The significance of APACHEⅢ scoring system on evaluating condition and prognosis of patients with severe burns

DENG Xin-heng; WANG Li-min

Abstract：Objective:To explore the significance of acute physiology and chronic health evaluation system Ⅲ(APACHEⅢ)in evaluating prognosis of patients with severe burn. Methods:Retrospective study were used to analyze 60 severe and ex-traordinarily severe burn patients who admitted to our hospital. They were divided into severe group and extraordinarily severe group,survival group and non - survival group according to their burn severity and prognosis. APACHEⅢ score and mortality risk(R value)among groups were compared. Correlation analysis was processed among APACHEⅢ scores and R - value, age,total burn surface area,area of superficial second degree,deep second degree and full - thickness burns. The subjects were divided into two groups,regarding the 40 score as boundary. The differences of R value,Predicted mortality rate and the actual mortality rate were compared. Results:Extraordinarily severe group APACHEⅢ score obviously higher than the severe group, the difference was statistically significant(t = - 2. 531,P = 0. 014),while the value of R have no significant difference. Com -paredsurvivalandnon - survivalgroups,APACHEⅢ scores andR - value showedstatistically differences( t = - 7 . 895 ,P ﹤0. 01;t = - 4. 197,P ﹤ 0. 01). APACHEⅢ scores and R values in non - survival group were significantly higher than those in the survival group,and R values increased with APACHEⅢscore changes. Univariate correlation analysis demonstrated that A-PACHEⅢscore significantly negatively correlated with superficial second degree burn area and positively correlated with full -thickness burn area. It is negatively correlated between R value and age,superficial second degree,deep second degree burns area,positively correlated with total burn surface area and full - thickness burn area. Score ﹥ 40 group was significantly higher than the value of R score of 0 to 40 packets in ﹥ 40 packets and a sharp rise in mortality in patients with APACHEⅢ score in-creased,and the difference was statistically significance(t = - 8. 363,P ﹤ 0. 01). Conclusions:APACHEⅢ scoring system can be used as supplementary of evaluating burn severity and has significance for evaluating patient's prognosis.