prolonged hospital stay was seen in survivors with inhalational injury. Non survivors showed leucocytosis or leucopenia; where gram negative sepsis accounted for fall in leucocytes. Survivor group did not show any persistent thrombocytopenia whereas persistent thrombocytopenia was present in non survivors. A death probability scoring system is designed which shows if score is more than 200 chance of mortality is 94%.

Conclusions: High mortality and poor prognosis was seen in patients of higher age group, TBSA more than 45%, presence of early SIRS.  A non cumbersome death probability scoring system was developed which does not requires sophisticated techniques, equipment and investigations; can help clinicians to foresee the course of prognosis in burn patients.    


Keywords


SIRS, TLC, Platelet, Inhalation injury, TBSA

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References


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