Base Deficit, Serum Albumin Level And Blood Haemoglobin Concentration Can Be Used As Predictor Factors For Mortality In Major Burn Patients.

Abstract

Hypoalbuminemia as seen in major burn injury results in widespread endothelial dysfunction. Base deficit provides the best estimate for degree of tissue anoxia. Acute blood loss describes anemia present in burn patients. Controversy focuses on the administration of protein-based colloids: whether to provide them, which solutions to use, and when to begin? The aim of this study was to determine whether alteration of gas exchange, excess base deficit, hypoalbuminemia and anemia could predict mortality in major burn patients, whether to provide protein-based colloids, and when to begin fluid resuscitation. The prospective study included 42 major burn patients. All the patients were admitted to the burn intensive care unit at Menoufia University Hospital. Serum albumin level, hemoglobin concentration, arterial blood gases and base deficit were measured at admission, third day and after one week. Average serum albumin on admission was 3.33 ± 0.44, after 3 days 2.85 ± 0.54 and after 1 week 2.46 ± 0.67 gm./dL, while hemoglobin concentration was 14.79 ± 2.13, 12.25 ± 1.99, and 10.24 ± 2.47 gm./dl respectively. However, base deficit was 5.75 ± 2.40, 5.24 ± 2.05 and 5.45 ± 2.76 respectively, with significant statistical difference (p<0.001) between the death and survivor groups. Binary logistic regression analysis for independent predictors of mortality declared that base deficit, albumin and hemoglobin serum levels were independent predictors for mortality with an odds ratio of 2.23, 95% CI, 1.66-16.75 for base deficit, 3.56, 95% CI, 1.88-12.59 for albumin and 2.21, 95% CI, 1.56-13.54 for hemoglobin. Hypoalbuminemia, anemia and excess base deficit can be used as prognostic factors for mortality in major burn patients.