Red Cell Distribution Width/Albumin Ratio as a Predictive Tool for Mortality of Patients With Burn Injuries

August 15, 2026 updated by: Ain Shams University

Measurement of Red Cell Distribution Width/Albumin Ratio as a Predictive Tool for 30-day Mortality of Patients With Burn Injuries

The aim of this study is to evaluate the prognostic utility of the red cell distribution width/albumin ratio (RAR), measured within 24 hours of hospital admission, in predicting 30-day mortality among patients with burn injuries.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

The aim of this study is to evaluate the prognostic utility of the red cell distribution width/albumin ratio (RAR), measured within 24 hours of hospital admission, in predicting 30-day mortality among patients with burn injuries.

Patients presenting with acute thermal injuries will be screened based on inclusion/exclusion criteria.

After consent, patients' characteristics (age, sex, weight), clinical parameters (total burn surface area, Abbreviated Burn Severity Index), and comorbidities will be recorded.

  1. Emergency Department (ED) management (Arrival and Initial Stabilization)

    • Primary survey (ATLS principles): Immediate stabilization of Airway, Breathing, Circulation, Disability, Exposure (ABCDE).

    • Urinary catheter insertion to monitor urine output for proper resuscitation.
    • TBSA will be estimated using the Rule of Nines
    • All patients will be treated during the first 24 hours after burn injury guided by the Parkland Formula.

  2. In-Hospital Resuscitation (0-72 h)

    • Hemodynamic monitoring: ECG, pulse oximetry, respiratory rate, temperature, non-invasive blood pressure, arterial line if unstable, and central venous pressure.

    • Transition to Day 2 (24-48 h post-burn): Continue Lactated Ringer's and consider colloid therapy (5% albumin or plasma) after 24 h to maintain oncotic pressure and reduce crystalloid load.

    • Fluid adjustments according to urine output, mean arterial pressure with target MAP (≥65 mmHg), lactate clearance, and base deficit.

    Laboratory and calculation:

    On admission to ED, an arterial blood gas (ABG) sample will be collected to calculate base deficit (BD) and lactate level.

    Simultaneously, venous blood will be drawn for C-reactive protein (CRP) and serum albumin, CBC, serum urea, creatinine, AST, ALT, and electrolytes (Na+, K+, Mg+) estimation.

    Red Cell Distribution Width/Albumin will be calculated as:

    ((RDW (Standard Deviation of Red Blood Cell Volume / Mean Corpuscular Volume) × 100%.) / albumin (g/L)) from admission labs.

    Serial: Lactate/Base Deficit at 6 hr, 12 hr, 24 hr as a monitor for proper resuscitation Calculation of Severity Scores

    • R-Baux score: Age (years) + %TBSA + (17 × inhalation injury [yes=1, no=0])

    • Abbreviated Burn Severity Index (ABSI): The ABSI includes five parameters: sex, age category, %TBSA, presence of full-thickness burns, and inhalation injury. Each parameter is assigned weighted points, and the total ABSI score is associated with graded survival probabilities.

    Both scores will be calculated on admission and compared with admission (RDW/albumin) ratio to assess relative and incremental predictive value for 30-day mortality.

    Supportive care:

    • Early enteral nutrition, proper multimodal analgesia (paracetamol 1gm/8hr, nalbuphine 0.1mg/kg if VAS score>4), IV proton pump inhibitor to guard against curling ulcer, prophylactic anticoagulation to guard against DVT.

    • Vasopressors (norepinephrine) only after adequate fluid resuscitation guided by UOP, lactate and BD if MAP below 65 mmHg.

      3 - Post-Resuscitation and Definitive Management Protocol (After 72 h) Hemodynamic stabilization (post-resuscitation phase) Transition from resuscitation fluids to maintenance fluids. Avoid "fluid creep" (excess positive balance leading to pulmonary edema, abdominal compartment). → cautious use of diuretics to mobilize edema.

    Maintain: MAP ≥65 mmHg, urine output ≥0.5 mL/kg/h. Ongoing ventilatory support if required; lung-protective strategy for ARDS. Weaning as early as possible.

