Use of the Braden Scale to Predict Injury Severity in Mass Burn Casualties

BACKGROUND Mass burn casualties impose an enormous burden on triage systems. The triage capacity of the Braden Scale for detecting injury severity has not been evaluated in mass burn casualties. MATERIAL AND METHODS The New Injury Severity Score (NISS) was used to dichotomize the injury severity of patients. The Braden Scale and other potentially indicative measurement tools were evaluated using univariate analysis and multivariate logistic regression. The relationships between the Braden Scale and other continuous variables with injury severity were further explored by correlation analysis and fitted with regression models. Receiver operating characteristic (ROC) curve analysis was used to validate triage capacity and compare prognostic accuracy. RESULTS A total of 160 hospitalized patients were included in our study; 37 were severely injured, and 123 were not. Injury severity was independently associated with the Numerical Rating Scale (adjusted OR, 1.816; 95% CI, 1.035-3.187) and Braden Scale (adjusted OR, 0.693; 95% CI, 0.564-0.851). The ROC curve of the fitted quadratic model of the Braden Scale was 0.896 (0.840-0.953), and the cut-off value was 17. The sensitivity was 81.08% (64.29-91.44%) and the specificity was 82.93% (74.85-88.89%). Comparison of ROC curves demonstrated an infinitesimal difference between the Braden Scale and NISS for predicting 30-day hospital discharge (Z=0.291, P=0.771) and Intensive Care Unit admission (Z=2.016, P=0.044). CONCLUSIONS The Braden Scale is a suitable triage tool for predicting injury severity and forecasting disability-related outcomes in patients affected by mass burn casualty incidents.