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Burns. 2007 Mar;33(2):189-94. Epub 2007 Jan 9.

Inflammatory markers in patients with severe burn injury. What is the best indicator of sepsis?

Author information

1
Aristotle University, Pulmonary, Exochi, Thessaloniki, Greece.

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.

PMID:
17215085
DOI:
10.1016/j.burns.2006.07.001
[Indexed for MEDLINE]

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