title: Prediction of mortality in patients with major burns: clinical and biochemical factors.
abstract: OBJECTIVE
  The plasma electric charge, in addition to clinical factors, was considered to improve the prediction of mortality in patients with major burns.
  
  
  METHODS
  A software called PICAL 5.0 was used to determinate the plasma electric charge in 143 patients with major burns from the intensive care burn unit-Unfallkrankenhaus Berlin (Germany). In addition, a retrospective study with these patients was developed involving: (1) biochemical variables in the first 48 hours: pH value, [albumin], [Ca(2+)], etc; (2) clinical aspects: age, total body surface area and full-thickness surface area burned, diagnosis of inhalation injury, etc. A mortality predictive equation was calculated from univariate and multivariate logistic regression analyses in a set of randomly chosen participants and applied to a validation set of 35 participants.
  
  
  RESULTS
  The importance of each ion and protein for the equilibrium in the plasma charge is determinant. In statistical multivariate analysis, age, total body surface area burned, pH value, and [Mg(2+)] were independently associated with mortality.
  
  
  CONCLUSIONS
  [Na(+)], [HCO(3)(-)] (bicarbonate), and [Cl(-)] are the ions contributing the most to the plasma charge equilibrium in patients with major burns; a loss of 50% of plasma proteins in the first 48 hours is equivalent to the loss of 1 mmol/L of HCO(3)(-). Moreover, the consideration of plasma biochemical parameters in the first 48 hours may improve the mortality predictive equation of mortality for burned victims.
authors: Plastic Surgery and Burns Department, Hospital Universitario de Getafe, Madrid, Spain. mail@andresmaldonado.es
authors: Andrés A
authors: AA
authors: Maldonado
authors: Antonio
authors: A
authors: Sillero
authors: Markus
authors: M
authors: Küntscher
mesh_terms: D000137:Acid-Base Imbalance / Q000097:blood / Q000209:etiology; D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002056:Burns / Q000097:blood / Q000150:complications / Q000401:mortality* / Q000473:pathology; D055724:Electrophysiological Phenomena; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D010949:Plasma / Q000737:chemistry; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012984:Software
chemical_list: D015415:Biomarkers