PCT Kinetics in the First Week Postburn for Sepsis Diagnosis and Death Prognosis-An Accuracy Study

Area of Science:

• Burn Care and Management
• Infectious Diseases
• Biomarker Research

Background:

• Sepsis remains the leading cause of mortality in burn patients despite advancements in care.
• Procalcitonin (PCT) is recognized as a valuable biomarker for sepsis diagnosis and a predictor of mortality.
• Understanding PCT kinetics post-burn is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the role of procalcitonin (PCT) kinetics within the first week post-burn for sepsis diagnosis.
• To assess the prognostic value of PCT levels in predicting mortality in burn patients.
• To analyze the influence of factors like Total Body Surface Area (TBSA), age, sex, and inhalation injury on PCT accuracy.

Main Methods:

• A retrospective analysis of 142 burn patients (≥15% TBSA) admitted between 2011-2014.
• Sepsis diagnosis based on American Burn Association criteria.
• Statistical analysis of PCT range and median values during the first 7 days post-burn, with subanalyses for demographic and injury-related factors.

Main Results:

• First-week PCT range and median values were significant for both sepsis diagnosis and mortality prognosis.
• PCT median demonstrated a greater area under the curve for prognosis compared to range.
• Accuracy of PCT was higher for TBSA <40% and in patients younger than 40 years.
• Prognostic accuracy was better in women and affected by inhalation injury, unlike diagnostic accuracy.

Conclusions:

• PCT kinetics monitoring in the first week post-burn is valuable for early sepsis detection and mortality prediction.
• The median PCT value is a more reliable indicator than its range for prognosis.
• Integrating PCT monitoring with clinical assessment can potentially reduce burn patient morbidity and mortality.