title: Serum albumin level as a risk factor for mortality in burn patients.
abstract: OBJECTIVE
  Hypoalbuminemia is a common clinical deficiency in burn patients and is associated with complications related to increased extravascular fluid, including edema, abnormal healing, and susceptibility to sepsis. Some prognostic scales do not include biochemical parameters, whereas others consider them together with comorbidities. The purpose of this study was to determine whether serum albumin can predict mortality in burn patients.
  
  
  METHODS
  We studied burn patients ≥16 years of age who had complete clinical documentation, including the Abbreviated Burn Severity Index, serum albumin, globulin, and lipids. Sensitivity and specificity analyses were performed to determine the cut-off level of albumin that predicts mortality.
  
  
  RESULTS
  In our analysis of 486 patients, we found that mortality was higher for burns caused by flame (p=0.000), full-thickness burns (p=0.004), inhalation injuries (p=0.000), burns affecting >30% of the body surface area (p=0.001), and burns associated with infection (p=0.008). Protein and lipid levels were lower in the patients who died (p<0.05). Albumin levels showed the highest sensitivity and specificity (84% and 83%, respectively), and the area under the receiver-operating characteristic curve (0.869) had a cut-off of 1.95 g/dL for mortality.
  
  
  CONCLUSIONS
  Patients with albumin levels <2 g/dL had a mortality risk of >80%, with 84% sensitivity and 83% specificity. At admission, the albumin level could be used as a sensitive and specific marker of burn severity and an indicator of mortality.
authors.affiliation: Internal Medicine and Geriatrics Department, Medical Unit of High Specialty, Mexican Institute of Social Security, Specialties Hospital of the Western Medical Center, Guadalajara, Jalisco/Mexico. avygail5@gmail.com
authors.forename: Olivia Alejandra
authors.initials: OA
authors.lastname: Aguayo-Becerra
authors.forename: Carlos
authors.initials: C
authors.lastname: Torres-Garibay
authors.forename: Michel Dassaejv
authors.initials: MD
authors.lastname: Macías-Amezcua
authors.forename: Clotilde
authors.initials: C
authors.lastname: Fuentes-Orozco
authors.forename: Mariana de Guadalupe
authors.initials: Mde G
authors.lastname: Chávez-Tostado
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Andalón-Dueñas
authors.forename: Arturo
authors.initials: A
authors.lastname: Espinosa Partida
authors.forename: Andrea Del Socorro
authors.initials: Adel S
authors.lastname: Alvarez-Villaseñor
authors.forename: Ana Olivia
authors.initials: AO
authors.lastname: Cortés-Flores
authors.forename: Alejandro
authors.initials: A
authors.lastname: González-Ojeda
mesh_terms: D000328:Adult; D002056:Burns / Q000097:blood* / Q000401:mortality*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood* / Q000150:complications / Q000401:mortality; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis*; D055815:Young Adult
chemical_list: D012709:Serum Albumin
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