Kuo et al reported a model for predicting mortality in a patient with burn injury. They also studied the impact of acute kidney injury (AKI). The authors are from the Kidney Research Center and Chang Gung Memorial Hospital in Taiwan.
Criteria for AKI - one or more of the following:
(1) increase in serum creatinine >= 0.3 mg/dL over 48 hours
(2) increase in serum creatinine to 1.5 times baseline over 7 days
(3) urine volume less than 0.5 mL per kg per hour for 6 hours
Parameters:
(1) percent body surface area with moderate to severe injury
(2) ventilator use
(3) acute kidney injury (AKI)
(4) Stevens-Johnson syndrome, toxic epidermal necrolysis (SJS/TEN)
|
Parameter
|
Finding
|
Points
|
|
percent BSA
|
|
* 0.079
|
|
ventilator use
|
no
|
0
|
|
|
yes
|
3.939
|
|
acute kidney injury
|
no
|
0
|
|
|
yes
|
2.688 (see below)
|
|
SJS/TEN
|
no
|
0
|
|
|
yes
|
3.341
|
where:
• The author score AKIN as 0 for none, 1 for Stage 1, 2 for Stage 2 and 3 for Stage 3. It is not stated that points for AKIN would be this score times 2.688.
X =
= SUM(points for the 4 parameters) - 10.908
probability of mortality =
= 1 / (1 + EXP((-1) * X))
|
Acute Kidney Injury
|
60-day Survival
|
|
none
|
91%
|
|
Stage 1 AKI
|
68%
|
|
Stage 2 AKI
|
41%
|
|
Stage 3 AKI
|
16%
|
