Development and Validation of an Age-Risk Score for Mortality Predication after Thermal Injury
Abstract
Background: In burn patients, the risk of mortality typically decreases as children mature, reaches a nadir at age 21, rises linearly thereafter, and levels off in old age. We hypothesized that a single age-risk score (AGESCORE), incorporating a cubic functional form, can be used in predictive models for mortality after burns. Methods: Data from 6,395 thermally injured patients admitted to a single burn center between January 1, 1950, and December 31, 1999, were used. Variables included age, total burn size, year of discharge, and survival. AGESCORE was defined as follows: -5(age) + 14(age2 /100) -7(age3 /10,000). Logistic regression verified the cubic functional form of the age- mortality relationship. Models using a general cubic functional form of age, and AGESCORE, were compared for lack of fit. The stability of AGESCORE was assessed over six distinct treatment eras within the 50-year period. AGESCORE was also validated using data from a different burn center. Results: AGESCORE provided an accurate method for modeling mortality in burn patients across different age groups, burn sizes, eras, and burn centers. Conclusion: The benefits of a stan- dardized index of age risk include ease of comparison, reduction of bias, and in- creased efficiency attributable to statistical parsimony. The applicability of this approach to nonthermal trauma petients remains to be seen.
Document Details
- Document Type
- Technical Report
- Publication Date
- May 01, 2005
- Accession Number
- ADA628085
Entities
People
- Aimee R. Moreau
- Arthur D. Mason Jr.
- Leopoldo C. Cancio
- Peter H. Westfall
Organizations
- United States Army Institute of Surgical Research