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Evaluation of Alternative Predictors of Mortality in Burn Patients Controlled for Age and TBSA
Tiffany Shi, PhD; Trent James, BA; Sydni Meunier, MD; Julia C. Slater, MD
University of Cincinnati
2025-01-10
Presenter: Tiffany Shi, PhD
Affidavit:
All co-authors contributed to this project and approve of the abstract.
Director Name: Ann R. Schwentker
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background:
Predictors of mortality in burn patients, including age, total body surface area (TBSA) of burn, and inhalation injury, are well-established components of scoring systems like the Baux score. However, outcomes still vary despite similar Baux scores. This study explores hematologic and clinical parameters as predictors of mortality, focusing on patients controlled for age, TBSA, and Baux scores to limit influence of these factors.
Methods:
Retrospective analysis included 35 patients ages 40-70 years with TBSA 30-70% surviving >4 days post-burn injury with ≥4 days in the intensive care unit. Associations between mortality and coagulation markers (PT, INR), hematologic parameters (white blood cell, platelets, and absolute neutrophils, lymphocytes, and monocytes), and differential blood count ratios (NLR, NMR, LMR) were assessed using labs nearest to time of admission. R software (v.4.2.0) was used for statistical analyses.
Results:
Of the included 35 patients, 24 (68.6%) survived and 11 (31.4%) died. Age, TBSA, and Baux scores were appropriately controlled with no significant differences between groups. Logistic regression identified NMR as significantly associated with mortality (p=0.03) in univariate analyses but not in a multivariable model (p=0.80). Correlation analyses revealed positive association between mortality and absolute monocyte counts (r = 0.409, p = 0.04). No variables were significantly associated with length of hospital stay.
Conclusions:
When age and TBSA were controlled, differential blood count data, including NMR and absolute monocyte counts, emerged as potential predictors of mortality in burn patients. These findings suggest non-traditional parameters could complement established predictors to differentiate burn outcomes.
