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The blood parameters and liver function changed inconsistently among children between burns and traumatic injuries
Chan Nie1, Tao Wang1, Huiting Yu1
1Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China.
Insights
Burned children show a greater acute response and liver damage compared to traumatically injured children, indicated by distinct routine blood parameters and liver enzyme levels. These findings highlight differences in pediatric injury severity and outcomes.
Area of Science:
- Pediatric Traumatology
- Clinical Biochemistry
- Injury Pathophysiology
Background:
- Burn and traumatic injuries trigger acute phase responses with significant physiological changes.
- Understanding differences in these responses is crucial for pediatric patient management.
Purpose of the Study:
- To investigate disparities in routine blood parameters and liver enzyme levels between pediatric burn and traumatic injury cases.
- To identify potential biomarkers differentiating injury types in children.
Main Methods:
- Recruitment of pediatric patients (<18 years) with injuries.
- Collection of demographic and clinical data, including routine blood counts (WBC, RBC, PLT, HB) and liver function tests (ALT, AST, GGT, ALP, CHE, TP, ALB, GLB).
- Statistical analysis using generalized linear models and multivariate analysis of variance.
Main Results:
- Burned children exhibited higher RBC, HB, WBC, and AST levels, alongside lower TP, CHE, and ALB levels compared to traumatically injured children (P < 0.05).
- Sex, age, BMI, and Injury Severity Score (ISS) influenced various blood parameters and liver enzymes.
- WBC and HB levels were higher in males, while AST and TP levels were lower in males.
Conclusions:
- Pediatric burn injuries are associated with a more pronounced acute phase response and greater liver damage than traumatic injuries.
- These hematological and biochemical differences may contribute to observed variations in pediatric morbidity and mortality rates across different injury types.
Objective:
Burn and traumatic injury are two kinds of injury by modality. They cause acute phase response and lead to a series of pathological and physiological changes. In this study, we explored whether there are differences in routine blood parameters and liver enzyme levels between burned and traumatically injured children.
Methods:
Patients under 18 years old with injuries were recruited. Their demographic and clinical data were recorded. Collected clinical data included routine blood parameters (white blood cell count (WBC), red blood cell count (RBC), platelets (PLT), hemoglobin (HB)), serological enzyme levels (alanine aminotransferase (ALT), aspartate transaminase (AST), glutamyltransferase (GGT), alkaline phosphatase (ALP), cholinesterase (CHE)), and total protein (TP) levels (albumin (ALB), globulin (GLB)). A generalized linear model and multivariate analysis of variance were used to conduct comparisons.
Results:
A total of 162 children (109 with burns and 53 with traumatic injuries) with a mean age of 4.36 ± 4.29 years were enrolled in the study. Burned children had higher levels of RBC, HB, WBC, AST and lower levels of TP, CHE, ALB than traumatically injured children (P < 0.05). Moreover, the concentration of WBC and HB was higher in males compared to females (P < 0.001). Conversely, the level of AST and TP in males was lower, AST levels were significantly lower in males (P = 0.005). Age positively correlated with the levels of HB, AST and TP (P < 0.001), and negatively correlated with WBC (P < 0.001). With decreasing body mass index (BMI), the levels of WBC, HB, AST and TP significantly increased in both groups of injured children (P < 0.001). In addition, ISS was positively correlated with WBC and HB levels (P < 0.001), but negatively correlated with AST and TP levels (P < 0.001).
Conclusions:
Children with burn injuries suffered a greater acute response and liver damage than traumatically injured children. This may in part underlie clinical observations of differences in children morbidity and mortality in response to different injury types.
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