The Clinical Usefulness of Neutrophil-Lymphocyte Ratio and Serum Procalcitonin as a Diagnostic and Prognostic Biochemical Markers in Burn Patients Complicated with Sepsis: A comparative study

Abstract

Background: Burn injuries have become a major global health problem, with more than 120,000 burn-related deaths each year.Aim and objectives: To compare Neutrophil-lymphocyte Ratio (NLR) and S. Procalcitonin (PCT) level as a diagnostic and prognostic parameter in burn patients complicated with sepsis.Patients and methods: This was a prospective cohort study conducted on 40 patients at burn unit of the plastic, burn and maxillofacial surgery department in Ain Shams University hospitals from April to September 2023.According to the American Burn Association Criteria for the presence of infection [1], the patients were allocated into two groups: sepsis and non-sepsis. Also, according to the fate of the patients, they were classified into two groups: non survivors and survivors (discharged).We measured NLR and PCT as markers of infection on admission, day 3, day 10 and day 20 for all patients and compared their values in the finding groups.Results: There was no statistically significant difference between sepsis and non-sepsis patients as well as between survivors and non-survivors as regard NLR. There was Statistically significant increased PCT level on day 3 from admission and statistically highly significant increase on day 10 with sepsis patients when compared with non-sepsis patients (p= 0.003 and < 0.001 respectively). There was Statistically significant increased PCT level on day 3 and statistically highly significant increase on day 10 with non-survivor when compared with survivor patients (p= 0.043 and < 0.001 respectively).Conclusion: Our study admits that PCT level in burn patients is a good biomarker in detecting sepsis and good prognostic value as early detection of sepsis can facilitate an ideal management and initiate proper antimicrobial therapy. Furthermore, higher levels of PCT may indicate poor outcome. In contrast, higher NLR cannot be considered as a reliable independent predictor of sepsis or higher mortality because several factors (age, acute trauma, exogenous steroid intake, emotional stress, active haematological disorders) could determine a “false” increase in NLR.