Prediction of mortality from catastrophic burns in children

Marcus Spies, David Herndon, Judah I. Rosenblatt, Arthur P. Sanford, Steven Wolf

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background: We previously developed a model to predict survival in massive paediatric burns (>80% total body surface area [TBSA]). This model included not only demographic variables, but also variables obtained throughout the hospital course. We aimed to prospectively validate our model for accuracy of outcome prediction. Methods: We admitted 33 paediatric burn patients with burns greater than 80% TBSA. We recorded age, burn size, inhalation injury, resuscitation, packed-cell volume at admission, base deficit, serum osmolarity, sepsis, inotropic support, platelet count, creatinine, and ventilator dependency. We entered these data into our previous models. Results: 20 male and 13 female children with mean age 7.6 (SD 1) years with TBSA burns of 88% (SD 1; full thickness 86% [SD 1]) were admitted. Mortality was 39.4% (13 of 30). When all variables were integrated into our final model, we predicted outcome with 97% accuracy. When we used a model based only on demographic characteristics of age, burn size, and presence of inhalation injury, outcome was correctly predicted in only 51% of patients. Conclusions: We show prospectively that mortality in severely burned children can be reliably estimated at a burn centre, and that outcome cannot be reliably predicted on the basis of demographic and injury characteristics alone. These data suggest that all severely burned children should be given a course of treatment before consideration of treatment futility.

Original languageEnglish (US)
Pages (from-to)989-994
Number of pages6
JournalLancet
Volume361
Issue number9362
DOIs
StatePublished - Mar 22 2003

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Body Surface Area
Burns
Demography
Mortality
Wounds and Injuries
Inhalation Burns
Pediatrics
Medical Futility
Burn Units
Mechanical Ventilators
Platelet Count
Cell Size
Resuscitation
Osmolar Concentration
Inhalation
Creatinine
Sepsis
Survival
Serum
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Spies, M., Herndon, D., Rosenblatt, J. I., Sanford, A. P., & Wolf, S. (2003). Prediction of mortality from catastrophic burns in children. Lancet, 361(9362), 989-994. https://doi.org/10.1016/S0140-6736(03)12824-3

Prediction of mortality from catastrophic burns in children. / Spies, Marcus; Herndon, David; Rosenblatt, Judah I.; Sanford, Arthur P.; Wolf, Steven.

In: Lancet, Vol. 361, No. 9362, 22.03.2003, p. 989-994.

Research output: Contribution to journalArticle

Spies, M, Herndon, D, Rosenblatt, JI, Sanford, AP & Wolf, S 2003, 'Prediction of mortality from catastrophic burns in children', Lancet, vol. 361, no. 9362, pp. 989-994. https://doi.org/10.1016/S0140-6736(03)12824-3
Spies M, Herndon D, Rosenblatt JI, Sanford AP, Wolf S. Prediction of mortality from catastrophic burns in children. Lancet. 2003 Mar 22;361(9362):989-994. https://doi.org/10.1016/S0140-6736(03)12824-3
Spies, Marcus ; Herndon, David ; Rosenblatt, Judah I. ; Sanford, Arthur P. ; Wolf, Steven. / Prediction of mortality from catastrophic burns in children. In: Lancet. 2003 ; Vol. 361, No. 9362. pp. 989-994.
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