Revised Baux Score Calculator — Burn Mortality Prediction
The Revised Baux Score is a validated prognostic tool for predicting mortality in burn patients. It combines age, total body surface area (TBSA) of burns, and the presence of inhalation injury to estimate mortality risk. Originally described by Baux in 1961 and revised by Osler et al. in 2010, this score remains one of the most widely used burn prognosis tools.
About
The original Baux score, proposed by Professor Serge Baux in 1961, simply added the patient's age to the percentage of total body surface area (TBSA) burned. The Revised Baux Score, validated by Osler, Glance, and Hosmer in 2010 using the National Burn Repository database (n=39,888), adds 17 points for the presence of inhalation injury. This revision significantly improved the score's predictive accuracy for in-hospital mortality (AUC >0.95). The score is applicable to all burn etiologies and is recommended by the American Burn Association for baseline mortality risk stratification.
Formula
Revised Baux = Age (years) + TBSA (%) + (17 × Inhalation Injury [0 or 1])
The Revised Baux Score is calculated by adding the patient's age in years to the percentage of total body surface area (TBSA) burned, plus 17 points if inhalation injury is present. TBSA is estimated using the Rule of Nines or Lund-Browder charts. Inhalation injury is diagnosed clinically (history of closed-space fire, facial burns, carbonaceous sputum) or bronchoscopically. Mortality risk categories: <100 (<50% predicted mortality), 100-129 (50-90%), 130-149 (90-95%), ≥150 (>95%). Important caveats: The score is most accurate for patients aged 20-80 and TBSA 10-90%. Extremes of age or burn size may reduce accuracy. The score estimates baseline mortality risk and should be used alongside clinical judgment when making treatment decisions.
Score Interpretation
The Revised Baux Score is one of the most extensively validated burn mortality prediction tools. The original Baux score has been used clinically for over 60 years, and the revision incorporating inhalation injury significantly improved its accuracy. The score is used in burn triage, for patient and family counseling regarding prognosis, for benchmarking burn center outcomes, and for risk adjustment in burn research. The simple three-variable model (age, TBSA, inhalation injury) has proven to be as accurate as more complex scoring systems. The score is endorsed by the American Burn Association and is included in the National Burn Repository dataset as a standard prognostic variable.
Low Mortality Risk (<50%) — 0–99
Revised Baux <100. Low predicted mortality.
Management: Standard burn care with fluid resuscitation. Wound care and infection prevention. Consider burn unit referral if TBSA >10%.
Moderate Mortality Risk (50-90%) — 100–129
Revised Baux 100-129. Moderate predicted mortality.
Management: Admit to specialized burn unit. Aggressive fluid resuscitation. Monitor for inhalation injury complications. Consider early escharotomy.
High Mortality Risk (90-95%) — 130–149
Revised Baux 130-149. High predicted mortality.
Management: Burn ICU admission. Multidisciplinary burn team. Advanced hemodynamic monitoring. Discuss prognosis with family.
Very High Mortality Risk (>95%) — 150+
Revised Baux ≥150. Very high predicted mortality.
Management: Burn ICU with aggressive goal-directed therapy. Palliative care consult if appropriate. Ethical committee discussion for extreme cases.
Reference Ranges
| Population | Normal Range | Notes |
|---|---|---|
| Adult burn patients | 0-200+ (Low: <100, Moderate: 100-129, High: 130-149, Very High: ≥150) | Higher score = higher mortality. AUC >0.95 for in-hospital mortality prediction. |
Dr. Mahmoud El-Sayed
Dr. Mahmoud is an endocrinology consultant with expertise in critical care and surgical metabolic assessment.
View medical review board & editorial policy →Example Calculation
A 65-year-old man is brought to the emergency department following a house fire. He has facial burns with singed nasal hairs and carbonaceous sputum indicating inhalation injury. Physical exam shows burns covering approximately 40% TBSA involving his arms, anterior chest, and back. Revised Baux = 65 + 40 + (17 × 1) = 122. This falls in the moderate mortality risk category (50-90% predicted mortality). The patient is admitted to the burn ICU for aggressive fluid resuscitation, escharotomy of circumferential extremity burns, and bronchoscopic evaluation of inhalation injury. Despite intensive management, his hospital course is complicated by ARDS and multi-organ dysfunction.
Related Conditions
Related Medications
Common Mistakes
Not accounting for inhalation injury in the score
Inhalation injury adds 17 points and significantly increases mortality risk. Always assess for inhalation injury using history (closed-space fire) and clinical findings (facial burns, carbonaceous sputum).
Using the original Baux score (age + TBSA only)
The Revised Baux Score includes inhalation injury and is more accurate. Use the revised version for mortality prediction.
Applying the score to predict individual patient outcomes
The score predicts population-level mortality risk. Individual outcomes vary widely based on comorbidities, quality of care, and patient physiology. Use as a guide, not a deterministic prediction.
Frequently Asked Questions
How is TBSA estimated in burn patients?
Is the Revised Baux Score validated for all burn types?
Should the Revised Baux Score guide withdrawal of care decisions?
References
- Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the Baux score. J Trauma. 2010;68(3):690-697. PubMed
- Baux S. Contribution à l'étude du traitement local des brûlures thermiques étendues. Paris: These de Doctorat en Médecine; 1961.
- Smith DL, Cairns BA, Ramadan F, et al. Effect of inhalation injury, burn size, and age on mortality: a study of 1447 consecutive burn patients. J Burn Care Rehabil. 1994;15(3):259-265. PubMed
- American Burn Association. Advanced Burn Life Support Course Provider Manual. 2018 Update.