A model for acute kidney injury in severe burn patients

Karakaya, Emre; Akdur, Aydıncan; Aydoğan, Cem; Türk, Emin; Sayın, Cihat Burak; Soy, Ebru H. Ayvazoglu; Yücebaş, Sait Can; AlShalabi, Omar; Haberal, Mehmet

doi:10.1016/j.burns.2021.04.004

Cited by 8 publications

(8 citation statements)

References 41 publications

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“…Combining multiple independent risk factors to establish a risk prediction model has been proved to significantly improve the prognostic value (40,41). There is an urgent need for novel predictive models to improve and personalize burn outcomes (7).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns

Lin

Zheng

et al. 2021

Shock

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Background: Platelet distribution width (PDW) and PDW-to-platelet ratio (PPR) have been proven to be good prognostic indicators for many diseases. However, their prognostic values in severe burns have not been reported. Objective: To investigate the early time course of PDW and PPR in severe burn patients and investigate their prognostic values. Methods: This is a 16-year, single-center retrospective study of 590 severe burn patients. The complete blood count parameters on day 1, day 3, and day 7 postburn, including PDW and PPR, were collected. Receiver operating characteristic curves (ROC) analysis, multiple logistic regression analysis and Kaplan-Meier survival analysis were performed to evaluate the prognostic values of PDW and PPR in severe burn patients. Results: According to 120-day follow-up records, 96 patients were nonsurvivors and 494 patients were survivors. ROC and area under the curve (AUC) analysis showed that, for predicting 120-day prognosis, the AUC of PDW (0.782) and PPR (0.816) on day 3 was the highest, followed by the AUC of PDW (0.764) and PPR (0.750) on day 7. The ROC-AUC of PPR (0.816) on day 3 was very close to that of the ABSI score (0.818). Multiple logistic regression analysis showed that the PDW (P ¼ 0.033 and P ¼ 0.009) and PPR (P ¼ 0.052 and P ¼ 0.046) on day 3 and day 7 were all significantly independently positively associated with 120-day mortality. Kaplan-Meier survival analysis showed that high PDW and PPR were both significantly associated with a high 120-day mortality rate on day 3 and day 7. Conclusion: PDW and PPR on day 3 and day 7 were independent risk factors for 120-day mortality in severe burn patients. These objective and readily available prognostic indicators may be more clinically favored.

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Section: Discussionmentioning

confidence: 99%

Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns

Lin

Zheng

et al. 2021

Shock

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“…This increased risk may be due to the hypovolemia secondary to burn injury. Previous studies also demonstrated that increased hemoglobin values and heme proteins can lead to acute kidney damage [24][25]. In an interesting study by Karakaya et al where they created burn injury criteria, hemoglobin values were detected as a factor that affects development of AKI [25].…”

Section: Discussionmentioning

confidence: 99%

“…As a result of univariate analysis, the results of the multivariate logistic regression model made with the forward: wald method were given, taking into account the variables with p<0. 25…”

Section: Methodsmentioning

confidence: 99%

Acute Kidney Injury In Pediatric Burn Patients

KAHRAMANLAR,

OZLU,

DEMİR

et al. 2023

Preprint

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Objective: Acute kidney injury (AKI) is a common and important complication of burn injury. Although there are numerous adult studies data regarding AKI in pediatric burn patients is scarce. In this study we aimed to evaluate the frequency, clinical features and prognosis of AKI among pediatric burn injury patients. Methods: This is a retrospective cohort study. Patients aged between 1 month and 18 years followed in pediatric burn intensive care unit between years 2011 and 2017 were included in the study.Patients with known kidney disease were not included. Demographic data, laboratory and clinical variables, management strategies and prognosis were obtained from the hospital records of the patients. Factors associated with AKI were determined by logistic regression analysis. Results: A total of 697 patients had been followed up and among them 87 (12.5%) had acute kidney injury. Older age, being a refugee, prolonged duration between the incident and time of hospitalization, presence of sepsis and severity and type of burn, the amount of fluid administered, being intubated, accompanying organ failure were all related with the development of AKI. According to multivariate logistic regression analysis the most important contributors of AKI were older age and increased serum hemoglobin values. Conclusion: As observed in adults AKI is also an important and common complication of burn injury among pediatric burn patients. Early recognition and prompt and appropriate management is crucial to avoid morbidity and mortality.

