The systemic inflammation indexes after admission predict in-hospital mortality in patients with extensive burns

• Published in: Burns Vol. 50; no. 4; pp. 980 - 990
• Main Authors: Li, Fuying, He, Quanyong, Peng, Hao, Zhou, Jianda, Zhong, Chi, Liang, Geao, Li, Wengjuan, Xu, Dan
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.05.2024
• Subjects: Adult; Aged; Area Under Curve; Blood Indexes; Burns - blood; Burns - mortality; Extensive burns; Female; Hospital Mortality; Humans; Inflammation - blood; Leukocyte Count; Logistic Models; LPR; Lymphocyte Count; Lymphocytes; Male; Middle Aged; Monocytes; Multivariate Analysis; Neutrophils; NLPR; Platelet Count; Predictive Value of Tests; Prognosis; Prognostic; Retrospective Studies; ROC Curve; OR; NLPR; BI; ROC; Extensive burns; SIRI; Prognostic; LPR; AUC; NMR; MLR; SII; Blood Indexes; NLR; PBI; R-Baux; TBSA
• ISSN: 0305-4179; 1879-1409; 1879-1409
• DOI: 10.1016/j.burns.2024.01.020

To explore the clinical value of various complete blood count (CBC)-derived inflammation indicators to predict in-hospital mortality in patients with extensive burns. Systemic inflammation indexes, including lymphocyte-platelet ratio (LPR), neutrophil-lymphocyte ratio (NLR), neutrophil-monocyte ratio (NMR), monocyte-lymphocyte ratio (MLR), neutrophil-to-lymphocyte * platelet (NLPR), systemic inflammation index (SII), and systemic inflammation response index (SIRI) on days 1, 3, and 7 after admission were calculated in 135 patients with extensive burns. We included 135 patients with extensive burns, including 97 survivors and 38 non-survivors. After adjusting for confounders, only the LPR on day 1, NLPR on days 3 and 7 were significantly associated with survival (OR= 1.237, 1.097, 1.104; 95 % CI: 1.055–1.451, 1.002–1.202, 1.005–1.212; respectively) in the analysis of multivariate logistic regression. The optimum cutoff values of the LPR on day 1 and NLPR on day 3 were 6.37 and 8.06, and the area under the curves (AUC) were 0.695 and 0.794, respectively. The AUC of NLPR on day 7 had the highest value, 0.814, and the optimum cut-off value was 3.84. The efficacy of LPR on day 1, NLPR on days 3 and 7 combined with the burn prognostic score index in predicting the prognosis of patients was higher than that of the burn index alone, and the three composite inflammatory indexes combined with PBI had the highest efficacy in predicting the prognosis (AUC = 0.994). Kaplan-Meier survival analysis showed poor prognosis in patients with higher LPR on day 1 and higher NLPR on days 3 and 7 (log-rank χ2 =9.623,31.564, 20.771, respectively; P < 0.01). LPR on day 1 and NLPR on days 3 and 7 after admission are reliable predictors of prognosis in patients with severe extensive burns. The combination of the burn prognostic score index, LPR on day 1, and NLPR on days 3 and 7 was superior to the burn indexes alone in predicting a patient's prognosis. •Extensive burns have poor prognosis and significant fatality rate.•A retrospective study discusses the impacts of combined routine blood indexes on prognosis of severe burns.•LPR on day 1 and NLPR on days 3 and 7 as independent prognostic markers for extensive burns.•A combination of the burn prognostic score indexes and systemic inflammation indexes is better to predict a patient's prognosis.