Burns : journal of the International Society for Burn Injuries · 2026
Association of early qualitative myoglobinuria with in-hospital mortality and time to hospital discharge in burn patients: A 5-year retrospective cohort study.
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Cueva-Ramírez José Enrique, Valdez Rosario, Tejada Rosy, Mancebo Pablo, Ramos-Rincon Jose-Manuel
Аннотация
BACKGROUND: Early urinary myoglobin may indicate extensive tissue injury after burns, but its prognostic value remains uncertain. We evaluated its association with in-hospital mortality and time to hospital discharge.
METHODS: This single-centre retrospective cohort included 721 burn patients with an available urinary myoglobin result among 1005 potentially eligible admissions from 2020 to 2024. Myoglobinuria was assessed during the initial hospital evaluation using a qualitative ammonium sulphate precipitation test. Multivariable logistic regression evaluated in-hospital mortality. Time to hospital discharge was analyzed using cause-specific proportional hazards regression, with in-hospital death treated as a competing event.
RESULTS: Early qualitative myoglobinuria was present in 141 patients (19.6%). Positive patients had more extensive and deeper burns, more inhalation injury, and more associated injuries. Mortality was higher with positive than negative myoglobinuria (53.9% vs. 25.0%; p < 0.001). After adjustment for age, sex, total body surface area burned, burn depth, and inhalation injury, myoglobinuria remained associated with mortality (adjusted OR 2.27, 95% CI 1.37-3.78; p = 0.002). Positive myoglobinuria was associated with a lower unadjusted discharge rate (cause-specific HR 0.67, 95% CI 0.52-0.87; p = 0.003), but not after adjustment (adjusted HR 0.82, 95% CI 0.62-1.10; p = 0.185).
CONCLUSIONS: Early qualitative myoglobinuria was associated with greater burn severity and increased hospital mortality. Its association with time to discharge was attenuated after adjustment. These findings require prospective multicentre validation using standardized quantitative myoglobin measurements.
METHODS: This single-centre retrospective cohort included 721 burn patients with an available urinary myoglobin result among 1005 potentially eligible admissions from 2020 to 2024. Myoglobinuria was assessed during the initial hospital evaluation using a qualitative ammonium sulphate precipitation test. Multivariable logistic regression evaluated in-hospital mortality. Time to hospital discharge was analyzed using cause-specific proportional hazards regression, with in-hospital death treated as a competing event.
RESULTS: Early qualitative myoglobinuria was present in 141 patients (19.6%). Positive patients had more extensive and deeper burns, more inhalation injury, and more associated injuries. Mortality was higher with positive than negative myoglobinuria (53.9% vs. 25.0%; p < 0.001). After adjustment for age, sex, total body surface area burned, burn depth, and inhalation injury, myoglobinuria remained associated with mortality (adjusted OR 2.27, 95% CI 1.37-3.78; p = 0.002). Positive myoglobinuria was associated with a lower unadjusted discharge rate (cause-specific HR 0.67, 95% CI 0.52-0.87; p = 0.003), but not after adjustment (adjusted HR 0.82, 95% CI 0.62-1.10; p = 0.185).
CONCLUSIONS: Early qualitative myoglobinuria was associated with greater burn severity and increased hospital mortality. Its association with time to discharge was attenuated after adjustment. These findings require prospective multicentre validation using standardized quantitative myoglobin measurements.