Vol. 6, Issue 2, Part B (2024)

Background: Electrical burn injury is one of the common burn injuries in our country which leads to renal impairment in the form of AKI in early phase. Early diagnosis of AKI by evaluation of altered parameters of renal function following electric burn is essential. This study was conducted to evaluate the role of cystatin C in early detection of AKI in electric burn patients.
Methods: This prospective observational study was conducted in the Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka for a period of one and half years following the acceptance of the protocol. A total of 60 adult patients with electric burn were enrolled according to inclusion and exclusion criteria. Following informed written consent, each patient was subjected to detail clinical evaluation along with history taking, cystatin C, urine output and serum creatinine were measured at 0 and 3 post burn day. A standard guideline was followed during electric burn management. A semi-structured questionnaire was developed and collected data were analyzed by using the statistical software SPSS 24.
Results: Mean age of the study patients was 29.4±8.5 (SD) years with a male predominance (93.3%). Maximum (66.7%) had High voltage electric burn and had burn percentage 21% to 30% (48.3%). Mean creatinine and cystatin C at day 0 was 1.2±0.4 mg/dl and 0.9±0.3 mg/dl accordingly, while at day 3 was 1.5±0.9 mg/dl and 1.0±0.5 mg/dl accordingly. Overall, 14 patients (23.33%) had developed early AKI. Increased burn area percentage, creatinine and cystatin C were significantly associated risk factors for AKI. Diagnostic accuracy test of serum creatinine ≥1.23mg/dl showed sensitivity, specificity, PPV, NPV and accuracy was 78.57%, 80.43%, 55%, 92.5% and 80% accordingly, while diagnostic accuracy test of Cystatin C ≥0.99 mg/dl showed sensitivity, specificity, PPV, NPV and accuracy was 92.86%, 93.48%, 81.25%, 97.72% and 93.33% accordingly.
Conclusion: Cystatin C had better diagnostic accuracy than serum creatinine in the prediction of early AKI in electric burn patients. However, further extensive study is recommended.