title: The Hand Burn Severity (HABS) score: A simple tool for stratifying severity of hand burns.
abstract: Hand burns represent a unique challenge to the burns team due to the intricate structure and unrivalled functional importance of the hand. The initial assessment and prognosis relies on consideration of the specific site involved as well as depth of the burn. We created a simple severity score that could be used by referring non-specialists and researchers alike. The Hand Burn Severity (HABS) score stratifies hand burns according to severity with a numerical value of between 0 (no burn) and 18 (most severe) per hand. Three independent assessors scored the photographs of 121 burned hands of 106 adult and paediatric patients, demonstrating excellent inter-rater reliability (r=0.91, p<0.0001 on testing with Lin's correlation coefficient). A significant relationship was shown between the HABS score and a reliable binary outcome of the requirement for surgical excision on Mann-Whitney U testing (U=152; Z=9.8; p=0.0001). A receiver operator characteristic (ROC) curve analysis found a cut off score of 5.5, indicating that those with a HABS score below 6 did not require an operation, whereas those with a score above 6 did. The HABS score was shown to be more sensitive and specific that assessment of burn depth alone. The HABS score is a simple to use tool to stratify severity at initial presentation of hand burns which will be useful when referring, and when reporting outcomes.
authors: St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital Chelmsford, Essex, UK. Electronic address: sarahbache@doctors.org.uk.
authors: Sarah E
authors: SE
authors: Bache
authors: St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital Chelmsford, Essex, UK.
authors: Edmund
authors: E
authors: Fitzgerald O'Connor
authors: St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital Chelmsford, Essex, UK.
authors: Evgenia
authors: E
authors: Theodorakopoulou
authors: St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital Chelmsford, Essex, UK.
authors: Quentin
authors: Q
authors: Frew
authors: St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital Chelmsford, Essex, UK; St Andrew's, Anglia Ruskin (StAAR) Plastic Surgery and Burns Research Group, Anglia Ruskin University, Chelmsford, Essex, UK.
authors: Bruce
authors: B
authors: Philp
authors: St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital Chelmsford, Essex, UK; St Andrew's, Anglia Ruskin (StAAR) Plastic Surgery and Burns Research Group, Anglia Ruskin University, Chelmsford, Essex, UK.
authors: Peter
authors: P
authors: Dziewulski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001830:Body Surface Area; D002056:Burns / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006230:Hand Injuries / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D055815:Young Adult
keywords: Assessment; Hand burns; Severity; Upper extremity