title: Identification of predictors of early infection in acute burn patients.
abstract: Burn patients are at high risk for infections; however, common indicators of infection are unreliable in this population and can lead to unnecessary use of antibiotics. The study objective was to determine if predictors of early infection in adult acute burn patients are identified to provide clinicians with a practical tool to aid in the diagnosis of infection, thereby minimizing unnecessary exposure to antimicrobials. A retrospective chart review of all adult acute burn injury patients admitted over a 1 year period to the burn centre at Sunnybrook Health Sciences Centre was conducted. Early infection was defined as one that occurred within the first 10 days after injury and in accordance with American Burn Association guidelines. Those without infection were compared to patients with infection generally and also to patients with sepsis specifically. The period prevalence of early infection and sepsis in our patients was 50% (56/111) and 16% (18/111), respectively. It was determined that heart rate ≥110 bpm, systolic blood pressure ≤100 mmHg and intubation were the best predictors of sepsis (p<0.05); and fraction of inhaled oxygen >25% and maximum temperature ≥39 °C were the best predictors of infection (p<0.05). This pilot project identified significant predictors of early infection and sepsis in acute burns and will be validated in a prospective study.
authors.affiliation: Sunnybrook Health Sciences Centre, Department of Pharmacy, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Schultz
authors.forename: Sandra A N
authors.initials: SA
authors.lastname: Walker
authors.forename: Marion
authors.initials: M
authors.lastname: Elligsen
authors.forename: Scott E
authors.initials: SE
authors.lastname: Walker
authors.forename: Andrew
authors.initials: A
authors.lastname: Simor
authors.forename: Samira
authors.initials: S
authors.lastname: Mubareka
authors.forename: Nick
authors.initials: N
authors.lastname: Daneman
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D002056:Burns / Q000150:complications* / Q000503:physiopathology; D002170:Canada / Q000453:epidemiology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010865:Pilot Projects; D015995:Prevalence; D056152:Respiratory Rate / Q000502:physiology; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010100:Oxygen
keywords: Acute burn injury; Infection; Predictors