• Shengyu Huang, Dan Wang, Qimin Ma, Tuo Shen, Dinghong Min, Yusong Wang, Xincheng Liao, Rui Liu, Haiming Xin, Xiaoliang Li, Zhaohong Chen, Fei Chang, Guanghua Guo, and Feng Zhu.
• Medical Center of Burn plastic and wound repair, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, China.
• Burns. 2025 Jan 3; 51 (2): 107373107373.

BackgroundDisorders of the coagulation pathway are triggered in patients with severe burn and inhalation injuries in the early stages. There are multiple early coagulation indices identified to correlate with adverse outcomes.MethodA retrospective analysis of patients with severe burn and inhalation injuries from 12 centers in mainland China was performed to identify early changed coagulation indices with predictive value associated with four major 28-day adverse outcomes (death, anticoagulation, mechanical ventilation, continuous renal replacement therapy) by logistic regression. The optimal cut-off value was also determined by Youden's index.ResultsA total of 433 patients with severe burn and inhalation injuries were included in the study. Activated partial thromboplastin time (APTT) was found to be a risk factor for death, anticoagulation and continuous renal replacement therapy outcomes, while D-dimer was a risk factor for death and mechanical ventilation outcomes. Compared with previous definitions of coagulopathy, the occurrence of adverse outcomes was well predicted by both APTT and D-dimer. Patients were divided into high-risk and low-risk coagulopathy based on APTT and D-dimer cutoff values, with high-risk coagulopathy being an independent risk factor for death. Age, TBSA, lactate level, and pre-hospital infusion volume were identified as independent influencing factors on high-risk coagulopathy.ConclusionThe coagulation indices APTT and D-dimer in the early post-hospitalization period have a good early warning effect in the severe burn and inhalation injuries population, by which early screening to identify high-risk coagulopathies can be performed and targeted interventions can be implemented.Copyright © 2025 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.

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