The impact of first-day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortality

Introduction: In severe burns, there is a profound systemic response that persists till the wounds heal. Since these physiological and metabolic derangements are dynamic over the clinical course of burns, it is expected that both trend of change and absolute values of the protein and lipid levels, t...

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Main Authors: Shobhit Gupta, Sameek Bhattacharya, Parul Goyal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2018-01-01
Series:Indian Journal of Burns
Subjects:
Online Access:http://www.ijburns.com/article.asp?issn=0971-653X;year=2018;volume=26;issue=1;spage=48;epage=54;aulast=Gupta
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author Shobhit Gupta
Sameek Bhattacharya
Parul Goyal
author_facet Shobhit Gupta
Sameek Bhattacharya
Parul Goyal
author_sort Shobhit Gupta
collection DOAJ
description Introduction: In severe burns, there is a profound systemic response that persists till the wounds heal. Since these physiological and metabolic derangements are dynamic over the clinical course of burns, it is expected that both trend of change and absolute values of the protein and lipid levels, to have a bearing on the prognosis and the ultimate outcome. Hence, this study was envisaged evaluate the prognostic value of these metabolic variables in burn patients. Materials and Methods: The study conducted on 100 adult patients of thermal burn (20% and 60% total body surface area). Serum albumin, globulin, total proteins, cholesterol and triglycerides (TGs) were estimated on alternate days starting from day till discharge or death. The 1st-day value and the trend of serial values throughout the clinical course were compared among nonsurvivors and survivors. Results: Mean serum values of albumin, globulin, and total protein on first-day of burns in survivor group were higher. Serum albumin levels of ≤2.1 g/dl at day one was a poor prognostic factor. The trend in the serum values of albumin, globulin, total protein, and cholesterol in survivor group was significantly positive and negative in nonsurvivors. Serum TGs, however, showed a nonsignificant negative trend in the survivors. Among the biochemical markers evaluated, most significant prognostic parameter was serum albumin, with maximum sensitivity and specificity. Conclusion: The cutoff values of proteins and trend of subsequent serial values can guide metabolic manipulations, albumin infusion, and dietary intake. In addition, these biochemical parameters merit inclusion in burn prognostic index scales.
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spelling doaj.art-106b0974159147e5965c473c6e5662892022-12-21T23:21:12ZengWolters Kluwer Medknow PublicationsIndian Journal of Burns0971-653X2018-01-01261485410.4103/ijb.ijb_4_18The impact of first-day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortalityShobhit GuptaSameek BhattacharyaParul GoyalIntroduction: In severe burns, there is a profound systemic response that persists till the wounds heal. Since these physiological and metabolic derangements are dynamic over the clinical course of burns, it is expected that both trend of change and absolute values of the protein and lipid levels, to have a bearing on the prognosis and the ultimate outcome. Hence, this study was envisaged evaluate the prognostic value of these metabolic variables in burn patients. Materials and Methods: The study conducted on 100 adult patients of thermal burn (20% and 60% total body surface area). Serum albumin, globulin, total proteins, cholesterol and triglycerides (TGs) were estimated on alternate days starting from day till discharge or death. The 1st-day value and the trend of serial values throughout the clinical course were compared among nonsurvivors and survivors. Results: Mean serum values of albumin, globulin, and total protein on first-day of burns in survivor group were higher. Serum albumin levels of ≤2.1 g/dl at day one was a poor prognostic factor. The trend in the serum values of albumin, globulin, total protein, and cholesterol in survivor group was significantly positive and negative in nonsurvivors. Serum TGs, however, showed a nonsignificant negative trend in the survivors. Among the biochemical markers evaluated, most significant prognostic parameter was serum albumin, with maximum sensitivity and specificity. Conclusion: The cutoff values of proteins and trend of subsequent serial values can guide metabolic manipulations, albumin infusion, and dietary intake. In addition, these biochemical parameters merit inclusion in burn prognostic index scales.http://www.ijburns.com/article.asp?issn=0971-653X;year=2018;volume=26;issue=1;spage=48;epage=54;aulast=GuptaAlbuminburnslipidsprognosistotal proteintrends
spellingShingle Shobhit Gupta
Sameek Bhattacharya
Parul Goyal
The impact of first-day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortality
Indian Journal of Burns
Albumin
burns
lipids
prognosis
total protein
trends
title The impact of first-day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortality
title_full The impact of first-day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortality
title_fullStr The impact of first-day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortality
title_full_unstemmed The impact of first-day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortality
title_short The impact of first-day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortality
title_sort impact of first day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortality
topic Albumin
burns
lipids
prognosis
total protein
trends
url http://www.ijburns.com/article.asp?issn=0971-653X;year=2018;volume=26;issue=1;spage=48;epage=54;aulast=Gupta
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