Changes in Selected Biochemical Parameters in Thermal Burns Patients at the Korle Bu Teaching Hospital

Abstract

Background: Thermal burns injuries are associated with changes in biochemical parameters which require specialized care. Burn shock is the first consequence of deep and extensive burns that constitutes the main cause of mortality if local and systemic treatments are not correct and timely. Changes in the biochemical parameters are attributed to hyper metabolic state, arising mainly from increases in adrenaline release, hemolysis, sepsis, loss of fluid and electrolytes that requires specialized attention. The serum levels of these biochemical substances such as sodium, potassium, magnesium, albumin, globulin, total proteins, urea and creatinine are very important factors to be observed in thermal burns injury. This is because the serum levels of these parameters are indication of how the body of the patient is responding to the different therapies that are being provided. Determining the changes in these selected biochemical parameters in thermally burnt patients helps in proper and effective management of thermal burn injury that will reduce morbidity and mortality. General Aim: The aim of this study was to determine changes in selected biochemical parameters in thermally burnt patients who report at the (burn unit) at Korle Bu Teaching Hospital. Methodology: The study was a case-control longitudinal study involving a total of 106 subjects made up of 53 cases (thermally burnt patients) recruited between the period from September/2015 to April/2016 at the burns center of the Korle Bu Teaching Hospital and 53 age-matched controls. The subjects were classified into 4 groups. The ages of these groups were divided as follows: children (<10 years; n=22); adolescents (10-19 years; n=11); adults (20-45 years; n=16) and middle aged (46- 60 years; n= 4). All these age groups had age-matched controls. Serum electrolyte levels were determined using an Atomic Absorption Spectrophotometer. Serum total protein, albumin, globulin, urea and creatinine were measured using Vitros 5,1 FS chemistry auto-analyzer. Data collected were entered into SPSS software student version 20.0 and used for analyses. Results: The children constituted the majority (22)41.1% of the study population followed by the adults (16)30.2% for both cases and controls. The gender distributions were (22)41.5% males and (31)58.5% females for the cases and (36)67.9% had superficial burns whereas (17)32.1% had deep burns. Most of the burn injuries were caused by scalds in (21)39.6% cases followed by gas explosion in (14)26.4% cases and the least (4)7.5% cases caused by contact with hot objects. Serum sodium and magnesium levels were significantly low on ≤ 2, 7th and 14th days post thermal burns in Children (p<0.001) (p=0.001), Adolescents (p<0.001) (p=0.001), Adults (p<0.001) (p=0.003) and Middle aged (p<0.001) (p=0.007) respectively with ≤ 2 days recording the lowest serum sodium level in all age whereas serum potassium levels were significantly high on ≤ 2, 7th and 14th days post thermal burns in Children (p=0.020), Adolescents (p=0.001), Adults (p=0.004) and Middle aged (p=0.008) with ≤ 2 recording the highest serum potassium level in all age groups. The results show that serum urea and creatinine levels were significantly low on ≤ 2, 7th and 14th days post thermal burns in Children (p=0.010) (p=0.001), Adolescents (p=0.040) (p=0.005), Adults (p=0.021) (p=0.020) and Middle aged (p=0.001) (p=0.008) respectively. The results show that serum total protein, albumin and globulin levels were significantly low on ≤ 2, 7th and 14th days post thermal burns in Children (p=0.001) (p=0.004) (p=0.003), Adolescents (p<0.001) (p=0.003) (p=0.009), Adults (p=0.002) (p=0.007) (p=0.002) and Middle aged (p=0.001) (p=0.009) (p=0.004) with 14th day recording the highest serum total protein level in Children and middle aged groups respectively. Conclusion: Children and adult had the higher incidence TBIs as compared to the adolescent and the middle-aged age groups. The serum levels of sodium and magnesium were found to be generally low whereas serum potassium levels were high in thermal burnt patients of all ages as compared to controls. Serum albumin, globulin and total proteins were decreased in thermal burnt patients of all ages as compared to controls. Serum urea and creatinine levels were also found to be low in the thermal burnt patients in all age categories. The health team careful monitoring of these biochemical parameters can help improve the health of TBI patients to reduce mortality rate and improve survival.