Impact of anaemia on outcome in burn patients

Background: Currently, most critical care physicians maintain a patient's haemoglobin levels at 7 to 8 g dL-1. However,
little data have been available on haemoglobin-related outcomes in burn patients. The purpose of this study was
to evaluate inpatients with greater than 20% total body surface area burns and the effects of haemoglobin below
8 g dL-1 on clinical outcomes.

Methods: This study included 70 patients with burns amounting to greater than 20% of total body surface area. Data
were retrospectively evaluated and included age, gender, adult respiratory distress syndrome presence, length of
intensive care unit stay, length of mechanical ventilation, days requiring vasopressors, renal insufficiency, positive
cultures/infections, cardiovascular complications, number of operations, inhalation injury, and mortality. Logistic
regression analyses that were adjusted for age, sex, and percent total body surface area were used to assess the
relationships between haemoglobin and multiple clinical outcomes. Odds ratios (OR) were estimated with 99%
confidence intervals (99% CI).

Results: Haemoglobin below 8 g dL-1 was associated with a need for vasopressors (OR = 2.17; 99% CI = 1.03–8.22).
Furthermore, haemoglobin below 8 g dL-1 was associated with higher positive wound (OR = 2.86; 99% CI = 1.00–34.40),
urine (OR = 4.63; 99% CI = 1.15–67.00), and lung cultures (OR = 2.24; 99% CI = 1.06–5.47). These associations largely
remained after controlling for blood transfusions.

Conclusions: Contrary to most other patient groups, burn patients with burns amounting to greater than 20% of
total body surface area and low haemoglobin levels were more likely to develop positive cultures in urine, wounds,
and the lung and require vasopressor treatment.

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