Serum Album as a marker of burns injury severity and Hospital stay at Mulago National Refferal Hospital, Uganda

Abstract

Severe burns have been shown to lower serum albumin levels. Burns of TBSA as low as 10% have significant hyper catabolic, hyper metabolic and inflammatory process which lead to reduced albumin production and increased albumin loss in exudate through the burn wound. Serum albumin is required to maintain blood oncotic pressure and blood pressure. Low serum albumin affects wound healing and this could have an impact on the length of hospital stay which affects the patient and family psychologically and economically. Objective: The aim of this study was to determine the relationship between serum albumin levels, with the total body surface area burned (TBSA), and the length of hospital stay (LHS) after the burn injury. Methods: This was an analytical prospective cohort study. 45 patients admitted during the study period at the burns unit were recruited and followed up for a period of 3 weeks. Serum albumin levels were determined by photometry on the third day (baseline) of burns and a follow-up on the 7th post burn day. Data was analysed using Stata Vr. 14 and measures of association determined using regression analysis. Results: Sixty seven percent of the participants were below 18 years with F: M ratio of 1.05:1. Mean TBSA was 23.2 and mean length of stay 21.6 days. There was a significant difference in mean serum albumin between the baseline and follow-up measurements with a p-value of 0.026. A TBSA with percent of over 20% was associated with a significant decrease in baseline serum albumin (P value 0.042). Serum albumin measured on the third day is a better predictor of length of hospital stay (p value 0.048) than the one measured on the seventh day. Conclusion: We have found in our study a negative correlation between serum albumin and body surface area burnt. The third day post burn serum albumin is a better predictor of hospital length of stay than seven day follow up.