    Infection prevention and sepsis monitoring

    • Daily wound assessment for signs of infection, weekly or targeted wound/blood cultures and antibiotics only if infection is suspected/proven (not prophylactic).

    Wound care and surgical management

    • Regular dressing, use of negative-pressure wound therapy when indicated.

    • Early excision and grafting after 72 hr. Pain and sedation control
    • Multimodal analgesia, pre-procedure analgesia for dressing/grafting and long-term psychological and pain management.

    Rehabilitation and functional recovery • Early physiotherapy, occupational therapy for daily living skills and psychosocial support for patient and family.

    Criteria for transfer to ward • Hemodynamically stable, off vasopressors.

    • Stable oxygenation without advanced ventilatory support.

    • Tolerating enteral feeding.

    • Wounds coverage completed or adequately covered with new TBSA% below 20%.

    • Patients will be followed for 30 days at Ain Shams University burn unit. Measured outcomes

    Primary outcome:

    To determine the correlation between Red Cell Distribution Width/Albumin on admission and 30-day hospital mortality in burn patients.

    Secondary outcomes:

    To determine the correlation between Red Cell Distribution Width/Albumin with:

    • ICU length of stay
    • Hospital length of stay
    • Requirements of inotropes or vasopressors
    • Duration of mechanical ventilation
    • To compare Red Cell Distribution Width/albumin ratio with R-Baux score as a predictor of mortality in burn patients.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

  • Name: Sara H Saleh, MD
  • Phone Number: +201001584305

Study Locations

  • Egypt
    • Cairo Governorate
      • Cairo, Cairo Governorate, Egypt, 11111
        • Recruiting
        • Ain Shams University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

Patients presenting with acute thermal injuries will be screened based on inclusion/exclusion criteria.

After consent, Patients' characteristics (age, sex, weight), clinical parameters (Total burn surface area, Abbreviated burn severity index), and comorbidities will be recorded.

Description

Inclusion Criteria:

  • Age > 18 years.
  • Both sexes.
  • Patients with burn injuries (%TBSA >20%).
  • Availability of complete laboratory data (RDW, albumin) on admission.
  • Admission to ICU within 24 hours of burn injury.

Exclusion Criteria:

  • Age <18 years.
  • Patients with chronic hematologic disease.
  • Pre-existing liver disease.
  • Nephrotic syndrome.
  • patients on chemotherapy.
  • Patients with incomplete or missing lab records.
  • Pregnant females.
  • Patient or guardian refusal.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
• Patients with burn injuries (%TBSA >20%)
each patient will be followed for 30 days for mortality prediction

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
mortality in burn patients
Time Frame: 30 days
To determine the correlation between Red Cell Distribution Width/Albumin on admission and 30 days hospital mortality in burn patients.
30 days

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
ICU length of stay
Time Frame: 30 days
To determine the correlation between Red Cell Distribution Width/Albumin with o ICU length of stay
30 days
Requirements of inotropes or vasopressors
Time Frame: 30 days

To determine the correlation between Red Cell Distribution Width/Albumin with

o Requirements of inotropes or vasopressors
30 days
Duration of mechanical ventilation
Time Frame: 30 days

To determine the correlation between Red Cell Distribution Width/Albumin with

o Duration of mechanical ventilation
30 days
To compare RDW/albumin ratio with Revised Baux score as a predictor of mortality in burn patient.
Time Frame: 30 days
Revised Baux score = (percent body surface burned) + (patient's age) + 17 (if inhalational injury is present) A higher Revised Baux score generally indicates a higher risk of mortality, with scores over 140 unsurvivable .
30 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ain Shams University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Adel M Fahmy Shenouda, MD, Department of Anesthesia, Intensive care and pain management, Faculty of Medicine, Ain Shams University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
February 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 12, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 18, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 15, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • FMASU MD361/2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data underlying the study results will be made available upon reasonable request from qualified researchers

IPD Sharing Time Frame

Within 6:12 months

IPD Sharing Access Criteria

Access will be granted to researchers who submit a methodologically sound proposal to the principal investigator. Requests should be directed to g19-29502090100101@med.asu.edu.eg

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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