Inflammatory markers in patients with severe burn injury. What is the best indicator of sepsis?
OBJECTIVE
To estimate the diagnostic value of serum PCT, CRP, leukocyte count and temperature as markers of sepsis in critically ill ICU burn patients.


METHODS
Prospective, observational study in a four bed Burn Intensive Care Unit.


METHODS
Forty-three patients admitted in a Burn ICU were included in our study.


RESULTS
Serum PCT, CRP concentrations, WCC (white cell count), neutrophils and temperature were measured within the first 24h after-burn and daily thereafter. Severity of organ failure was estimated by sequential organ failure assessment (SOFA) score. Every day we classified all patients in one of the following three categories: non-systemic inflammatory condition (non-SIRS), SIRS non-infected and SIRS 2 infected or sepsis. Patients with infected SIRS differ significantly from non-infected SIRS in PCT (11.8+/-15.8 versus 0.63+/-0.0.43, respectively, p < 0.001). On the other hand, WCC, temperature and neutrophils did not differ significantly between patients with SIRS non-infected and infected SIRS. CRP was elevated in all three groups but didn't differ significantly between SIRS non-infected and septic patients. Area under receiver operating curves was 0.975 and showed reasonable discriminative power (p = 0.002, 95% CI, 0.91-1.035) in predicting of sepsis only for PCT.


CONCLUSIONS
Serum procalcitonin levels can be used as an early indicator of septic complication in patients with severe burn injury.
Lavrentieva
Athina
A
Aristotle University, Pulmonary, Exochi, Thessaloniki, Greece.
Kontakiotis
Theodore
T
Lazaridis
Lambis
L
Tsotsolis
Nikolaos
N
Koumis
John
J
Kyriazis
George
G
Bitzani
Militsa
M
D000704:Analysis of Variance; D015415:Biomarkers / Q000378:metabolism; D001831:Body Temperature / Q000502:physiology*; D002056:Burns / Q000097:blood / Q000401:mortality / Q000473:pathology*; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000378:metabolism*; D015740:Calcitonin Gene-Related Peptide; D003422:Critical Care; D016638:Critical Illness; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000378:metabolism*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis* / Q000401:mortality; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide