Statistical Study for the Prognostic Value of NLR Values in Patients with Severe Burns: A Study in the Service of Burns in Albania.

The phases of burn care include initial resuscitation, definitive wound management, and rehabilitation of physical and psychological injuries. In severe burns, this response lasts for the first two to three days post-burn and burns larger than 15% of total body surface area lead to the initiation of systemic inflammatory response syndrome. Neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker that can indicate systemic inflammation. NLR is defined by the absolute number of neutrophils divided by the absolute number of lymphocytes. Many studies have been done in severe burn patients because they reflect changes in the systemic inflammatory response. This study aimed to investigate the prognostic value of NLR values in patients with severe burns and provide clinical guidance for sepsis and mortality. This was a retrospective cohort study conducted in the Service of Burns of the University Hospital Centre "Mother Teresa" in Tirana (UHCT), Albania. We compared NLR levels in burn patients with sepsis and without sepsis. Our data showed a significantly higher level of NLR in burn patients with sepsis, while the values of NLR on the 3rd day (NLR 3) have statistical significance (p<0.0001). From the logistic regression analysis, we found that only NLR 3 can predict mortality, whose cut-off (4.59) was determined with the help of ROC curve analysis and was accurately presented with the help of Kaplan-Meier curves with statistical significance. From multiple regression, we understand that mortality can be predicted based on TBSA%, age, presence of inhalatory burn, and NLR 3 together.