ABSI scoring system for burns: concerns and modifications in a developing country

Abstract

Background

Burns are a major health problem worldwide. In some countries, they are the fourth leading cause of death in trauma patients. Every year, more than 200,000 deaths occur because of diverse types of burns, and the majority of these deaths occur in low-income countries. The incidence of burn mortality depends on both patient factors (age, gender, and comorbidities) and burn factors (depth and total burn surface area (TBSA)). Mortality prediction for burn patients is important not only to determine the prognosis of individual patients but to assess the performance of the burn institute and the quality of the health care the patients receive. Many mortality or survival prediction models have been developed, modified, and validated. The abbreviated burn scoring index (ABSI) is one of the most commonly used scores for assessing patients' mortality. It was reviewed, modified, and validated in this study.

Methods

This is a retrospective analysis of cases admitted to Kasr Al-Ainy Burn Unit (KABU), Cairo University Hospitals, Egypt, over a period of 5 years (January 2012 to December 2016). The data were analyzed using the ABSI scaling system.

Results

The predicted survival using the ABSI was the same as the actual survival for all age groups except children less than 10 years and pregnant females, who had actual survival rates that differed from those predicted.

Conclusion

ABSI is one of the best indicators of the mortality and well-being of burn patients. A modification of the ABSI score that added one point for children less than 10 years yielded closer predicted and actual survival rates and this change was statistically significant. A larger number of pregnant females is needed to validate the scoring system for pregnant patients. Close attention and care are always recommended for these two special high-risk groups.

Level of Evidence: Level II, risk / prognostic study.

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