title: Inflammatory markers in patients with severe burn injury. What is the best indicator of sepsis?
abstract: 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.
authors.affiliation: Aristotle University, Pulmonary, Exochi, Thessaloniki, Greece.
authors.forename: Athina
authors.initials: A
authors.lastname: Lavrentieva
authors.forename: Theodore
authors.initials: T
authors.lastname: Kontakiotis
authors.forename: Lambis
authors.initials: L
authors.lastname: Lazaridis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsotsolis
authors.forename: John
authors.initials: J
authors.lastname: Koumis
authors.forename: George
authors.initials: G
authors.lastname: Kyriazis
authors.forename: Militsa
authors.initials: M
authors.lastname: Bitzani
mesh_terms: 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
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide