Abstract
Abstract Introduction Thermal injuries represent a major health problem. Biomarkers capable of predicting burned patients outcomes are missing. Certain parameters of complete blood count (CBC) such as red cell distribution width (RDW) and mean platelet volume (MPV), as well as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and RDW-to-platelet ratio (RPR) have been associated with inflammatory status and outcome in diverse medical conditions. The aim of this study was to describe the evolution pattern of these parameters in adult burned patients. Methods Adult burned patients admitted to the National Burn Center of a University Hospital between May 2017 and March 2018 were included. Patients characteristics and outcomes were recorded, as well as CBC parameters on days 1, 3, 5 and 7 after thermal injury. Results Eighty-eight patients were included. Total body surface area burned was 14 [7–23] %, and mortality was 15%. Non-survivors presented higher RDW (days 3, 5 and 7; P < 0.01) and MPV (days 3 and 7; P < 0.01). NLR decreased after admission in all patients (P < 0.01), but was higher in non-survivors compared to survivors on days 1 and 7 (P < 0.01). On day 3, PLR was higher in survivors than in non-survivors (P < 0.05). In deceased patients, RPR was significantly higher on days 3, 5 and 7 (P < 0.01). There was a significant correlation between NLR on admission and burn extension and severity. Kaplan-Meier analysis revealed that NLR, PLR and RPR could identify patients with increased mortality. Conclusions Basic CBC parameters and derived indices could be useful as biomarkers to determine prognosis in adults with thermal injuries. Applicability of Research to Practice The study allowed us to identify basic CBC parameters and indices that behave differently in survivors and non-survivors. Interestingly, the CBC profile that differentiates survivors and non-survivors varies at each time point. A particular combination of CBC parameters might be used as a prognostic indicator depending on evolution time since thermal injury.
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