Role of the revised Baux score in predicting mortality among burn patients in an African low-income country: a multicentre prospective cohort

Abstract

Introduction: Burn injury is a major cause of mortality. Majority of the burns occur in low and middle-income countries like Uganda. Uganda has a limited number of burn centres and medical resources, making a predictor of mortality necessary in allocation of the limited resources. Although the revised Baux (r-Baux) score has been validated and used in many high income countries, no study has assessed its role in an African low-income country; the reason this study was done. Methods: This was a prospective multicentre cohort that enroled 101 burn patients with moderate and severe burns admitted in three tertiary hospitals in western Uganda. Follow-up was done until discharge, documenting mortality. A receiver operator characteristic curve was used to determine the role of r-Baux score in predicting mortality. Results: This study included 101 patients, with a mean age of 21.3 (SD=16.8) years. The majority of the participants were male (69.3%). The area under the curved for r-Baux score’s prediction of mortality was 0.943 (P<0.001). The most appropriate cut-off was determined to be 74.5. At this cut-off, r-Baux score predicted mortality with a sensitivity of 100% and specificity of 83.5%. After controlling for burn severity using Poisson regression, a patient with r-Baux score greater than 74.5 was 1.358 times more likely to die (adjusted risk ratio=1.358, 95% CI=1.195–1.543, P<0.001). Conclusion: The r-Baux score was found to be excellent at predicting mortality among burn patients in Uganda and therefore should be done for all patients at admission, in order to predict mortality and do proper planning.