Procalcitonin in the burn unit and the diagnosis of infection

Abstract

Objective: To determine the usefulness of procalcitonin (PCT) in decision-making when faced with suspected infection in patients with extensive burns.

Study: Retrospective, observational follow-up study.

Institution: Burn Unit of the Complexo Hospitalario Universitario A Coruña (CHUAC), Spain.

Patients and method: We included all patients admitted to the Unit from June 2011 to March 2012 with ≥20% total body surface area burned or ≥10% full-thickness body surface area burned with suspected infection (17 patients with 34 events of suspected infection).

Results: The infections were confirmed in 16/34 episodes (47.1%), and documented in 44.1% (n=15). There were no statistically significant differences in the PCT figures at the time the infection was suspected between the cases with confirmed and unconfirmed infection (p=0.682). The PCT values showed no discriminative value for differentiating patients with SIRS from those with sepsis, severe sepsis and septic shock (area under ROC curve (AUC)=0.546; 95% CI: 0.326-0.766). No significant correlation was found between SOFA and PCT, although there were differences in the PCT values in the patients who had tissue hypoperfusion.

Conclusion: Results show that PCT is not a precise indicator of sepsis at the time of diagnosis. A correlation between PCT levels and hypoperfusion was observed.

Keywords: Burns; Diagnosis; Intensive care; Procalcitonin; Sepsis.