Evidence map›Paper›PMID 39789624›Full record

ArticleInternational journal for equity in health2025

Country economic status is strongly associated with burn survival - validation of the (modified) ABSI.

Julia Elrod, Christoph Mohr, Ludvik Branski, Joshua M Peterson, Fionna M Wood, Dale W Edgar, Pius Agbenorku, Shobha Chamania, Anant Sharma, Flavio N Novaes and 4 more

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In one paragraph

Article in International journal for equity in health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Julia ElrodDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Christoph MohrDepartment of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Ludvik BranskiDepartment of Surgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0527, USA.
Joshua M PetersonDepartment of Surgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0527, USA.
Fionna M WoodBurn Injury Research Unit (BIRU), University of Western Australia, 35 Stirling Hwy, Perth, WA, 6009, Australia.
Dale W EdgarBurn Injury Research Unit (BIRU), University of Western Australia, 35 Stirling Hwy, Perth, WA, 6009, Australia.
Pius AgbenorkuDepartment of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Shobha ChamaniaChoithram Hospital and Research Centre, Indore, Madhya Pradesh, India.
Anant SharmaChoithram Hospital and Research Centre, Indore, Madhya Pradesh, India.
Flavio N NovaesIrmandade de Misericordia de Campinas, Av. Julio de Mesquita, 571 Cambini/Campinas-JP, São Paulo, CEP:13024-180, Brazil.
Jean Bosco KatabogamaRuhengeri Referral Hospital, P.O.Box 57, Musanze District, Musanze, Northern Province, Rwanda.
Michael BoettcherDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Konrad ReinshagenDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Ingo KoenigsDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. ingo.koenigs@kinderkrankenhaus.net.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPredicting burn-related mortality is vital for family counseling, triage, and resource allocation. Several of the burn-specific mortality prediction scores have been developed, including the Abbreviated Burn Severity Index (ABSI) in 1982. However, these scores are not tested for accuracy to support contemporary estimates of the global burden of burn injury. This study compares burn mortality across countries with varying economic levels, as indicated by the Human Development Index (HDI), to assess if a modified ABSI (mABSI) offers enhanced predictive accuracy.

methodsA retrospective study was performed, including over 90,000 patients from seven sources in five continents, including two burn registries and five referral burn centers. Data from 2015 to 2019 were collected, including age, gender, presence of inhalation injury, full-thickness burn, percentage of total body surface area, and outcome. The participating countries were classified based on the HDI and mortality was predicted using both the original and the modified ABSI.

resultsAfter removal of incomplete data, 74,460 sets remained for the analysis. Significant variations in population demographics, sample sizes, total body surface area (TBSA), and age distributions across the studied regions were noted. The modified ABSI demonstrated a smaller deviation from the 95% CI of the true survival probability than the original ABSI in countries with a very high or high HDI, indicating improved accuracy here. In these countries, the original ABSI overestimates mortality. Conversely, in countries with a middle or low HDI, the original ABSI remains more accurate, reflecting the significantly greater burn related mortality in countries with a low HDI.

conclusionIn burn patients, the probability of survival remains highly dependent on the level of development of a country. Our results support the use of the modified ABSI in countries with a (very) high HDI, yet in resource constraint settings, the original ABSI seems to provide more accurate predictions. These findings underscore the need for adaptive models that take into account socioeconomic variables, potentially guiding health policy adjustments and emphasizing the necessity of resource allocation and training in lower HDI countries. Such adaptations could enhance clinical outcomes and reduce disparities in burn care effectiveness globally.

Indexed as

BurnsAdolescentAdultAgedFemaleHumansMaleMiddle AgedRegistriesRetrospective StudiesABSIBurnsBurn survivalCountry economic statusHDIHealth inequalitiesInternational burn careOutcome

Identifiers

PMID39789624
PMCPMC11715549

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.