Plasma chromogranin A after severe burn trauma

Area of Science:

• Trauma and Burn Care
• Neuroendocrinology
• Critical Care Medicine

Background:

• Plasma chromogranin A (P-CgA) is a marker of sympathetic stress, predicting mortality in medical intensive care.
• The magnitude of P-CgA release may reflect stress load and injury severity in burn patients.

Purpose of the Study:

• To investigate the relationship between plasma chromogranin A (P-CgA) levels and injury severity in burn intensive care patients.
• To determine if P-CgA can predict organ dysfunction after major burn injuries.

Main Methods:

• Fifty-one burn patients with >10% burn area were studied.
• Plasma chromogranin A (P-CgA) was measured twice daily for seven days post-injury.
• Organ dysfunction was assessed using SOFA scores at day 7; P-CgA measures (24h value, mean, max, AUC) were correlated with SOFA scores.

Main Results:

• P-CgA variability differed between patient groups, with high variability linked to deeper injuries and older age.
• All P-CgA measures correlated with SOFA scores, but not total burn size.
• Age, burn size, and P-CgA levels (at 24h, mean, or max) independently predicted organ dysfunction. Age, burn area, and P-CgA at 24h best predicted organ dysfunction (AUC 0.91).

Conclusions:

• Neuroendocrine activation, indicated by plasma chromogranin A (P-CgA), is independently associated with organ dysfunction after major burn injuries.
• P-CgA serves as a valuable marker for assessing injury severity and predicting outcomes in burn patients.