The Baux score is a system used to predict the chance of
mortality
Mortality is the state of being mortal, or susceptible to death; the opposite of immortality.
Mortality may also refer to:
* Fish mortality, a parameter used in fisheries population dynamics to account for the loss of fish in a fish stock throug ...
due to
burn
A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. Burns occur mainl ...
s.
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.
Studies have shown that the Baux score is highly correlative with length of stay in hospital due to burns and final outcome.
Methods
Original method
The original Baux score was the addition of two factors, the first being the
total body surface area Total body surface area (TBSA) is an assessment of injury to or disease of the skin, such as burns or psoriasis.
In adults, the Wallace rule of nines can be used to determine the total percentage of area burned for each major section of the body. ...
affected by burning (usually estimated using the
Wallace rule of nines The Wallace rule of nines is a tool used in pre-hospital and emergency medicine to estimate the total body surface area (BSA) affected by a burn. In addition to determining burn severity, the measurement of burn surface area is important for estima ...
, or calculated using a
Lund and Browder chart
The Lund and Browder chart is a tool useful in the management of burns for estimating the total body surface area affected. It was created by Dr. Charles Lund, Senior Surgeon at Boston City Hospital, and Dr. Newton Browder, based on their experien ...
) 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 considered as being unsurvivable, depending on the available treatment resources.
Modified method
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.
[
Recent analysis of mortality in burn units worldwide has shown that for well performing units the ]LD50
In toxicology, the median lethal dose, LD50 (abbreviation for "lethal dose, 50%"), LC50 (lethal concentration, 50%) or LCt50 is a toxic unit that measures the lethal dose of a toxin, radiation, or pathogen. The value of LD50 for a substance is the ...
(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 full-thickness burns) should be considered survivable injuries and actively treated.
Efficacy
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.[
The Baux score has been shown to be effective in predicting outcome in 87% of presenting patients aged 60 and above.]
References
{{Reflist
Diagnostic emergency medicine
Diagnostic intensive care medicine
Medical scoring system