Background/Objectives: Severe burn injury is associated with high postoperative morbidity and mortality due to profound metabolic and nutritional stress. The blood glucose-to-serum albumin ratio (GAR) may reflect both metabolic derangement and nutritional status, but its prognostic significance in burn intensive care unit (ICU) patients remains unclear. This study evaluated the association between preoperative GAR and postoperative outcomes in adult burn ICU patients undergoing surgery. Methods: We retrospectively analyzed adult burn ICU patients who underwent surgery between 2014 and 2024. GAR was calculated using blood glucose and serum albumin levels measured within one day before surgery. The primary outcome was 90-day postoperative mortality. Secondary outcomes included 90-day hospital-free days and ICU-free days. Multivariable Cox regression and restricted cubic spline analyses were performed to assess the relationship between GAR and mortality risk. Receiver operating characteristic curve analysis was used to evaluate the discriminatory performance of GAR and determine the optimal cutoff value. Results: Among 1119 patients, the 90-day mortality rate was 25.6%. Higher preoperative GAR was independently associated with increased 90-day mortality in multivariable Cox regression analysis. Restricted cubic spline analysis demonstrated a significant overall association, with progressively increasing mortality risk at higher GAR levels. Receiver operating characteristic curve analysis showed moderate discriminatory performance (area under the curve = 0.789), and the optimal cutoff value based on the highest Youden index was 62.5. Patients with GAR ≥ 62.5 had significantly lower 90-day survival rates and fewer 90-day hospital-free days and ICU-free days than those with lower GAR values (all p < 0.001). Conclusions: Higher preoperative GAR was significantly associated with adverse postoperative outcomes, including increased 90-day mortality and fewer hospital-free and ICU-free days in adult burn ICU patients.

Background and Objectives: Major burn injury causes profound hypermetabolism and altered thermoregulation. While perioperative hypothermia is linked to adverse outcomes, the prognostic significance of preoperative core temperature in major burn patients remains poorly defined. Therefore, we investigated the association between preoperative core temperature and postoperative mortality in patients with major burns. Materials and Methods: This retrospective study included 635 adult patients with major burns who underwent surgery. Preoperative core temperature was measured in the intensive care unit before surgery. The primary outcome was 90-day postoperative mortality. Secondary outcomes were 30-day postoperative complications, including major adverse cardiovascular events (MACE), bloodstream infection, and continuous renal replacement therapy (CRRT) requirement. Cox proportional hazards regression, receiver operating characteristic (ROC) curve, Kaplan–Meier survival, and restricted cubic spline analyses were performed. Results: The 90-day postoperative mortality rate was 35.6%. Mortality increased in a graded manner as preoperative core temperature decreased. In multivariable Cox regression analysis, preoperative core temperature remained independently associated with 90-day mortality. Restricted cubic spline analysis showed an inverse linear association between preoperative core temperature and mortality risk. ROC curve analysis identified 37.0 °C as an exploratory and hypothesis-generating cohort-specific threshold for risk stratification. Regarding secondary outcomes, the core temperature ≤37.0 °C group had higher rates of MACE, bloodstream infections, and CRRT requirement (all p < 0.05). Conclusions: Lower preoperative core temperature was associated with increased 90-day postoperative mortality in adults with major burns undergoing surgery. Preoperative temperature may serve as a clinically relevant marker of physiologic vulnerability and postoperative risk.

Background and Objectives: Major burn injury causes systemic immune dysregulation and increases susceptibility to infectious complications. While poor oral health is a potential reservoir for respiratory pathogens, its impact on burn patients—who often require repeated airway manipulation—is not well-defined. This study investigated the association between preoperative dental status and postoperative pneumonia in patients undergoing burn surgery. Materials and Methods: We conducted a retrospective cohort study of 894 adult patients (≥19 years) admitted to a burn intensive care unit (ICU) between 2015 and 2024. Preoperative dental status was categorized as favorable or unfavorable (≥2 missing teeth, loose teeth, or fractured teeth). The primary outcome was 30-day postoperative pneumonia. Secondary outcomes included 90-day hospital-free days and ICU-free days. Results: Postoperative pneumonia occurred in 294 patients (32.9%). The incidence of postoperative pneumonia was 47.7% among patients with unfavorable preoperative dental status, compared with 31.2% among those with favorable preoperative dental status (p < 0.001). In multivariable analysis, unfavorable dental status was an independent predictor of 30-day pneumonia (odds ratio, 1.681; 95% confidence interval, 1.084–2.599; p = 0.018). Patients with unfavorable status also had significantly fewer 90-day hospital-free days (9 vs. 22 days, p = 0.034) and ICU-free days (65 vs. 68 days, p = 0.012). Conclusions: Unfavorable preoperative dental status is independently associated with an increased risk of postoperative pneumonia and poorer clinical recovery in burn patients. Routine dental assessment may serve as a simple tool for perioperative risk stratification in patients undergoing burn surgery.