title: Can leukocyte antisedimentation rate (LAR) predict septic complications and critical care survival early in polytrauma and burn victims?
abstract: BACKGROUND
  In polytrauma and burn injury Systemic Inflammatory Response Syndrome (SIRS) develops. SIRS is presented in many hospitalized patients, including those who never develop infection or sepsis. Both in SIRS and sepsis the leukocyte activation occurs. In acute phase reaction leukocytes' upward flotation i.e. leukocyte antisedimentation rate (LAR) can indicate infectious origin.
  
  
  OBJECTIVE
  To evaluate the predictive power of LAR, serum C-reactive protein (CRP) and procalcitonin (PCT) levels regarding mortality risk and development of septic complications.
  
  
  METHODS
  In a prospective, observational study, 36 patients were followed for 5 days (T1-T5) after admission to a critical care unit immediately with severe polytrauma or burn injury. Eleven patients developed septic complications, their LAR, CRP and PCT levels were analyzed before and after 3 days of sepsis was declared.
  
  
  RESULTS
  Ten patients died due to septic complications. In survivors LAR at T1 (p < 0.001) and T2 (p < 0.001) as well as CRP at T1 (p < 0.05) were significantly higher compared to controls and non survivors. In septic patients LAR (p < 0.05) and CRP (p < 0.05) showed a significant drop one day before sepsis was declared. PCT levels failed to predict this.
  
  
  CONCLUSIONS
  Drop in LAR and CRP levels may be warning signs regarding the onset of septic complications after severe polytrauma and burn injury.
authors: Department of Anesthesiology and Intensive Care, University of Pécs, Hungary.
authors: Martin
authors: M
authors: Rozanovic
authors: Department of Anesthesiology and Intensive Care, University of Pécs, Hungary.
authors: Csaba
authors: C
authors: Csontos
authors: Department of Anesthesiology and Intensive Care, University of Pécs, Hungary.
authors: Lajos
authors: L
authors: Bogár
authors: Department of Anesthesiology and Intensive Care, University of Pécs, Hungary.
authors: Lívia
authors: L
authors: Szélig
authors: Department of Anesthesiology and Intensive Care, University of Pécs, Hungary.
authors: Tímea
authors: T
authors: Bocskai
authors: Department of Anesthesiology and Intensive Care, University of Pécs, Hungary.
authors: Patrícia
authors: P
authors: Kovács
authors: 1st Department of Internal Medicine, University of Pécs, Hungary.
authors: Marianna
authors: M
authors: Matancic
authors: Department of Laboratory Medicine, University of Pécs, Hungary.
authors: Attila
authors: A
authors: Miseta
authors: Department of Anesthesiology and Intensive Care, University of Pécs, Hungary.
authors: Csaba
authors: C
authors: Loibl
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002056:Burns / Q000097:blood*; D003422:Critical Care; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000276:immunology*; D008297:Male; D009104:Multiple Trauma / Q000097:blood*; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood*; D015996:Survival Rate; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: C-reactive protein; Mechanical and heat trauma; inflammatory response; leukocyte antisedimentation rate; procalcitonin