title: The impact of laser Doppler imaging on the early decision-making process for surgical intervention in adults with indeterminate burns.
abstract: OBJECTIVE
  We aimed to analyze whether laser Doppler imaging (LDI) can lead to earlier decision-making regarding the need for surgery in adults with indeterminate burns.
  
  
  METHODS
  In a retrospective cohort study, we developed a prediction model for surgery in adults with indeterminate burns. Patient data (n=101) from January 2007 to December 2009 were used for model development, and those (n=40) from January 2010 to October 2010 for external validation.
  
  
  RESULTS
  Between non-surgical and surgical groups, there were significant differences for mean age (p=0.009), % total body surface area burn (p=0.016), site of burn wound (p=0.033), and mean perfusion units (PU) (p<0.001). Multiple logistic regression showed that only the mean PU differed significantly between the groups. The area under the curve (AUC) of the equation derived from multiple logistic regression was 0.938, which did not differ from that of the mean PU alone (0.931; p=0.453). Using a cut-off point of 154.7PU, the sensitivity of LDI was 78.3% and the specificity was 92.7%. This cut-off point also yielded a sensitivity of 77.8% and specificity of 95.5% in the external validation dataset.
  
  
  CONCLUSIONS
  LDI can help make a decision for surgery in the early stages of care for adults with indeterminate burns.
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yoo Seok
authors.initials: YS
authors.lastname: Park
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Choi
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.forename: Duk Ju
authors.initials: DJ
authors.lastname: Moon
authors.forename: Seon Gyu
authors.initials: SG
authors.lastname: Kim
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Jin Kyung
authors.initials: JK
authors.lastname: Cho
authors.forename: Cheon Jae
authors.initials: CJ
authors.lastname: Yoon
mesh_terms: D000328:Adult; D002056:Burns / Q000175:diagnosis* / Q000601:surgery; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012867:Skin / Q000098:blood supply*; D016038:Skin Transplantation