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Correlation of microalbuminuria and outcome in patients with extensive burns

W S Yew1, S K Pal

  • 1Clinical Fellow, Department of Anaesthesia, St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, Essex, UK.

British Journal of Anaesthesia
|August 4, 2006
PubMed
Abstract

Insights

Urinary albumin-creatinine ratio (ACR) predicts mortality in extensive burn patients. While ACR trends don't correlate with oxygenation, elevated levels indicate poorer outcomes, with distinct peaks in non-survivors.

Area of Science:

  • Critical Care Medicine
  • Burn Injury Research
  • Renal Physiology in Critical Illness

Background:

  • Microalbuminuria, assessed via urinary albumin-creatinine ratio (ACR), is linked to systemic inflammation and predicts outcomes.
  • Its role in extensive burn patients, particularly concerning mortality and oxygenation, requires further investigation.

Purpose of the Study:

  • To evaluate the urinary albumin-creatinine ratio (ACR) as a predictor of mortality in extensive burn patients.
  • To explore the correlation between ACR and PaO2/FIO2 ratios in this patient cohort.

Main Methods:

  • Retrospective observational study of adult patients with extensive burns (≥40% TBSA) or significant inhalational injury.
  • Daily ACR measurements and collection of PaO2/FIO2 ratios.
  • Mortality was the primary outcome studied.

Main Results:

  • Seven mortalities occurred among 21 studied patients; patient characteristics were similar between survivors and non-survivors.
  • No correlation was found between ACR trends and PaO2/FIO2 ratios.
  • Non-survivors exhibited two ACR peaks (days 8-9 and day 32), while survivors maintained stable levels.

Conclusions:

  • Urinary albumin-creatinine ratio (ACR) is a useful predictor of mortality in extensive burn patients.
  • A mean ACR exceeding 20 mg mmol(-1) is associated with poorer outcomes.
  • ACR changes do not directly reflect immediate clinical status in these patients.

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