Albumin is essential for maintaining oncotic pressure and vascular integrity. In burn injuries, increased capillary permeability leads to hypoalbuminaemia, which is a recognised marker of poor outcomes in critical illness. However, its prognostic value in acute burn care remains underexplored. This study evaluated the prognostic value of admission serum albumin in predicting mortality, acute kidney injury (AKI), hospital and intensive care unit (ICU) length of stay, ventilatory requirements, sepsis, and pulmonary infection in burn patients. A systematic search of PubMed, Scopus, Cochrane Library, Web of Science, MEDLINE, and Embase was conducted. Of 5,587 studies screened, 19 were included in the systematic review and 9 in the meta-analysis. Statistical analysis was performed using RStudio, with pooled outcomes reported as odds ratios (OR), standardised mean differences (SMD), and hierarchical summary receiver operating characteristic (HSROC) curves. Heterogeneity was assessed using Cochran's Q, I2, and Tau.2 Hypoalbuminaemia on admission was significantly associated with increased mortality during admission (OR 9.51; 95%CI 3.04-29.78; I2 49.3%). Admission hypoalbuminaemia was also associated with an increased risk of AKI (OR 2.83; 95%CI 2.49-3.22; I2 0%). Evidence for other outcomes was limited and heterogeneous. Admission serum albumin appears to be a valuable prognostic marker in burn patients, particularly for mortality and AKI. Further research is required to support its integration into burn-specific risk models, characterise albumin trends within the first 24 hours post-injury, and establish optimal cut-off values.
Ye et al. (Wed,) studied this question.