Pan-Immune Inflammation Value as a Novel Comprehensive Predictor of In-Hospital Mortality in Patients with Severe Burns: A Single-Center Retrospective Analysis

Abstract

Background and Objectives: Despite the advances in the treatment, severe burns with total burn surface area ≥ 20% are still a major cause of mortality worldwide. Pan-immune inflammation value (PIV) is a novel and promising biomarker to predict prognosis and mortality in various diseases. The aim of this study was to evaluate the utility of PIV to predict in-hospital mortality of patients with severe burn. Materials and Methods: This retrospective cross-sectional study included ≥18 years old patients with severe burn who were admitted to hospital within 12–24 h after the burn injury between January 2007 and August 2024. The demographics, clinical and laboratory characteristics of patients were recorded from electronic hospital records. Pan-immune inflammation value was calculated as neutrophil counts x monocyte count x platelet counts divided by lymphocyte counts. The receiver operating characteristic (ROC) analysis was conducted to determine the predictive value of PIV for mortality. Results: A total of 100 patients (median age 41 (26.3–55) years; 79% male) were included in the study of whom 23 were non-survivors. The PIV was significantly higher in non-survivors when compared to survivors (p = 0.009). The ideal cut-off of PIV was 1185, with a sensitivity of 69.6% and a specificity of 66.2%. The multivariate analysis showed that high PIV along with inhalation injury, and the need for surgery were predictors of in-hospital mortality. Conclusions: This study is the first to demonstrate that the novel, comprehensive index, PIV, is a reliable immuno-inflammatory marker predicting in-hospital mortality in patients with severe burn.