To explore the construction of a death risk diagnosis model in elderly burn patients after tracheotomy and analyze the countermeasures.

From January 2013 to January 2023, clinical data of 212 senior burn patients at the third Affiliated Hospital of Inner Mongolia Medical University were collected. The patients were divided into 2 groups based on whether they survived (n=156) or died (n=56) after 60 days of hospitalization. The 2 groups′ clinical data and complications during hospitalization were compared and studied. To examine the independent risk factors for mortality, the variables with statistically significant differences between the 2 groups were included in the multivariate Logistic regression model. To test the model's performance, the model nomogram was established and the receiver operating characteristic (ROC) curve was generated. The concordance index was used to evaluate the model′s prediction performance, while the calibration curve was utilized to explain the prediction model′s conformance.

The age [(67.32±5.87) years old, (71.67±7.57) years old, t=2.76], total hospitalization time [(49.35±18.76) days, (30.14±8.81) days, t=7.12], the stay time in the burn intensive care unit [(20.83±10.61) days, (26.64±8.81) days, t=2.59], Ⅲ ° burn area [9.50(3.00, 15.00)%, 12.00(4.00, 17.00)%, Z=2.84], total burn area [20.00(15.00, 26.00)%, 38.00(24.25, 55.00)%, Z=3.84], basic disease before injury [64(41.02%), 44(78.57%), χ²=23.24], ventilator-assisted respiration [49(31.41%), 25(44.64%), χ²=13.70] and incidence of ventilator-associated pneumonia (VAP) [34(21.79%), 25(44.64%), χ²=10.71] showed statistically significant differences between the 2 groups (all P<0.05). The results of multivariate Logistic regression analysis showed that age (OR=2.041, 95%CI 1.524-2.807), basic disease before injury (OR=2.153, 95%CI 1.572-3.046), and VAP (OR=3.697, 95%CI 1.622-9.035) were independent risk factors for mortality (all P<0.01).The calibration curve′s concordance index was 0.906, and the area under the ROC curve was 0.872 (95%CI 0.821-0.923). The prediction model's calibration curve demonstrated that the prediction results were congruent with the clinical prognosis.

Age, pre-existing disease before injury and VAP are independent risk factors for death in elderly burn patients with tracheotomy, the treatment of pre-existing diseases before injury, as well as VAP prevention should be strengthened.