title: Serum transthyretin level is associated with clinical severity rather than nutrition status in massively burned patients.
abstract: BACKGROUND
  The purpose of this study is to clarify the clinical significance of serum transthyretin (TTR) in massively burned patients in nutrition support and clinical severity.
  
  
  METHODS
  A retrospective study was performed with 204 patients admitted to Hangang Sacred Heart Hospital's Burn Center September 2010-September 2012 with burn wounds > 20% of total body surface area (TBSA) burned. Serum TTR, C-reactive protein (CRP), lactic acid, and an NST index (calculated by dividing real caloric intake by estimated caloric need for 7 days) were analyzed on a weekly basis for 5 weeks after admission.
  
  
  RESULTS
  When we classified patients with severity according to mortality, percentage of TBSA burned, serum lactic acid, and CRP, mean serum TTR level was significantly higher in the less severe patient group than in the severe patient group in each week for every severity index. And the serum TTR level did not show significant differences by NST index in both the severe patient group and the less severe patient group. In a multivariate logistic regression, percentage TBSA burned, TTR, and lactic acid had an independent association with mortality.
  
  
  CONCLUSIONS
  Serum TTR did not show a significant difference by nutrition support in massively burned patients with >20% of TBSA burned. But serum TTR was significantly different by the severity of the patient and independently associated with mortality. Hence, serum TTR level can be 1 of the useful biomarkers for comprehending the severity of the illness in massively burned patients.
authors: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Hyeong Tae
authors: HT
authors: Yang
authors: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Haejun
authors: H
authors: Yim
authors: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Yong Suk
authors: YS
authors: Cho
authors: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Dohern
authors: D
authors: Kim
authors: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Jun
authors: J
authors: Hur
authors: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Jong Hyun
authors: JH
authors: Kim
authors: Department of Plastic Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Jong Wook
authors: JW
authors: Lee
authors: Department of Anesthesiology and Pain Medicine, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Yoon Kyung
authors: YK
authors: Lee
authors: Department of Internal Medicine, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Jeonghwan
authors: J
authors: Lee
authors: Department of Internal Medicine, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors: Seong Woo
authors: SW
authors: Han
authors: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea chun0414@hallym.ac.kr.
authors: Wook
authors: W
authors: Chun
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001830:Body Surface Area; D002056:Burns / Q000097:blood* / Q000401:mortality; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011228:Prealbumin / Q000378:metabolism*; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D011228:Prealbumin; D019344:Lactic Acid; D002097:C-Reactive Protein
keywords: burn, nutrition; severity; transthyretin