A model of British in-hospital mortality among burns patients.
BACKGROUND
Mortality 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.


METHODS
Data 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.


RESULTS
Overall 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).


CONCLUSIONS
We 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.
Centre for Health Informatics, Institute of Population Health, University of Manchester, United Kingdom.
Neophytos
N
Stylianou
Centre for Health Informatics, Institute of Population Health, University of Manchester, United Kingdom.
Iain
I
Buchan
University Hospital South Manchester, United Kingdom; Centre for Health Informatics, Institute of Population Health, University of Manchester, United Kingdom. Electronic address: ken.dunn@uhsm.nhs.uk.
Ken W
KW
Dunn
D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D001830:Body Surface Area; D002056:Burns / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004739:England; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012372:ROC Curve; D015208:Smoke Inhalation Injury / Q000401:mortality; D014852:Wales; D055815:Young Adult
Audit; Burn; Mortality; Prediction; UK