Serum amyloid A protein in the prediction of postburn complications and fatal outcome in patients with severe burns.
Fifty adults hospitalized with extensive burns formed the basis of the present study. Serum amyloid A protein, C-reactive protein, alpha 1-antichymotrypsin and alpha 1-acid glycoprotein were measured in serum samples taken on admission, and 3 and 7 days later. Fatal outcome was observed in 13 out of 14 (93%) patients with serum amyloid A protein over 100 mg/l on admission and in only 2 of the remaining 36 (6%) patients with serum amyloid A protein below 100 mg/l. The median serum amyloid A protein concentration on admission in 15 patients with fatal outcome was 134 mg/l, and only 30 mg/l in 35 patients who recovered (p < 0.00005). As a reference value, the level of 100 mg serum amyloid A protein per litre on admission gave an evident predictive value (93%) and sensitivity (87%) for fatal outcome. The difference between serum amyloid A protein concentrations in patients with complications (median 642 mg/l) and those without complications (median 250 mg/l) was statistically very significant (p = 0.0003) three days after burn injury. The level of 400 mg/l as a reference value 3 days after burn injury gave a reasonable predictive value (80%) and sensitivity (74%) for the development of postburn complications, but patients who died did not develop a hypermetabolic reaction and their serum amyloid A protein concentration remained below 400 mg/l, despite high serum amyloid A protein concentrations observed on admission (above 100 mg/l). No statistical significance was observed for the other 3 acute phase proteins investigated in this study.
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Department of Clinical Chemistry, University Hospital for Traumatology, Zagreb, Croatia.
Coen
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Simić
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000097:blood* / Q000401:mortality; D002097:C-Reactive Protein / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D009961:Orosomucoid / Q000032:analysis; D011379:Prognosis; D000685:Serum Amyloid A Protein / Q000032:analysis*; D000514:alpha 1-Antichymotrypsin / Q000032:analysis
D009961:Orosomucoid; D000685:Serum Amyloid A Protein; D000514:alpha 1-Antichymotrypsin; D002097:C-Reactive Protein