Laboratory Predictors for Morbidity and Mortality after Thermal Burns in Pediatrics

Abstract

Background: The utility of laboratory values to predict complications in pediatric burn patients is poorly understood. This study assessed the laboratory investigations’ role in morbidities and mortalities prediction after moderate and severe thermal burn in pediatrics.
 Methods: This prospective cohort study was carried out on 40 children with moderate and major thermal burn. All patients were subjected to clinical evaluation and laboratory investigations such as CBC, c-reactive protein (CRP), serum albumin, serum creatinine and urea.
 Results: Patients were subdivided into two groups: uncomplicated group (n=25) and complicated group (n=15). CRP, serum albumin, platelet count, serum creatinine and urea can significantly predict sepsis incidence with AUC of 0.922, 0.912, 0.911, 0.807, 0.810, at cut off >12, ≤2, ≤194, >0.7, >23, with sensitivity of 100%, 90.91%, 100 %,100 %, 85.71%, specificity of 86.21 %, 86.21%, 79.31%, 24.24%, 39.39%, PPV of 73.3 %, 71.4%, 64.7%, 21.9% , 23.1% and NPV of 100 %, 96.2 %, 100 %, 100 % , 92.9% respectively. Serum creatinine and urea can significantly predict incidence of acute kidney injury (AKI) with AUC of 0.807, 0.810 At cut off >0.7, >23, with sensitivity of 100.00 %, 85.71%, specificity of 24.24%, 39.39%, PPV of 21.9%, 23.1% and NPV of 100.0%, 92.9% respectively. Percent of burn, total ABSI, CRP, platelet, inhalation injury, albumin, creatinine and urea were dependent predictors for mortality. Sex, inhalation injury, percent of burn, total ABSI, hemoglobin, CRP, platelet, albumin, and creatinine were dependent predictors for sepsis. Sex, inhalation injury, percent of burn, total ABSI, CRP, hemoglobin, platelet, albumin and creatinine were dependent predictors for complication of acute kidney disease.
 Conclusions: CRP, serum albumin, platelet count, serum creatinine and urea are good predictors of sepsis, AKI and mortalities after moderate to severe burn in pediatrics.