Alright.
I like how you added a slight tint to the picture to show that its a room with lots of smoke in it. The blood coming from the guy is alright. But i you added more detail to it like his ribs hanging out, or his intestines or some other bodily organ coming out.
The shadow from the guy has a nice effect. The smoke from the fire has a nice effect, too. The fire, on the other hand has no visible effects added to it, whick kind of lets that part of the picture down. You also should have made the glasses on the guy look more how the look like in the actual madness series.
The barrels are ok, and I like how there is "help" written in blood on the wall.
--Good points--
1: Nice blood.
2: Nice smoke from the fire.
3: Reasonable amount of blood. >:)
4: Nice shadow effect.
5: Nice tint on the picture.
--Bad points--
1: Fire needs effects to make it look more like fire.
2: Glasses need to look loke the ones from the madness series.
3: Organs need to be coming out of the guy.
4: Make is ribs or something hang out.