Burn Mortality Prediction Scores

Comparative Performance of ABSI, Revised Baux Score, and Modified Ryan Score for In-Hospital Mortality Prediction in Hospitalized Burn Admissions: A Retrospective Cohort Study

This retrospective observational cohort study evaluates hospitalized burn admissions treated at the Burn Center of Gaziantep City Hospital between October 2023 and February 2026. The study aims to compare the ability of three burn severity scoring systems, the Abbreviated Burn Severity Index (ABSI), Revised Baux score, and modified Ryan score, to predict in-hospital mortality.

Electronic medical records were reviewed for demographic characteristics, burn-related variables, inhalation injury, burn depth, intensive care admission, mechanical ventilation, sepsis, surgical procedures, length of hospital stay, and survival status at hospital discharge. The primary outcome is in-hospital mortality. The predictive performance of the scoring systems will be evaluated using receiver operating characteristic analysis and logistic regression.

Burn injuries are associated with substantial morbidity, mortality, intensive care use, prolonged hospitalization, and surgical burden. Early identification of patients at high risk of death may support clinical triage, intensive care planning, resource allocation, and communication with patients' families.

This study is a single-center, retrospective, observational cohort study conducted at the Burn Center of Gaziantep City Hospital, a tertiary referral burn center serving southern Türkiye and cross-border regions. The study includes hospitalized burn admissions treated between October 2023 and February 2026.

A total of 1315 burn admission records were screened. Admissions transferred to another facility before final clinical outcome assessment and admissions in which treatment was refused were excluded. After applying eligibility criteria, 1082 hospitalized burn admissions were included in the primary analysis cohort.

The study evaluates the prognostic performance of the Abbreviated Burn Severity Index (ABSI), Revised Baux score, and modified Ryan score for predicting in-hospital mortality. ABSI is calculated using age, sex, total body surface area burned, inhalation injury, and full-thickness burn status. Revised Baux score is calculated using age, total body surface area burned, and the presence of inhalation injury. The modified Ryan score is calculated using age category, total body surface area burned category, inhalation injury, and third-degree burn status.

The primary outcome is in-hospital mortality, defined as death occurring during the index hospitalization. Secondary evaluations include associations between mortality and selected clinical variables, including inhalation injury, sepsis, intensive care admission, mechanical ventilation, number of surgical procedures, and length of hospital stay.

The discriminative performance of prognostic scores will be assessed using receiver operating characteristic analysis. Area under the curve, confidence intervals, optimal cut-off values, sensitivity, and specificity will be reported. Associations between score increments and mortality will be examined using univariable logistic regression.

Inclusion Criteria: Hospitalized burn admissions treated at the Burn Center of Gaziantep City Hospital between October 2023 and February 2026.

Admissions with a documented in-hospital outcome of discharge alive or death. Admissions with available electronic medical records for age, sex, total body surface area burned, burn depth, inhalation injury, and core clinical variables.

Exclusion Criteria: Admissions transferred to another facility before final clinical outcome assessment.

Admissions in which treatment was refused. Admissions without sufficient electronic medical record data for calculation of the prognostic scores or assessment of the primary outcome.