Predictors for Identifying Burn Sepsis and Performance vs Existing Criteria

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Burn Surgery

Background:

• Sepsis is a leading cause of death in burn patients.
• Traditional Systemic Inflammatory Response Syndrome (SIRS) criteria are inadequate for diagnosing sepsis in burn centers.
• Existing sepsis indicators in thermal injury lack consistency and evidential support for guiding antimicrobial therapy.

Purpose of the Study:

• To evaluate novel diagnostic parameters for sepsis in thermally injured patients.
• To compare the efficacy of these novel parameters against existing diagnostic criteria.
• To identify reliable indicators for early sepsis detection and prompt treatment in burn patients.

Main Methods:

• Retrospective electronic medical record review of thermally injured patients.
• Analysis of baseline demographics using chi-square, Mann-Whitney U test, and t test.
• Development and validation of predictive models using generalized linear mixed modeling and receiver operating curve analysis.

Main Results:

• A multivariable model including temperature extremes, elevated heart rate, decreased mean arterial pressure, and increased gastric residual volumes demonstrated superior performance.
• This novel model effectively identified sepsis with positive bloodstream infections.
• The proposed model outperformed current diagnostic criteria in the studied patient population.

Conclusions:

• Novel diagnostic parameters, including specific vital sign derangements and gastric residual volume changes, can accurately identify sepsis in burn patients.
• The developed model offers improved diagnostic capability compared to traditional criteria.
• This research supports the need for updated diagnostic guidelines for sepsis in thermal injury.