The prognostic value of nutritional and inflammatory indices in patients with burns.
The Prognostic Inflammatory and Nutritional Index (PINI = [alpha 1-acid glycoprotein x C-reactive protein] divided by [albumin x prealbumin]) has been proposed as a means of predicting morbidity or mortality in hospitalized patients. This study compared the efficacy of the PINI versus its individual determinants as potential prognostic indicators of infection or death in patients with burns. Laboratory data from postburn days 7 to 10 were evaluated in a series of 60 patients who had a mean total body surface area (TBSA) burn of 44.7% (range 10% to 81%) and a mean age of 18.9 years (range, 0.5 to 71 years). Survivors had a mean TBSA burn of 42.9%, whereas patients who subsequently died had a mean TBSA burn of 51.8% (not significant). Percent third-degree burn and alpha 1-acid glycoprotein were likewise not related to the mortality rate. We found the PINI to be associated with death (p less than 0.0003), as were the variables C-reactive protein (p less than 0.0002), prealbumin (p less than 0.0001), and albumin (p less than 0.03). Thirty-six patients had infectious complications that were statistically related to percent burn (p less than 0.02), percent third-degree burn (p less than 0.003), alpha 1-acid glycoprotein (p less than 0.05), prealbumin (p less than 0.0009), and the PINI (p less than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)
Gottschlich
M M
MM
Nutrition Services, Shriners Burns Institute, Cincinnati, OH 45219.
Baumer
T
T
Jenkins
M
M
Khoury
J
J
Warden
G D
GD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000418:Albumins / Q000032:analysis; D002056:Burns / Q000401:mortality / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007239:Infections / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011228:Prealbumin / Q000032:analysis; D011379:Prognosis; D012680:Sensitivity and Specificity
D000418:Albumins; D011228:Prealbumin; D002097:C-Reactive Protein