The Role of Serum Procalcitonin as a Diagnostic and Prognostic Biomarker for Sepsis in Major Burn Patients: A Prospective Study

Document Type : Research article

Authors

The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University

Abstract

Background: Sepsis in burns worsens the patient’s prognosis
and increases the risk of organ failure and death. Multiple
organ dysfunction syndrome (MODS), which is a direct
response to sepsis is the main reason for death in burn patients.
Identifying early sepsis is especially important, given that
every 6h delay in the diagnosis of sepsis reduces survival by
10%. Complexity in diagnosing sepsis in the burn is due to
the systemic response to the burn itself clinically simulating
sepsis.
Objective: The aim of this study is: To investigate the diagnostic
validity of PCT in burn sepsis as an early diagnostic
tool and to identify its prognostic value in major burn patients
with sepsis.
Patients and Methods: The study was a prospective study
that was conducted in a six months period carried out in the
Burn Intensive Care Unit (ICU) of Ain Shams University Hospitals
on 30 patients that were admitted from October 2021 to
March 2022 with major burn (more than 20% of TBSA) were
included, the Local Ethics Committee approved the study, and
informed consent was obtained from all participants or their
guardians.
Results: It had been revealed that the first 3 samples that
were drowned on admission and after 24 hours and then on day
3 of admission have no significant increase in PCT levels in
relation to sepsis. However, the following 2 samples which had
been withdrawn on day 5 show a significant increase in PCT
levels, and these on day 7 are highly significant with a median
(IQR) range of 9ng/dl and median (IQR) range of 13.2ng/dl
respectively. Moreover, it had been noted that the PCT level
on admission was significant for the prognosis of death with a
median (IQR) range of 1.65ng/dl while in survivor patients the
median was 0.45ng/dl.
Conclusion: Our study demonstrated that PCT level in major
burn patients is a promising diagnostic biomarker in detecting
sepsis that could facilitate ideal management and initiate
proper antimicrobial therapy and good prognostic value as an
early predictor of mortality.

Keywords

Main Subjects

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