Abstract Major burn injuries commonly present with hypoalbuminemia within the first 24 hours. This study aimed to determine whether early hypoalbuminemia independently predicts mortality in severe burns. This single-center, retrospective cohort study included patients aged 14 years and older with burns covering at least 20% of their body surface area, admitted between January 2006 and December 2023 in a university teaching hospital. Exclusion criteria were admission more than 8 hours post-injury or transfer to another unit within the first week. Albumin levels within the first 24 hours were recorded. The primary outcome was 28-day mortality. 161 patients were included with a median burn area of 38% (IQR 25-65) and an Abbreviated Burn Severity Index score of 9 (IQR 7-11.5). Mortality was 33% (53/161). While univariate analysis showed that lower albumin was associated with increased mortality (OR 0.91, 95% CI 0.86–0.96, p=0.001), this association was not significant after adjustment for burn severity (OR 0.99, 95% CI 0.93–1.06, p=0.87). The predictive value of minimum serum albumin for mortality was low with an area under the curve of 0.68. The optimal albumin threshold for predicting mortality was 24 g/L (sensitivity 81.0%, specificity 49.5%). Albumin levels below this threshold were not significantly associated with higher mortality in a time-to-event analysis (HR 1.72, 95% CI 0.79–3.73, p=0.169). Hypoalbuminemia in the first 24 hours was not found to be an independent risk factor for 28-day mortality in this cohort, suggesting it as a marker of burn severity rather than an independent predictor.
Ils et al. (Thu,) studied this question.