體表面積(TBSA) ；如何計算燒燙傷死亡機率 The Baux score

合併吸入性灼傷(Inhalation)再加上23%的死亡率
(有插管的那些都是有吸入性灼傷)


郭峻廷


你知道燙傷病人的死亡率有多高嗎？

在美國，體表面積(TBSA)90%以上的燒燙傷，
死亡率都已經85%以上了


除此之外，粉塵極易吸入肺部，
燃燒時幾乎都合併吸入性灼傷(Inhalation)
再加上23%的死亡率
(有插管的那些都是有吸入性灼傷)

不知道該說甚麼，
但請別糟蹋醫護人員的努力與付出，
不論是大醫院小醫院，
所有的人無不是盡心盡力
在替非親非故的傷患
和死神拔河！

張志華的相片。

張志華和張志華及吳元宏

【參考資料】如何計算燒燙傷死亡機率？

計算死亡機率，依據 Baux score (修正版)：
Baux分數 = 燒傷面積% + 年齡 + 17 x (吸入性灼傷, 1: 有/0: 無)


計算(2度以上)燒傷面積，依據 "rule-of-nine" ：
頭9%，一隻手9%，一隻腳18%，身體前後各18%。

[舉例] 假設以最常見的，20歲年輕人，雙手雙腳燒燙傷，Baux分數就是20%+(9%+18%)x2 = 74分，如果有吸入性灼傷需要插管要再加17分，也就是91分。【註】Baux score 算出來的是分數，並不直接等於死亡率，若 Baux score > 140分，存活率是零。依台灣正常(非災難時)的醫療水準看，Baux score 可以到達 130分左右。

圖來源：http://www.thefreedictionary.com
舉例來源：吳元宏醫師臉書

From Wikipedia, the free encyclopedia

The Baux score is a system used to predict the chance of mortality due to severe burns.^[1] The score is an index which takes into account the correlative and causal relationship between mortality and factors including advancing age, burn size, the presence of inhalational injury.^[2] Studies have shown that the Baux score is highly correlative with length of stay in hospital due to burns and final outcome.^[3]

Contents

  [hide] 

• 1 Methods
  • 1.1 Original method
  • 1.2 Modified method
• 2 Efficacy
• 3 References

Methods[edit]

Original method[edit]

The original Baux score was the addition of two factors, the first being the total body surface area affected by burning (usually estimated using the Wallace rule of nines, or calculated using a Lund and Browder chart) and the second being the age of the patient.

The score is expressed as:

• 

The score is a comparative indicator of burn severity, with a score over 140 indicated as being unsurvivable.

Modified method[edit]

Research demonstrated that with improvements in medical care rendered the original method too pessimistic in its outcome prediction. This resulted in the publication of a modified methodology which took into account the effect of inhalation injury. It was found that inhalation injury resulted in an increase of around 17 on the Baux score, and this addition means that a patient with inhalation injury would have their score calculated by body area affected + age of patient + 17.^[1] Recent analysis of mortality in burn units worldwide has shown that for well performing units the LD50 (the point at which 50% of patients would be expected to die) for major burns has significantly improved and the best units have a modified Baux score of 130-140. This means that all burns in children (except 100% TBSA burns) should be considered survivable injuries and actively treated.^[4]

Efficacy[edit]

Studies have shown Baux score to be effective in measuring comparative severity of burn injuries, and in predicting the prognosis for the patient. The modified version, which includes inhalation injuries, is more accurate than the original method, although neither method is as accurate as more complex calculated scores using advanced computer modelling.^[1]

The Baux score has been shown to be effective in predicting outcome in 87% of presenting patients aged 60 and above.^[5]