Juárez GU, Sánchez ZMJ

Language: Spanish
References: 12
Page: 17-20
PDF size: 191.32 Kb.

ABSTRACT

Introduction: burns are a serious public health problem, with several studies estimating that more than 11 million people were affected by burn injuries with approximately 300,000 deaths worldwide. Studies showed that the main causes of death were inhalation injuries, infection, and metabolic and hemodynamic complications ending in multi-organ failure. It has been shown that the increase in the systemic inflammatory response, whose parameters can be easily obtained, can be useful and directly related to poor prognosis. Several clinical studies indicate that the ratio of neutrophils to lymphocytes, an indicator of systemic inflammatory response, can signify the presence of inflammation in some diseases such as diabetes, coronary artery disease, cholangitis, rheumatoid arthritis, and recently COVID-19. Objective: to know the association between the neutrophil lymphocyte index as a biomarker of mortality in patients with major burns. Material and methods: an observational, retrospective, descriptive, longitudinal study will be carried out: with a user population of the National Center for Research and Attention to Burned Patients (CENIAQ) of the Luis Guillermo Ibarra Ibarra National Rehabilitation Institute. A review of the clinical records of the patients treated in the period will be carried out during the period from February 1, 2020 to February 28, 2022, the data of admission and discharge will be taken into account, as well as initial laboratory studies. The information will be recorded in an Excel spreadsheet to be later analyzed in the SPSS software, the results will be obtained and finally their analysis will be carried out. Results: in the analyzed population we found that the average age is 40 years, it was also found that the most affected gender in this population corresponds to the male gender with 81.2%. It was also found that, within the diagnoses of the population studied, fire burn was the one that most affected the population, this being 67.1% of all diagnoses. However, in this study no significant difference was found in the neutrophil lymphocyte index with respect to the type of burn. In our analysis, the neutrophil lymphocyte index was included as a biochemical predictor of mortality, since high levels of this index at admission are associated with increased mortality. In our population, a significant difference was found between the groups with a fatal clinical outcome and those who recovered, which is why it can be considered as a predictor of mortality in these patients since they presented a p value < 0.023, data that is consistent with what is reported in the international literature where the Neutrophil lymphocyte index value can be used as a predictor of mortality. Conclusions: an association was found between the elevation of the neutrophil/lynphocyte ratio and mortality in patients with severe burns

REFERENCES

1. Jeschke MG, van Baar ME, Choudhry MA, Chung KK, Gibran NS, Logsetty S. Burn injury. Nat Rev Dis Primers. 2020;6(1):11.

2. McCann C, Watson A, Barnes D. Major burns: Part 1. Epidemiology, pathophysiology and initial management. BJA Educ. 2022;22(3):94-103.

3. Hu L, Wang B, Hong Y, Xu L, Jiang Y, Wang C, et al. Admission neutrophil-lymphocyte ratio (NLR) predicts survival in patients with extensive burns. Burns. 2021;47(3):594-600.

4. Angulo M, Moreno L, Aramendi I, Dos Santos G, Cabrera J, Burghi G. Complete blood count and derived indices: evolution pattern and prognostic value in adult burned patients. J Burn Care Res. 2020;41(6):1260-1266.

5. Qi X, Yu Y, Sun R, Huang J, Liu L, Yang Y, et al. Identification and characterization of neutrophil heterogeneity in sepsis. Crit Care. 2021;25(1):50.

6. Montalvo Aguilar M, González López CA. Índice neutrófilos/linfocitos: un predictor de mortalidad en paciente con infección por SARS-CoV-2. Med Crit. 2021;35(3):130-135.

7. Sierawska O, Malkowska P, Taskin C, Hrynkiewicz R, Mertowska P, Grywalska E, et al. Innate immune system response to burn damage-focus on cytokine alteration. Int J Mol Sci. 2022;23(2):716.

8. Osuka A, Ishihara T, Shimizu K, Shintani A, Ogura H, Ueyama M. Natural kinetics of blood cells following major burn: Impact of early decreases in white blood cells and platelets as prognostic markers of mortality. Burns. 2019;45(8):1901-1907.

9. Qiu L, Jin X, Wang JJ, Tang XD, Fang X, Li SJ, et al. Plasma neutrophil-to-lymphocyte ratio on the third day postburn is associated with 90-day mortality among patients with burns over 30% of total body surface area in two Chinese burns centers. J Inflamm Res. 2021;14:519-526.

10. Liu S, Li Y, She F, Zhao X, Yao Y. Predictive value of immune cell counts and neutrophil-to-lymphocyte ratio for 28-day mortality in patients with sepsis caused by intra-abdominal infection. Burns Trauma. 2021;9:tkaa040.

11. Jimeno S, Ventura PS, Castellano JM, García-Adasme SI, Miranda M, Touza P, et al. Prognostic implications of neutrophil-lymphocyte ratio in COVID-19. Eur J Clin Invest. 2021;51(1):e13404.

12. Gunduz M, Ciftci I, Yasti AC, Guven A. Red cell distribution width and neutrophil-to-lymphocyte ratio as a predictive factor in treatment of pediatric patients with burns. Int J Burns Trauma. 2020;10(4):101-106.