Predictive value of lactate dehydrogenase combined with the abbreviated burn severity index for acute kidney injury and mortality in severe burn patients |
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| Affiliation: | 1. Department of Burn and Plastic Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province 226001, People’s Republic of China;2. Nantong University Medical School, Nantong, Jiangsu Province 226001, People’s Republic of China;3. Cancer Research Centre Nantong, Tumor Hospital Affiliated to Nantong University, Nantong, Jiangsu Province 226300, People’s Republic of China;4. Nantong Center for Disease Control and Prevention Institute of Chronic Non-communicable Diseases Prevention and Control, Nantong, Jiangsu Province 226001, People’s Republic of China;1. Department of Burns, Plastic and Maxillofacial Surgery, Royal North Shore Hospital, Australia;2. New South Wales Agency for Clinical Innovation Statewide Burn Injury Service, Australia;3. Northern Clinical School, University of Sydney, Australia;1. Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA;2. Department of Emergency Medicine and Department of Pediatrics, University of California, San Francisco, San Francisco, CA;3. Department of Emergency Medicine, University of California, Los Angeles, Los Angeles, CA;4. Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA;5. Department of Anesthesia, Critical Care and Emergency Medicine, University Hospital Bonn, Bonn, Germany;1. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Islamic Azad University, Urmia, Iran;2. Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran;3. Department of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran;4. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran;1. Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA;1. UW Medicine Regional Burn Center, University of Washington, Seattle, WA, USA;2. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA;3. Ross Tilley Burn Centre, University of Toronto, Toronto, Canada;4. Harborview Injury Prevention and Research Center, Seattle, WA, USA;1. Departments of Trauma and Burn surgery, Maasstad Hospital, Rotterdam, the Netherlands;2. Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Intensive Care, De Boelelaan 1117, Amsterdam, the Netherlands;3. Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Anesthesiology, De Boelelaan 1117, Amsterdam, the Netherlands;4. Department of Anesthesiology, Maasstad Hospital, Rotterdam, the Netherlands;5. Department of Anesthesiology, Erasmus MC, Rotterdam, the Netherlands;6. Maasstad Academy, Maasstad Ziekenhuis, Rotterdam, the Netherlands;7. Trauma Research unit Department of surgery, Erasmus MC, Rotterdam, the Netherlands |
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| Abstract: | BackgroundExtensive burns are devastating trauma. This study aimed to explore the predictive value of early lactate dehydrogenase (LDH) level, the abbreviated burn severity index (ABSI) and their combination on acute kidney injury (AKI) and mortality after severe burns.Methods and results194 severe burn patients (TBSA ≥ 30%) were included. After multivariate analyses, early LDH value (first 24 h after admission) was an independent risk factor for early AKI (OR=1.095, CI,1.025–1.169,p = 0.007) and AKI (OR=1.452, CI,1.131–1.864, p = 0.003) in severe burn patients and was still a significant risk factor for mortality (OR=1.059, CI,1.006–1.115，p = 0.03). In ROC analysis, after combining LDH and ABSI, the AUC values were 0.925 for AKI, 0.926 for stage 3 AKI, and 0.904 for mortality. Based on cut-off values, patients were divided into different risk groups. The cumulative incidence of AKI (within 5 days, 30 days) and survival rate (within 60 days) were analyzed by the Kaplan-Meier method. The mortality, AKI incidence, and AKI staging showed a significant upward trend with the increasing risk level (P < 0.001).ConclusionEarly LDH level is an independent risk factor for early AKI and AKI. LDH combined with ABSI can better predict mortality and AKI than single indicators. |
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| Keywords: | Severe Burns LDH AKI ABSI Mortality Prognosis Prediction |
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