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Admission Circulating Cell-Free DNA Levels as a Prognostic Factor in Pediatric Burns
D Halpern1, A Cohen2, N Sharon2
1Joyce & Irving Goldman Medical School, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheba, Israel.
Insights
Admission levels of cell-free DNA (cfDNA) show promise in assessing pediatric burn severity. Higher cfDNA levels correlate with more severe burns and longer hospital stays, offering a potential new objective measure for burn care.
Area of Science:
- Biochemistry
- Pediatric Medicine
- Trauma Care
Background:
- Pediatric burn injuries represent a significant source of trauma with lasting effects.
- Current methods for evaluating burn extent upon admission lack precision.
- Circulating cell-free DNA (cfDNA) is emerging as a potential biomarker for tissue damage in burn management.
Purpose of the Study:
- To investigate the utility of cfDNA levels at admission as a prognostic indicator for pediatric burn severity and patient outcomes.
- To establish cfDNA as an objective tool for assessing burn injury severity.
Main Methods:
- Quantified cfDNA levels in 38 pediatric burn patients and 12 matched controls using a direct fluorometric assay.
- Compared cfDNA levels between burn patients and controls, and between partial-thickness and full-thickness burns.
- Analyzed correlations between cfDNA levels and hospitalization duration, surgical procedures, and PICU admission.
Main Results:
- Pediatric burn patients exhibited significantly higher admission cfDNA levels than controls (p=0.03).
- Full-thickness burns showed significantly higher cfDNA levels compared to partial-thickness burns (p=0.01).
- cfDNA levels significantly correlated with hospitalization duration (R=0.42, p<0.01) and need for surgery (R=0.40, p<0.01).
Conclusions:
- Admission cfDNA levels may serve as a valuable objective tool for assessing pediatric burn severity.
- The findings suggest cfDNA is a promising novel method for pediatric burn assessment.
- Further research with larger cohorts and age-standardized healthy children is needed to validate cfDNA as a prognostic factor.
Background:
Burn injuries in children are a major physical and psychological trauma, often a severe condition with long-term consequences. Current methods of assessing the extent of burn injuries on admission are inaccurate. Circulating cell-free DNA (cfDNA) is a potential marker of tissue damage that may be useful in burn care.
Objective:
To explore the use of cfDNA admission levels as a prognostic marker of pediatric burn severity and outcome.
Methods:
cfDNA levels of 38 pediatric burn patients (otherwise healthy) and 12 matched pediatric controls (minor elective surgery patients) admitted to our center were quantified by a direct fluorometric assay.
Results:
We found significantly higher admission cfDNA levels in the patient group (median 724 ng/ml, range 44-4405), compared to the control group (median 423 ng/ml, range 206-970, Mann-Whitney, P = 0.03) and a significant difference between cfDNA levels of partial-thickness burns (median 590 ng/ml, range 44-2909) and full-thickness burns (median 2394 ng/ml, range 528-4405, Mann-Whitney, P = 0.01). We also found significant correlations between cfDNA levels and hospitalization duration (Spearman, R = 0.42, P < 0.01) and undergoing surgical procedures (Spearman, R = 0.40, P < 0.01). PICU admission did not correlate to cfDNA levels (Spearman, R = 0.14, P = NS). Discussion. Admission cfDNA levels may be a valuable objective tool for assessing the severity of pediatric burn injuries on admission, including correlations with the length of hospitalization and surgical burden.
Conclusion:
Admission cfDNA levels may be a promising novel pediatric burn assessment method. Further investigation of cfDNA levels in healthy children standardized to age and larger cohorts are needed to establish cfDNA as a valuable prognostic factor for pediatric burn injury.
