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Integration of biochemical parameters into mortality prediction scores for burn patients: a step toward a new scoring system
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- Published: October 6, 2026
Integration of biochemical parameters into mortality prediction scores for burn patients: a step toward a new scoring system
Isidora Djozic 1, 2 
, Marija Marinkovic 1, 2 , Teodora Tubic 3, 4 , Ljubica Višnjevac 2 , Vanja Tatalovic 1, 2 , Senjin Djozic 1, 5 , Nenad Djermanov 2 , Jelena Nikolic 1, 2
1 Department of Surgery, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2 University Clinical Center of Vojvodina, Clinic of Plastic and Reconstructive Surgery, Novi Sad, Serbia; 3 Department of Anesthesiology and Perioperative Medicine, University of Novi Sad, Novi Sad, Serbia; 4 University Clinical Center of Vojvodina, Clinic of Anesthesia and Intensive Care, Novi Sad, Serbia; 5 University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
Isidora Djozic, Marija Marinkovic, Teodora Tubic, Ljubica Višnjevac, Vanja Tatalovic, Senjin Djozic, Nenad Djermanov, Jelena Nikolic
La información completa de afiliaciones y autor de correspondencia está disponible en la versión original en PDF.
*Correspondence: Isidora Djozic. Email: isidora.djozic@mf.uns.ac.rs
Abstract
Objectives: This study aimed to evaluate and compare the performance of five prognostic scoring systems for predicting burn mortality: chronic health evaluation II (APACHE II), abbreviated burn severity index (ABSI), Ryan score, rBaux, and Belgium outcome in burn injury, alongside the influence of initial laboratory analyses. Methods: A retrospective clinical study analyzed 343 patients hospitalized for moderate to severe burn injuries at a major clinical Center in Serbia. Data were extracted from medical records, and logistic regression assessed the impact of laboratory results on mortality. Sensitivity, specificity, and area under the curve were calculated for each scoring system. Results: The overall mortality rate was 11.4%. Non-survivors were significantly older (60.87 ± 15.72 years) and had a higher median total body surface area burned (40%) compared to survivors (6%). Inhalation injuries were more common in non-survivors (53.8%). Higher potassium levels were significantly associated with mortality (p < 0.001; odds ratio = 3.624). The APACHE II score demonstrated the highest accuracy (89.7%), while the ABSI score had the lowest (71.8%). Conclusion: In this cohort, the APACHE II score showed the highest discriminative accuracy. However, its performance may vary in other populations. Incorporating potassium levels into future scoring systems may improve mortality prediction.
Keywords: Burn injury. Prediction. Mortality. Blood count. Scores.
