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

Abstract

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 very important, given that every 6 h 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. Aim of the Work 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 carried out in the Burn Intensive Care Unit (ICU) of Ain Shams University Hospitals on 30 patients that were admitted from October 2021 to April 2022 with major burn (more than 20% of TBSA) were included and 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 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 However, the following 2 samples which had been withdrawn on day 5 show a significant increase in PCT levels, and these on day 7 on admission are highly significant with a median (IQR) range of 9 ng/dl and median (IQR) range of 13.2 ng/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 1.65 ng/dl while in survivor patients the median was 0.45 ng/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.