Serum albumin level as a risk factor for mortality in burn patients

Abstract

OBJECTIVE:Hypoalbuminemia is a common clinical deficiency in burn patients and is associated with complications related to increased extravascular fluid, including edema, abnormal healing, and susceptibility to sepsis. Some prognostic scales do not include biochemical parameters, whereas others consider them together with comorbidities. The purpose of this study was to determine whether serum albumin can predict mortality in burn patients.METHODS:We studied burn patients ≥16 years of age who had complete clinical documentation, including the Abbreviated Burn Severity Index, serum albumin, globulin, and lipids. Sensitivity and specificity analyses were performed to determine the cut-off level of albumin that predicts mortality.RESULTS:In our analysis of 486 patients, we found that mortality was higher for burns caused by flame (p = 0.000), full-thickness burns (p = 0.004), inhalation injuries (p = 0.000), burns affecting >30% of the body surface area (p = 0.001), and burns associated with infection (p = 0.008). Protein and lipid levels were lower in the patients who died (p<0.05). Albumin levels showed the highest sensitivity and specificity (84% and 83%, respectively), and the area under the receiver-operating characteristic curve (0.869) had a cut-off of 1.95 g/dL for mortality.CONCLUSION:Patients with albumin levels <2 g/dL had a mortality risk of >80%, with 84% sensitivity and 83% specificity. At admission, the albumin level could be used as a sensitive and specific marker of burn severity and an indicator of mortality.

Does Ringer Lactate Used in Parkland Formula for Burn Resuscitation Adequately Restore Body Electrolytes and Proteins?

“…Moreover, note that those at the highest risk of death with albumin levels of less than 20 g/L [20] were 6 (7.3%) and 15 (18.3%) initially and in the post-resuscitation phases, respectively in this study. It follows that a significant number of our patients may have been at risk of passing away even though none actually expired in the burn shock phase.…”

“…Similarly, hypertonic crystalloid saline has been associated with renal failure and death in one observational study and seems to offer no added benefit to isotonic solutions [18] [19]. However, there is a resurgence in interest in albumin and a relatively recent study [20] having shown that albumin levels of less than about 2 g/dl (20 g/L) emerged with the highest sensitivity and specificity for mortality. …”

Advanced Age, High β-CTX Levels, and Impaired Renal Function are Independent Risk Factors for All-Cause One-Year Mortality in Hip Fracture Patients

“…Previous authors have [24][25][26]. Low serum albumin levels have also been used as predictors of poor outcome in other diseases as well [27][28][29]. Hypoalbuminaemia is an indicator of protein energy depletion and a marker of poor nutritional status; furthermore, it increases the risk of postoperative complications including poor wound healing, wound infections, pneumonia, and sepsis.…”

Factors affecting mortality among victims of electrical burns

“…Aguayo-Becerra et al [18] reported that burn patients with albumin levels <2 g/dL at admission had a mortality risk of >80%, with 84% sensitivity and 83% specificity. Maldonado et al [19] investigated the role of some biochemical variables including albumin and calcium levels in the prediction of mortality in 143 patients with major burns hospitalized in the ICU but reported that in a multi-variate analysis, only age, the total body surface area burned, the pH value, and the magnesium levels were independently associated with mortality.…”