Early clinical complete blood count changes in severe burn injuries

Following a severe burn injury, significant hematologic changes occur that are reflected in complete blood count (CBC) measurements. Our aim for this study was to examine trend in the components of the CBC in severely burned patients over the first week after injury and compare differences in CBC components between survivors and non-survivors.

A 5-year retrospective review was performed of adult (≥18years) burn patients with a TBSA≥15%. Age, TBSA, gender, mortality, length of hospital stay, ventilator days, and CBC were collected.

Over the first week after injury, HBG and HCT decreased. This decrease was due to loss of red blood cells. WBC counts was initially elevated but decreased over the first 4days. PLT also decreased over the first 4days. Non-survivors had lower HBG, HCT, RCC, and PLT over the first week compared to survivors. Non-survivors had higher WBC compared to survivors. RDW was elevated during the first week in non-survivors. MPV was elevated at the end of the first week in non-survivors and MPV on day 7 was independently associated with mortality (O.R. 2.01 (1.1-3.7)). Compared to survivors non-survivors received more transfusions of blood products during the first week after injury.

Burn-injury specific trends in CBC measurements can be used as references to determine expected clinical course of burn patients. Non-survivors have early hematologic differences compared to survivors.