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The Diagnostic and Prognostic Value of Procalcitonin and High-Sensitivity C-Reactive Protein in Early-Stage Burn
Guo-Xun Yang1, Zhong-Fei Cui2, Shan-Shan Zhao3
1Department of Burns, Plastics and Wound Repair Surgery, The First Affiliated Hospital of Dali University, Dali, Yunnan, 671000, People's Republic of China.
Objective:
To evaluate procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) for early diagnosis and prognosis of burn sepsis.
Methods:
A retrospective cohort study included 159 critically ill burn patients (2021-2024) divided into burn sepsis group (n=72) and non-sepsis group (n=87). Clinical data were analyzed to evaluate the biomarkers' diagnostic value. Sepsis patients were further grouped by outcome (mortality/survival) to explore biomarkers' relationship with severity and prognosis.
Results:
Compared with the non-sepsis group, the sepsis group had significantly higher early PCT and hs-CRP (P < 0.05), with no significant differences in IL-6, white blood cell (WBC) count, or body temperature. Multivariate logistic regression identified PCT and hs-CRP as independent diagnostic factors. Their areas under the receiver operating characteristic (ROC) curve were 0.802 and 0.768, respectively; combined areas under the curve (AUC) was 0.821, all higher than those of body temperature, WBC, and IL-6 (0.536, 0.536, 0.579; P < 0.05). In sepsis patients, PCT was positively correlated with creatinine (r=0.625, R2=0.362; P < 0.05). Mortality subgroup had higher early PCT, hs-CRP, and IL-6 (P < 0.05), but these were not independent mortality risk factors.
Conclusion:
PCT and hs-CRP are useful for early burn sepsis diagnosis, with combined detection improving efficacy. Body temperature, WBC, and IL-6 have limited diagnostic value. Elevated PCT may relate to acute kidney injury. Early biomarker levels correlate with sepsis severity but have limited prognostic value.
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