Prognostic scoring system for elderly burn patients: a five-year evaluation at the Vietnam national burn hospital

Background Prognostic scoring systems for elderly burn patients may differ from those used in the general burn population because of age-related comorbidities. This study aimed to evaluate the prognostic scoring system in elderly burn patients treated at the Vietnam National Burn Hospital. Methods A retrospective descriptive study was conducted involving 648 burn patients aged ≥65 years who were treated at the Department of Emergency and Intensive Care, Vietnam National Burn Hospital. Results The mortality rate was 7.62%. Increasing age, hypertension, deep TBSA, and inhalation injury were independent factors associated with mortality in elderly burn patients ( p < 0.05). The VNB score for prognostic assessment in elderly burn patients was calculated as follows: VNB score = Age + 2 × Deep Burn Area (%TBSA) + 15 × Inhalation Injury +10 × Hypertension. The VNB score showed excellent prognostic performance for mortality, with an AUC of 0.95 (95% CI: 0.91–0.98). At a cut-off of 99 points, sensitivity and specificity were 86.96% and 88.89%, respectively. The model demonstrated good calibration, with a Hosmer-Lemeshow χ 2 = 3.40 ( p = 0.907), a low Brier score (0.03), an observed-to-expected (O: E) ratio of 1.000, and a calibration-in-the-large (CITL) of 0. Kaplan–Meier survival analysis showed a significant difference in survival probability between patients with a VNB score < 99 and those with a VNB score ≥ 99. Patients with a VNB score ≥ 99 showed a significantly lower survival probability, particularly within the first 20 days after burn injury ( p < 0.001). Conclusion Increasing age, hypertension, deep TBSA, and inhalation injury were independent factors associated with mortality in elderly burn patients ( p < 0.05). The VNB score demonstrated excellent performance in predicting mortality among elderly burn patients (AUC = 0.95).