Initial Laboratory Values Can Predict Mortality in Burn Patients

Abstract

Background There are several burn scores used to predict mortality in burn patients. However, minimal data exists on the role of laboratory values in risk stratification. We hypothesized that laboratory derangements seen on admission can predict mortality in burn patients. Materials and Methods A retrospective chart review was conducted on burn patients admitted to a busy Level 1 Trauma and Burn Center from 2013 to 2019. Data analysis included patients with partial or full thickness burns and a total body surface area (TBSA) burn greater than 15%. Exclusion criteria included patients presenting with electrical burns, non-thermal conditions (Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, or soft tissue infections) or patients with significant polytrauma. Results 112 patients were included in the analysis. Admission phosphate, creatinine, albumin, and glucose levels were associated with mortality. There was a difference in serum phosphate (3.48 and 6.04 mg/dL), creatinine (0.85 and 1.13 mg/dL), albumin (3.26 and 2.3 mg/dL), and glucose (138 and 233 mmol/L) levels for survivors and non-survivors; respectively. There were increased mortality rates seen in patients presenting with abnormal serum levels compared to normal serum levels (Phosphate: 7.5% vs. 53.3%, creatinine: 13.5% vs. 38.9%, albumin: 38.5% vs. 8.10% and glucose: 10.1% vs. 31.6% (normal vs. abnormal; respectively)). Serum sodium, potassium, and hemoglobin levels had no association with mortality. Discussion Specific laboratory derangements seen on admission are associated with an increased risk for mortality. This can be used as a framework for future studies in risk stratification of burn victims.

Influence of Nutritional Parameters on the Evolution, Severity and Prognosis of Critically Ill Patients with COVID-19

“…Decreased albumin levels are associated with an increased risk of acute respiratory failure and increased frequency of mechanical ventilation [53]. An association of albumin with mortality was also found in other studies; in COVID-19 patients [54], hip fracture patients [55,56], patients with infectious diseases [57], newborn patients [58], the lactate-to-albumin ratio in patients with acute myocardial infarction [59], the albumin-bilirubin score in patients with hypertrophic cardiomyopathy [60], a combined index of hemoglobin, albumin, lymphocyte, and platelet in patients with acute exacerbations of chronic obstructive pulmonary disease [61], and the albumin-to-prealbumin ratio in hemodialysis patients [62]. In malnourished patients, atrophy of the diaphragmatic muscle and loss of muscle mass can occur, in addition to a deterioration of the immune response, which leads to an increased risk of pneumonia.…”