Role of first day levels and subsequent trends of serum proteins in acute burns

Abstract

Objective: To explore the role of first day levels and subsequent trends of serum proteins as prognostic indicators in acute burns. Methods: This prospective observational study was carried on 100 burn patients (18-60 years with 20% to 60% total burned body surface area). Serum albumin, globulin and total protein were estimated on alternate days starting from first day of burn. The first day value and the trend of serial values throughout the clinical course were compared between survivor and non-survivor groups. Results: Mean day 1 serum values of albumin, globulin, and total protein were significantly higher in the survivors compared to non-survivors (P<0.000 1). Univariate logistic regression showed that increase in day one value of serum albumin, globulin and total protein by 10g /L each, significantly decreased risk of mortality by 99.4%, 98.3% and 96.6%, respectively. The serial serum values of albumin, globulin and total protein showed rising and declining trends in survivors and non-survivor respectively. Based on the ROC curve, the cut off values at any point during the course below which the prognosis was poor were 16.0 g/L, 18.0 g/L and 39.0 g/L for albumin globulin and total protein, respectively. Conclusions: The study highlights the prognostic importance of day one value and trend of serum albumin, serum globulin and total protein in acute burns. The trend of serum proteins over the course of burns should be monitored for better patient management.