Prognostic value of red blood cell distribution width/protein and red blood cell distribution width/platelet count ratios in intensive care burn patients

BACKGROUND: Red cell distribution width (RDW), serum protein levels, platelet count (PLT), and RDW/protein and RDW/PLT ratios have been associated with adverse outcomes in various medical conditions such as sepsis and critical illness. This study aimed to investigate the association between these parameters and in-hospital mortality following severe burn injury. METHODS: Intensive care burn patients admitted between March 2007 and December 2020 with a total body surface area (TBSA) burned ≥ 20 % were analyzed. Multivariate analysis was conducted to examine variables associated with mortality. RDW/protein and RDW/PLT ratios on post-burn days 1, 3 and 7 were analyzed by receiver operating characteristic curves. RESULTS: A total of 288 patients were included. Mortality was 26 %, with non-survivors being significantly older, more frequently male, and presenting with an average of 49 % of TBSA burned. RDW, serum protein levels and PLT were not independent predictive values. The RDW/protein ratios on post-burn days 3 and 7 were significantly associated with in-hospital mortality. The respective AUC value exceeded 0.8 on post-burn day 7, indicating good predictive ability. CONCLUSION: Post-burn evaluation of the RDW/protein ratio may provide a simple, cost-effective, and valuable predictor for mortality risk assessment following burn injury.