Background: Early prediction of mortality remains fundamental in the management of severe burn injuries because it facilitates risk stratification, clinical decision-making, family counseling, and allocation of limited healthcare resources. Although the Revised Baux Score (rBaux), which incorporates age, total body surface area (TBSA), and inhalation injury, has demonstrated favorable prognostic performance in several countries, evidence from low- and middle-income settings remains limited. This study aimed to evaluate the predictive value of the Revised Baux Score for in-hospital mortality among burn patients treated at a tertiary referral burn center in Indonesia.

Methods: A retrospective cohort study was conducted using medical records of burn patients admitted to the Burn Unit of H. Adam Malik General Hospital, Medan, Indonesia, between 2021 and 2026. Demographic characteristics, burn etiology, TBSA, burn depth, inhalation injury, comorbidities, and Revised Baux Scores were collected. Clinical characteristics were compared between survivors and non-survivors. Multivariable logistic regression was performed to identify independent predictors of mortality, while the discriminatory performance of the Revised Baux Score was evaluated using receiver operating characteristic (ROC) curve analysis with calculation of the area under the curve (AUC).

Results: A total of 113 patients were included, of whom 59 (52.2%) died during hospitalization. Non-survivors were significantly older, had larger total body surface area (TBSA) burns, and higher Revised Baux Scores than survivors (all p < 0.001). Inhalation injury was observed exclusively among non-survivors (30.1%, p < 0.001). In multivariable logistic regression, the Revised Baux Score was the only independent predictor of in-hospital mortality (OR 1.265, 95% CI 1.127–1.421; p < 0.001). Receiver operating characteristic analysis demonstrated excellent predictive performance, with an area under the curve of 0.972 (95% CI 0.948–0.997). An optimal cutoff value of ≥86 yielded 89.8% sensitivity and 94.4% specificity for predicting mortality.

Conclusions: The Revised Baux Score is a robust and clinically practical predictor of in-hospital mortality among burn patients in a tertiary referral burn center in Indonesia. Given its simplicity and strong discriminatory performance, the score may serve as an effective early risk stratification tool, particularly in resource-limited healthcare settings. Prospective multicenter validation is warranted to confirm its generalizability across diverse burn populations.