The epidemiology and prognosis of patients with massive burns: A multicenter study of 2483 cases

•The etiological characteristics of different age groups should be considered for prevention.•The prehospital emergency burn care in China is relatively unsatisfactory at present.•BI can be a reliable prognostic factor in severely burned patients.•The BI of 29 in the 0–14 years, 43.5 in the 15–59 years and 35.5 in the ≧60 years group are the threshold for mortality.•A large BI, elderly age, delayed admission and inhalation injury are the main risk factors for death. Epidemiological features of massively burned patients in China remains unclear. This study was designed to investigate the epidemiological characteristics and evaluate the burn index (BI) and other risk factors associated with the prognosis of massively burned patients. Data of patients with ≥30% total body surface area burned admitted in 2014 were retrieved from 106 burn centers in the mainland of China. Information of epidemiological features and the outcome were collected for retrospective analysis. A total of 2483 massively burned patients were included in this study, with a male-to-female ratio of 2.29:1, the mean age of 49.23±16.67 years, mean TBSA of 55.53±21.39% and the mean BI of 39.75±21.59. Scald accounted for 81.07% of the injuries in children, while flame accounted for 66.89% and 74.31% of the injuries in adults and seniors. Approximately 17.76% of the patients were admitted to the local burn center after 6h of injury, and the wound areas of 1154 (46.48%) patients were covered with folk remedies. The mortality was 9.79%, and the area under the receiver operating characteristic (ROC) curve for BI was 0.941 (95% CI, 0.929–0.954). When the value of BI was above a threshold of 29 in the 0–14 years age group, 43.5 in the 15–59 years age group and 35.5 in the 60 years or older age group, the mortality increased significantly. Multivariate logistic regression analyses showed that the odds ratio (OR) of death increased 6% with an increase in the BI of 1.0. Patients older than 60 years, the admission time longer than 6h after-injury (adjusted OR, 1.797; 95% CI, 1.179–2.740; adjusted p