Efficacy of a rise in C-reactive protein serum levels as an early indicator of sepsis in burned children.
C-Reactive protein serum levels were measured in 57 pediatric patients with 3% to 92% total body surface area burns to determine whether a defined rise in C-reactive protein serum levels could indicate sepsis earlier in burn patients. A rise in C-reactive protein serum levels was defined as an increase of at least 3 mg/dL for 2 days or 10 mg for 1 day. Increases the first 2 days after the burn or the day after surgery were excluded, since these injuries increase C-reactive protein serum levels. Patients were defined as septic when they were on systemic antibiotics and exhibited at least two of 16 specific clinical parameters. C-Reactive protein serum levels correctly predicted sepsis 82% of the time (efficiency=82%). Nonseptic patients generally did not show increased C-reactive protein serum levels (specificity=69%). When sepsis did occur, it always was preceded by increased C-reactive protein (sensitivity=100%), and the increased C-reactive protein occurred 2.3+/-0.5 days before the patient was deemed septic clinically. Hence, a defined rise in C-reactive protein serum levels can predict sepsis sooner in burned children.
Neely
A N
AN
Shriners Hospitals for Children, Cincinnati Burns Institute, Ohio 45229, USA.
Smith
W L
WL
Warden
G D
GD
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002056:Burns / Q000150:complications* / Q000382:microbiology; D002097:C-Reactive Protein / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005544:Forecasting; D006801:Humans; D007223:Infant; D008297:Male; D018805:Sepsis / Q000175:diagnosis*
D015415:Biomarkers; D002097:C-Reactive Protein