engleski

Serum Amyloid A Protein in the Prediction of Postburn Complications and Fatal Outcome in Patients with Severe Burns

Fifty adults hospitalized with extensive burns formed the basis of the present study. Serum amyloid A protein, C-reactive protein, arantichymotrypsm and aracid glycoprotein were measured in serum samples taken on admission, and 3 and 7 days later. Fatal outcome was observed in 13 out of 14 (93%) patients with serum amyloid A protein over 100 mg/1 on admission and in only 2 of the remaining 36 (6%) patients with serum amyloid A protein below 100 mg/1. The median serum amyloid A protein concentration on admission in 15 patients with fatal outcome was 134 mg/1, and only 30 mg/1 in 35 patients who recovered (p < 0.00005). As a reference value, the level of 100mg serum amyloid A protein per litre on admission gave an evident predictive value (93%) and sensitivity (87%) for fatal outcome. The difference between serum amyloid A protein concentrations in patients with complications (median 642 mg/1) and those without complications (median 250 mg/1) was statistically very significant (p = 0.0003) three days after burn injury. The level of 400 mg/1 as a reference value 3 days after burn injury gave a reasonable predictive value (80%) and sensitivity (74%) for the development of postburn complications, but patients who died did not develop a hypermetabolic reaction and their serum amyloid A protein concentration remained below 400 mg/1, despite high serum amyloid A protein concentrations observed on admission (above 100 mg/1). No statistical significance was observed for the other 3 acute phase proteins investigated in this study.

serum amyloid A ; prediction of outcome ; burns

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