Inflammatory markers in patients with severe burn injury. What is the best indicator of sepsis?
- PMID: 17215085
- DOI: 10.1016/j.burns.2006.07.001
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.
Design and setting: Prospective, observational study in a four bed Burn Intensive Care Unit.
Patients: Forty-three patients admitted in a Burn ICU were included in our study.
Measurements and 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.
Comment in
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Inflammatory markers in patients with severe burn injury: what is the best indicator of sepsis?Burns. 2007 Nov;33(7):939-40; author reply 941-2. doi: 10.1016/j.burns.2007.02.003. Epub 2007 Jul 17. Burns. 2007. PMID: 17644262 No abstract available.
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