Serum Albumin Concentration on Admission as a Predictor of Morbidity and Mortality in Patients With Burn Injuries

• Published in: Journal of burn care & research 2021-09, Vol.42 (5), p.991-997
• Main Authors: Bandeira, Nilmar G, Barroso, Marcus Vinícius V S, Matos, Marcos Antônio A, Filho, Alexandre L M, Figueredo, Adson A, Gravina, Paula R, Klein, Sibele O T
• Format: Article
• Language: English
• Subjects: Adult; Burns - blood; Burns - mortality; Burns - physiopathology; Female; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; Prospective Studies; Risk Factors; Serum Albumin - analysis
• ISSN: 1559-047X; 1559-0488
• DOI: 10.1093/jbcr/irab004

Abstract Efforts have been made to determine new predictors of morbidity and mortality in patients with severe burn injuries. This prospective cohort study aimed to determine the association of serum albumin concentration on admission and renal failure, pulmonary infection, sepsis, and death in patients with burn injuries. We included 141 patients, aged >18 years, who were admitted to our institution between April and August 2018. Among them, 59.1% were male and 83.8% had burns covering 2.2 g/dL (odds ratios [OR]: 18.7; 95% confidence interval [CI]: 4.9 to 70.8). Serum albumin ≤2.2 g/dL was also significantly associated with pulmonary infection (OR: 13.1, 95% CI: 3.8 to 45.7), renal failure (OR: 30.2, 95% CI: 7.4 to 122.3), and sepsis (OR: 16.9, 95% CI: 4.9 to 58.3). Serum albumin concentration cut-points and ABSIs were determined to be death predictors using areas under the receiver operating characteristic curves (AUCs). The AUCs with albumin or ABSI alone were 0.89 (95% CI: 0.79 to 0.98) and 0.92 (95% CI: 0.87 to 0.96), respectively. The AUC including both albumin and ABSI was 0.96 (95% CI: 0.90 to 0.98), indicating that the combination is a better death predictor than either measure alone. We confirmed that burn patients with a serum albumin concentration ≤2.2 g/dL on admission have substantially increased morbidity and mortality.