Yang Hyeong Tae, Yim Haejun, Cho Yong Suk, Kim Dohern, Hur Jun, Kim Jong Hyun, Lee Jong Wook, Lee Yoon Kyung, Lee Jeonghwan, Han Seong Woo, Chun Wook
Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
Department of Plastic Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
JPEN J Parenter Enteral Nutr. 2014 Nov;38(8):966-72. doi: 10.1177/0148607113499588. Epub 2013 Aug 23.
The purpose of this study is to clarify the clinical significance of serum transthyretin (TTR) in massively burned patients in nutrition support and clinical severity.
A retrospective study was performed with 204 patients admitted to Hangang Sacred Heart Hospital's Burn Center September 2010-September 2012 with burn wounds > 20% of total body surface area (TBSA) burned. Serum TTR, C-reactive protein (CRP), lactic acid, and an NST index (calculated by dividing real caloric intake by estimated caloric need for 7 days) were analyzed on a weekly basis for 5 weeks after admission.
When we classified patients with severity according to mortality, percentage of TBSA burned, serum lactic acid, and CRP, mean serum TTR level was significantly higher in the less severe patient group than in the severe patient group in each week for every severity index. And the serum TTR level did not show significant differences by NST index in both the severe patient group and the less severe patient group. In a multivariate logistic regression, percentage TBSA burned, TTR, and lactic acid had an independent association with mortality.
Serum TTR did not show a significant difference by nutrition support in massively burned patients with >20% of TBSA burned. But serum TTR was significantly different by the severity of the patient and independently associated with mortality. Hence, serum TTR level can be 1 of the useful biomarkers for comprehending the severity of the illness in massively burned patients.
