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Procalcitonin and Bacterial Sepsis in Burn Patients in South Africa
Devorah Wineberg1, Rachel Moore2, Deirdre Kruger1
1Department of Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Background:
Burn patients are at high risk of infection, and as sepsis contributes significantly to morbidity and mortality, early diagnosis is essential. Procalcitonin (PCT) is a biomarker released in response to inflammation and specifically bacterial infection. This study aimed to determine the value of PCT as a diagnostic biomarker of sepsis in burns patients in Johannesburg, South Africa.
Materials And Methods:
All adult patients admitted to two burns intensive care units in Johannesburg over a 3-year study period were included in a retrospective data review. Records of 178 patients were accessible and reviewed.
Results:
The most significant risk factor for sepsis was percentage total body surface area burned (P = 0.012). A rise in PCT was a significant biomarker for bacterial infection in the early phase after a burn (P = 0.03) but not after day eight. PCT correlated with C-reactive protein as a biomarker for sepsis (P < 0.001), but not with other biomarkers. The mean PCT in patients who died was significantly higher on every study day until death compared with those who remained alive (P < 0.02, consistently). Patients on inotropes also had a significantly increased PCT level (P = 0.0001), as did those who were not discharged from intensive care unit by day 14.
Conclusions:
PCT may be useful as an adjunct biomarker of infection in burn patients and has potential as a predictive biomarker of early discharge.
