Recalibrating the revised Baux score: Admission and 48-hour landmark survival models in contemporary older…

Cohort studyBurns : journal of the International Society for Burn Injuries· Jul 2026

Recalibrating the revised Baux score: Admission and 48-hour landmark survival models in contemporary older adult patients with burn injury.

Noam Goder, Yasmin Meghdadi, Marshall Thibedeau … Stephanie A Mason

Burns & Wound ReconstructionCohort studyPrognosisQ1IF 2.3

Revised Baux score underestimates in-hospital mortality in older burn patients.

Recalibrating the revised Baux score: Admission and 48-hour landmark survival models in contemporary older adult patients with burn injury.

Noam Goder … Stephanie A Mason

Burns · Jul 2026 · Q1 in Surgery

Background

Mortality prediction in burn care commonly relies on the revised Baux (rBaux) score, yet its calibration in contemporary cohorts of older adults is uncertain.

Purpose

We aimed to assess the discrimination and calibration of rBaux in older adults and to develop simple admission and early landmark models using routinely available physiologic variables.

Methods

We conducted a single-center retrospective cohort study of patients aged ≥ 65 years with acute burn injury admitted to a tertiary burn center between 2018 and 2023. rBaux discrimination was assessed using ROC analysis and calibration via observed-versus-expected (O:E) mortality.

n = 109 patients

O:E 1.30

Results

O:E 1.30

revised Baux underestimates death risk in older burn patients

n = 109 patients

More results

Two admission models incorporating age, burn extent, inhalation injury, and admission creatinine showed excellent corrected discrimination (AUC 0.904 and 0.897) and outperformed rBaux (p < 0.02).

More results

Among 48-hour survivors (n = 89), mortality was 34.8%; landmark models incorporating mechanical ventilation, age, admission creatinine, and burn extent achieved high corrected discrimination (AUC 0.919 and 0.910) and outperformed rBaux (AUC 0.786; both p ≈ 0.001).

“

Conclusion · 1 of 2

The revised Baux score demonstrates clinically meaningful calibration drift in contemporary older adult burn patients, with systematic underestimation of mortality.

Conclusion · 2 of 2

Simple admission models incorporating burn severity, inhalation injury, and admission creatinine improved prognostic performance compared with rBaux, while 48-hour landmark models may support reassessment after initial resuscitation.

Recalibrating the revised Baux score: Admission and 48-hour landmark survival models in contemporary older adult patients with burn injury.

Recalibrating the revised Baux score: Admission and 48-hour landmark survival models in contemporary older adult patients with burn injury.

Related papers