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The Creatinine-to-Protein Ratio Predicts All-Cause In-Hospital Mortality After Major Burns.
Doha Obed1, Ahmed E Eid1, Mustafa Salim2
1Department of Plastic, Aesthetic, Hand, and Reconstructive Surgery, Hannover Medical School, 30625 Hannover, Germany.
Summary
The post-burn creatinine-to-protein ratio, especially on day 7, effectively predicts mortality in severe burn patients. This accessible biomarker aids early risk assessment for better patient outcomes.
Area of Science:
- Biomarkers in critical care
- Burn injury outcomes
- Prognostic indicators in trauma
Background:
- Serum creatinine and protein levels are explored as potential biomarkers for burn patient outcomes.
- Predicting adverse events in severe burn injuries remains a clinical challenge.
Purpose of the Study:
- To evaluate the prognostic utility of serum creatinine, protein levels, and their ratio for in-hospital mortality in severe burn patients.
- To assess the predictive accuracy of the creatinine-to-protein ratio using receiver operating characteristic (ROC) curves.
Main Methods:
- Retrospective cohort study of burn patients with total body surface area (TBSA) ≥20% over 13 years.
- Serum creatinine, protein levels, and creatinine-to-protein ratio measured on post-burn days (PBD) 1, 3, and 7.
- Multivariate analysis and ROC curve analysis to identify mortality predictors and assess predictive capability.
Main Results:
- Overall mortality rate was 24.7% among 283 patients.
- Neither creatinine nor protein levels alone predicted mortality.
- The creatinine-to-protein ratio was elevated in non-survivors, with PBD 7 ratio independently predicting mortality (AUC=0.75).
Conclusions:
- The post-burn creatinine-to-protein ratio, particularly on PBD 7, is a reliable and cost-effective biomarker for mortality risk in severe burn patients.
- This ratio can enhance early prognostic evaluation and clinical decision-making in burn care.
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