Lower Serum Albumin Shortly After Admission Predicts Prolonged Hospital Stay in Younger Burn Patients.

The purpose of this study was to assess whether albumin levels could be used to aid in the prediction of hospital stay in adult burn patients. A retrospective review of burn patients from 2009 to 2014 was used. Demographic, injury details, albumin levels within 72 hours of admission, and clinical outcomes were recorded. The abbreviated burn severity index (ABSI) was calculated for each patient. Hospital stay >3 weeks was defined as "prolonged stay." Since albumin showed a significant interaction with age, patients were divided into two groups based on a median age of 40 years. Albumin, total BSA, and ABSI were each used as predictors, and the area under the curve (AUC) of a receiver operating characteristic curve was calculated. A composite score was created for the ≤ 40 years age group using ABSI and albumin levels to predict an increased length of stay. Thirty-eight of 198 (19.2%) patients had a stay >3 weeks. The AUCs for albumin level, total BSA, and ABSI alone in younger patients were 0.97, 0.97, and 0.96, respectively. Among patients older than 40, the AUC values were substantially lower indicating lower predictive value. The probability of prolonged stay for patients with albumin level ≥ 2.4 g/dl was low (.8%) compared with those with albumin level <2.4 g/dl (96.5%). Adding ABSI to this model increased predictive accuracy. Albumin level obtained within 72 hours of admission was an effective predictor of prolonged hospital stay in adult burn patients ≤ 40 years.