A model of British in-hospital mortality among burns patients |
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| Affiliation: | 1. Centre for Health Informatics, Institute of Population Health, University of Manchester, United Kingdom;2. University Hospital South Manchester, United Kingdom;1. The Scar Free Foundation Birmingham Centre for Burns Research, Birmingham, UK;2. Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK;3. NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, UK;4. Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham B15 2WB, UK;1. Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran;2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;1. Clinic of Plastic, Reconstructive, Hand and Burn Surgery, Hospital Cologne Merheim, University of Witten-Herdecke, Germany;2. Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne, Germany;3. Clinic of Anesthesiology at the University Hospital Bonn, Germany;4. Department of Plastic and Aesthetic Surgery, Burn Surgery, Leverkusen Hospital, Leverkusen, Germany;5. Hannover Medical School, Hannover, Germany;6. Committee of the German Burn Registry, Germany;1. Third Faculty of Medicine, Charles University, Prague, Czech Republic;2. Department of Cardiology, University Hospital Kralovske Vinohrady, Prague, Czech Republic;3. The Burn Center Prague, University Hospital Kralovske Vinohrady, Prague, Czech Republic;1. Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Eyssoniusplein 18, 9714 CE Groningen, The Netherlands;2. Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;3. Association of Dutch Burn Centers, Burn Center Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands;4. Department of Physiotherapy, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands;5. Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands |
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| Abstract: | IntroductionMortality among patients treated in hospital for burn is routinely examined, but none of the many models in use in the UK was developed using nationwide data. The aim of this research was to develop a prediction model using national data, representative of the British population.MethodsData were gathered from the international Burns Injury Database (iBID) and included 66,611 patients from England and Wales from 2003 to 2011. Core variables were selected following systematic review of the literature, expert consultation and then supplemented with variables selected through logistic regression. Discrimination and calibration of the model were assessed using the area under the receiver operating characteristic curve and the Hosmer–Lemeshow χ2 test respectively.ResultsOverall mortality for the years of the study in England and Wales was 1.27%. Mortality was predicted by age (and quadratic term) total burn surface area, presence of inhalation injury, presence of existing disorders and category of injury. The model gave a discrimination area under the curve of 0.97 in both internal and external validation. The calibration of the model gave a Hosmer–Lemeshow χ2 of 11.9 (p = 0.3).ConclusionWe have reported a strongly predictive and theoretically well-founded model of in-patient mortality using nine years of data from all burn care services in England and Wales. We recommend this model for British burn service development and for international consideration of the variables to use in developing similar models with other data sources. |
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| Keywords: | Burn Mortality Prediction Audit UK |
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