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“…An increased NLR may also be a risk factor for MODS, though the literature primarily focuses on acute kidney injury (AKI). Tissue destruction may include structures below the skin and infection within the visceral organs [ 76 ]. Karakaya and colleagues found that burn patients who maintained an increased NLR also exhibited a higher incidence of AKI.…”

Section: Discussionmentioning

confidence: 99%

“…Karakaya and colleagues found that burn patients who maintained an increased NLR also exhibited a higher incidence of AKI. This is likely due to the impact concomitant infections have on AKI pathogenesis [ 76 ]. Interestingly, Younan and colleagues found an increased NLR to be significantly associated with both the development of organ failure.…”

Section: Discussionmentioning

confidence: 99%

Association of inflammatory biomarkers with overall survival in burn patients: a systematic review and meta-analysis

Nourigheimasi,

Yazdani,

Ghaedi

et al. 2024

BMC Emerg Med

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Introduction The inflammatory response to burn injuries can lead to organ dysfunction that ultimately results in increased mortality and morbidity. This meta-analysis was conducted to determine the efficacy of inflammatory biomarkers, including the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), procalcitonin (PCT), and C-reactive protein (CRP) as predictive tools of mortality among burn patients. Material and methods The biomarker levels of survivors and non-survivors were consolidated according to guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Three main databases were searched electronically: PubMed, Web of Science, and Scopus, on December 8, 2022. The Newcastle–Ottawa Quality Assessment Scale (NOS) was used to evaluate and score the methodological quality of the included studies. The standard mean difference (SMD) with a 95% confidence interval (CI) was utilized. Results Twenty-four studies were included in our systematic review and meta-analysis, (3636 total burn patients), of whom 2878 survived. We found that deceased burn patients had elevated levels of NLR (SMD = 0.60, 95% CI; 0.19–1.00, P < 0.001), CRP (SMD = 0.80, 95% CI; 0.02–1.58, P = 0.04), and PCT (SMD = 0.85, 95% CI; 0.45–1.24, P < 0.001), compared to survivors. However, we found no association between PLR and mortality among burn patients (SMD = 0.00, 95% CI; -0.14–0.15, P < 0.001). In addition, CRP was significantly higher in non-survivors (SMD = 0.80, 95% CI; 0.02–1.58, P =0.04). Similar results were also found about PCT (SMD = 0.85, 95% CI; 0.45–1.24, P < 0.001). When we analyzed the PCT data, collected in the first 24-48 hours, we found similar results; the PCT level was significantly higher in non-survivors in the immediate postinjury-period (SMD = 0.67, 95% CI; 0.31–1.02, P < 0.001). There was no publication bias among studies on the role of NLR in burn (Egger’s test P = 0.91). The based cut-off values for NLR (13), CRP (71), and PCT (1.77) yielded sensitivities of 69.2%, 100%, and 93.33%, and specificities of 76%, 72.22%, and 72.22% respectively. Discussion/Conclusions PCT is a marker of sepsis, therefore its elevated level is presumably associated with a higher incidence and severity of sepsis among non-survivors. In addition, NLR and CRP are promising biomarkers for predicting and guiding prevention against burn deaths in clinical settings.

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A model for acute kidney injury in severe burn patients

Cited by 8 publications

References 41 publications

Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns

Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns

Acute Kidney Injury In Pediatric Burn Patients

Association of inflammatory biomarkers with overall survival in burn patients: a systematic review and meta-analysis

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